Reference Values for The Triglyceride to High-Density Lipoprotein Cholesterol Ratio and Non-High-Density Lipoprotein Cholesterol in Korean Children and Adolescents: The Korean National Health and Nutrition Examination Surveys 2007-2013

Aim: Cholesterol levels vary throughout childhood and adolescence. The aim of the present study was to evaluate and identify age-and gender-specific reference values for serum lipid concentrations including non-high-density lipoprotein cholesterol (non-HDL-C) and the triglyceride to HDL-C ratio (TG/HDL-C ratio) in apparently healthy Korean children and adolescents. Methods: A total of 6197 participants aged 10 to 19 years old from the 2007-2013 Korean National Health and Nutrition Examination Survey were analyzed. Serum lipid concentrations were evaluated according to age and gender. Results: The overall mean concentration of non-HDL-C was 105.5 +/- 25.6 mg/dL, with a significant gender difference: 103.3 +/- 26.1 mg/dL in boys and 107.9 +/- 24.7 mg/dL in girls (p= 0.028). The median values of non-HDL-C concentrations in boys and girls, respectively, were 111 and 112 mg/dL in the 10-year-old age group, 95 and 103 mg/dL in the 15-year-old age group, and 109 and 103 mg/dL in the 19-year-old age group. The overall mean TG/HDL-C ratio was 1.74 +/- 1.22, and there were no significant gender differences: 1.77 +/- 1.25 in boys and 1.72 +/- 1.22 in girls (p= 0.183). The median values of the TG/HDL-C ratio in boys and girls were 1.16 and 1.00 in the 10-year-olds, 1.54 and 0.95 in the 15-year-olds, and 1.74 and 0.84 in the 19-year-olds, respectively. Conclusions: Age-and gender-specific reference values for non-HDL-C and for the TG/HDL-C ratio in children and adolescents could provide valuable information for individualized interpretations of lipid profiles and interventions as well as for strategies to prevent and manage childhood and adolescent dyslipidemia.