Relationship of blood lipids to anthropometric measures and family medical history in an ethnically diverse school-aged population.

High total cholesterol is an important risk factor for coronary heart disease, and high levels in adulthood can be linked to high levels in childhood. We evaluated total cholesterol and lipoprotein levels and their relationship to body composition and reported family medical history of premature myocardial infarction or high total cholesterol in 800 children, aged 10 to 13, of Hispanic (n = 612), Asian (n = 100), and white or other (n = 88) ethnic descent. Mean total cholesterol levels were similar among boys (168.6 mg/dL; n = 399) and girls (167.5 mg/dL; n = 401) and among ethnic groups; however, high-density lipoprotein cholesterol was highest in boys and in Asian children. Forty-six percent of all children tested had total cholesterol levels of 170 mg/dL or greater (13.4% were 200 mg/dL or higher). Body mass index and skinfold (triceps and subscapular) measurements were least in Asian children. A high prevalence of obesity was noted in white and Hispanic children. Body mass index was positively correlated with total cholesterol in Hispanic children; in all ethnic groups, body mass index was positively associated with triglyceride levels and negatively associated with high-density lipoprotein cholesterol. Skinfold measurements were also significantly correlated with total cholesterol (in Hispanic children) and triglycerides and were negatively associated with high-density lipoprotein cholesterol. Among children with family history data available, only 52% with a low-density lipoprotein cholesterol level of 130 mg/dL or higher had a reported family history of high total cholesterol or myocardial infarction in a parent or grandparent aged 55 or younger, although rates varied substantially by ethnic group. The present study demonstrates the importance of population-based lipid screening in Hispanic, Asian, or multiethnic children, where more than a third of the children have total cholesterol levels in need of dietary management. The majority of children with elevated total or low-density lipoprotein cholesterol levels will not be identified if screening is recommended on the basis of a positive family history alone. Finally, there is evidence that body composition in children may be more closely correlated with total cholesterol or lipoprotein levels in certain ethnic groups.