Lipid abnormalities in foreign-born and US-born patients in a medical group

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• 作者：Jawali Jaranilla ; Terese DeFor ; Gabriela Vazquez Benitez ; Thomas E. Kottke
• 关键词：Dyslipidemia ; Foreign-born ; Total cholesterol ; Low-density lipoprotein cholesterol ; High-density lipoprotein cholesterol ; Triglycerides
• 刊名：Journal of Clinical Lipidology
• 出版年：January-February, 2014
• 年：2014
• 卷：8
• 期：1
• 页码：77-85
• 全文大小：282 K

文摘

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Background

With an increasing foreign-born population in the United States, cardiovascular risk reduction through effective lipid treatment strategy is precluded by limited lipid profile information.

Objective

This study compares the patterns of lipid abnormalities of foreign-born and US-born patients treated by a single medical group.

Methods

We conducted a medical record review of 53,361 US-born and 6430 foreign-born patients in聽2010.

Results

Compared with US-born, a higher proportion of foreign-born patients are younger than 40 years (26% vs 14%), receive Medicaid (24% vs 8%), and are less likely to be obese (26% vs 43%). More foreign-born patients have diabetes (25% vs 22%), are poor (4.7% vs 3.6%), and not on lipid-lowering drugs (63% vs 56%). Place of birth is not associated with total cholesterol levels. Adjusted for social and demographic characteristics, however, foreign-born are more likely than US-born to have elevated low-density lipoprotein cholesterol (adjusted difference, 2.1; 95% CI, 0.6-3.7), depressed high-density lipoprotein cholesterol (adjusted difference, 6.1; 95% CI, 4.4-7.8), and elevated triglycerides (adjusted difference, 2.4; 95% CI, 0.8-4.1). Foreign-born patients, on lipid-lowering medications, are more likely to still have elevated levels of low-density lipoprotein cholesterol (adjusted difference, 3.5; 95% CI, 1.4-5.6).

Conclusion

Despite having a similar distribution of total cholesterol as their US-born counterparts, the other lipid fractions among foreign-born patients are more likely to be pathologic. Therefore, dyslipidemia screening tests need to include the lipid subfractions. The higher prevalence of dyslipidemias, both among foreign-born patients with and without lipid-lowering medications, challenges medical groups to intensify effective lipid treatment strategies.