Background
Cholesterol exerts complex effects upon inflammation. There has been little investigation of whether serum cholesterol is associated with asthma, an inflammatory airways disease with great public health impact.
Objective
To determine relationships between levels of three serum cholesterol measures (total cholesterol [TC], high density lipoprotein-cholesterol [HDL-C], and non-HDL-C), and asthma/wheeze in a sample representative of the U.S. population.
Methods
Cross-sectional study of 7,005 participants aged ≥6 years from the 2005–2006 National Health and Nutrition Examination Survey.
Results
Serum TC and non-HDL-C were lower in current asthmatics than in subjects without current asthma in the overall population (TC: 188.5 vs. 192.2 mg/dL; non-HDL-C: 133.9 vs. 137.7 mg/dL; p<.05 for both), whereas HDL-C was not different. Adjusted odds ratios (ORs) from multivariate logistic regression per 1-standard deviation increase of TC and non-HDL-C for current asthma were 0.92 (95% confidence interval [CI], 0.86–0.98) and 0.91 (95% CI, 0.85–0.98), respectively. Upon racial/ethnic stratification, these relationships reflect marked reductions unique to Mexican Americans (MAs)(TC: 171.4 vs. 189.3 mg/dL [p<.001], OR 0.62 [95% CI, 0.48–0.80]; non-HDL-C: 119.8 vs. 137.9 mg/dL [p<.001], OR 0.62 [95% CI, 0.48–0.79]). Among MAs, the adjusted OR for wheeze requiring medical attention was 0.57 (95% CI, 0.43–0.75) for TC and 0.53 (95% CI, 0.33–0.85) for non-HDL-C. Relationships between cholesterol and asthma/wheeze were independent of body mass index and serum C-reactive protein, and similar between atopic and non-atopic participants.
Conclusion
Serum TC and non-HDL-C are inversely related to asthma in the U.S. population, chiefly reflecting a relationship among MAs.