Abstract
Black people in the UK, in the Caribbean, and to a lesser extent in the USA, experience coronary heart disease events at different rates than white people. Despite having higher prevalence of hypertension, cigarette smoking and diabetes, black males have significantly lower coronary heart disease rates than white males, whereas no significant differences have been detected in females. The only known risk factor differences that could account for the difference in CHD rates are higher HDL cholesterol and lower triglycerides that are seen in blacks compared with whites. Obesity and, in particular abdominal obesity, seems to determine TG and HDL cholesterol levels: black males are less centrally obese than whites, while total adiposity and central distribution of fat is more predominant in black females compared with white females. We propose that the less degree of abdominal adiposity observed in black males is related with an increased anti-lipolytic effect of insulin, which could account for low triglycerides and high HDL cholesterol levels, and consequently explain the higher protection from coronary heart disease experienced by black males compared with whites and black females.
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Falase AO, Cole TO, Osuntokun BO. Rarity of myocardial infarctions in University Hospital, Ibadan, Nigeria. Trop Geogr Med 1973; 25: 147–154.
Ladipo G, Froll J, Parry EH. Pattern of heart disease in adults of the Nigerian Savannah: A prospective clinical study. Afr J Med Sc 1977; 6: 185–192.
Isaacson C. The changing pattern of heart disease in South African blacks. S Afr Med J 1977; 52: 793–798.
Bronte-Stewart B, Keys A, Brock JF, et al. Serum cholesterol, diet and coronary heart disease. An inter-racial survey in the Cape Peninsula. Lancet 1955; 2: 1103–1108.
Ashcroft MT, Stuart KL. Acute myocardial infarction in the University Hospital, Jamaica, 1968–1970. West Ind Med J 1973; 22: 60–66.
Tulloch JA. Some aspects of myocardial infarction in Jamaica. West Ind Med J 1958; 7: 235-243.
Wattley GH. Myocardial infarction in South Trinidad. West Ind Med J 1959; 8: 33–36.
Miller GJ, Alexis SD, Beckles GLA, et al. Serum lipoproteins and susceptibility of men of Indian descent to coronary heart disease. The St James Survey. Lancet 1982; ii: 200-203.
Miller GJ, Koplan JP, Morgan P, et al. High-density lipoprotein cholesterol concentration and other serum lipids in an isolated island community free of coronary heart disease. Int J Epidemiol 1979; 8: 219-225.
Office of Population Censuses and Surveys. Mortality and geography: A review in the mid-1980s. The Registrar General's decennial supplement for England and Wales, series DS no.9. London: HMSO, 1990.
Pedoe H, Clayton D, Morris J, et al. Coronary heart attacks in East London. Lancet 1975; 2: 833–838.
Balarajan R. Ethnic differences in mortality from ischaemic heart disease and cerebrovascular disease in England and Wales. Br Med J 1991; 302: 560–564.
Chaturvedi N, McKeigue PM, Marmot MG. Relationship of glucose intolerance to coronary risk in Afro-Caribbeans compared with Europeans. Diabetologia 1994; 37: 765–772.
Rosemberg HM, Klebba AJ. Trends in cardiovascular mortality with a focus on ischemic heart disease: US, 1950–76. In: Proceedings of the Conference on the Decline in Coronary Heart Disease Mortality. NIH Pub. No 79–1610. Washington, DC, May 1979, US Department of Health, Education, and Welfare.
Keil JE, Loadholt B, Weinrich MC, et al. Incidence of coronary heart disease in blacks in Charleston, South Carolina. Am Heart J 1984; 108: 779–786.
Cassel J. Review of the 1960 through 1962 cardiovascular disease prevalence study. Arch Intern Med 1962; 128: 890–895.
Cassel J, Hill C, Heyden S, et al. Incidence of coronary heart disease by ethnic group, social class and sex. Arch Intern Med 1971; 128: 901–906.
Vital Statistic of the United States, 1980. II Mortality, Part A. Washington, DC: US Dept of Health and Human Services, 1985. DHHS publication PHS, 85–1101.
Vital Statistics of the United States, 1987. II Mortality, Part A. Washington, DC: US Dept of Health and Human Services, 1989. DHHS publication PHS, 89–1101.
Keil J, Sutherland S, Knapp R, et al. Mortality rates and risk factors for coronary disease in black as compared with white men and women. N Engl J Med 1993; 329[2]: 73–78.
Keil J, Sutherland S, Hames C, et al. Coronary disease mortality and risk factors in black and white men. Results from the combined Charleston, SC, and Evans County, Georgia, heart studies. Arch Intern Med 1995; 155[14]: 1521–1527.
McGill HC, Strong JP. The geographic pathology of atherosclerosis. Ann NY Acad Sci 1968; 149: 923–927.
Oalman MC, McGill HC, Strong JP. Cardiovascular mortality in a community: Results of a survey in New Orleans. Am J Epidemiol 1971; 94: 546–555.
Maynard C, Fisher LD, Passamani ER, et al. Blacks in the Coronary Artery Surgery Study: Risk factors and coronary artery disease. Circulation 1986; 74: 64–71.
Blackburn H, Gillum RF. Heart disease. In: Last JM (ed), Public health and preventive medicine. New York: Appleton-Century-Crofts, 1980: 1168.
Gillum RF. Coronary heart disease in black populations: I. Mortality and morbidity. Am Heart J 1982; 104: 839–851.
Gillum RF, Grant CT. Coronary heart disease in black populations: II. Risk factors. Am Heart J 1982; 104: 852–864.
Tyroler HA, Heyden S, Bartel A, et al. Blood pressure and cholesterol as coronary heart disease risk factors. Arch Intern Med 1971; 128: 907–911.
MacMahon S, Peto R, Cutler J, et al. Blood pressure, stroke, and coronary heart disease. 1. Prolonged differences in blood pressure: Prospective observational studies corrected for the regression dilution bias. Lancet 1990; 335: 765–774.
National High Blood Pressure Education Program Working Group. Report on primary prevention of hypertension. Arch Intern Med 1993; 153: 186-208.
Neaton JD, Wentworth D. Serum cholesterol, blood pressure, cigarette smoking, and death from coronary heart disease: Overall findings and differences by age for 316.099 white men. Arch Intern Med 1992; 152: 56–64.
McDonough JR, Garrison GE, Hames CG. Blood pressure and hypertensive disease among negroes and whites: A study in Evans County. Ann Intern Med 1964; 61: 208–228.
Stamler J, Stamler R, Reidlinger WF, et al. Hypertension screening of 1 million Americans Community Hypertension Evaluation Clinic (CHEC) Program, 1973 through 1975. JAMA 1976; 235: 2299–2306.
Rowland ML, Fulwood R. Coronary heart disease risk factor trends in blacks between the first and the second National Health and Nutrition Examination Surveys, United States, 1971–1980. Am Heart J 1984; 108: 771–779.
Ashcroft MT, Beadnell HMSG, Bell R, et al. Characteristics relevant to cardiovascular disease among adults of African and Indian origin in Guyana. Bull World Health Organ 1970; 42: 205–223.
Miall WE, Cochrane AL. The distribution of arterial pressure in Wales and Jamaica. Pathol Microbiol 1961; 24: 690–697.
Schneckloth RE, Stuart KL, Moore FE. Arterial pressure and hypertensive disease in a West Indian Negro population: Report of a survey in St Kitts, West Indies. Am Heart J 1962; 63: 607–628.
Chaturvedi N, McKeigue PM, Marmot MG. Resting and ambulatory blood pressure differences in Afro-Caribbeans and Europeans. Hypertension 1993; 22: 90–96.
Neaton JD, Kuller LH, Wentwhorth D, et al. Total and cardiovascular mortality in relation to cigarette smoking, serum cholesterol concentration, and diastolic blood pressure among black and white males followed up for five years. Am Heart J 1984; 108: 759–770.
Doll R, Peto R. Mortality in relation to smoking: 22 years observations on female British doctors. Br Med J 1980; 280: 967–971.
Kannel WB, McGee DL, Castelli WP. Latest prospectives on cigarette smoking and cardiovascular disease: The Framingham Study. J Cardiac Reahb 1984; 4: 267–277.
Rosenberg L, Kaufman DW, Helmrich SP, et al. Myocardial infarction and cigarette smoking in women younger than 50 years of age. JAMA 1985; 253: 2965–2969.
Kleinman JC, Feldman JJ, Monk MA. The effects of changes in smoking habits on coronary heart disease mortality. Am J Publ Health 1979; 69: 745–749.
Linn S, Fulwood R, Rifkind B, et al. High density lipoprotein cholesterol levels among US adults by selected demographic and socioeconomic variables. The second National Health and Nutrition Examination Survey, 1976–1980. Am J Epidemiol 1989; 129: 281–294.
Sprafka JM, Folsom AR, Burke GL, et al. Prevalence of cardiovascular disease risk factors in blacks and whites: The Minnesota Heart Survey. Am J Public Health 1988; 78: 1546–1549.
Stearns S, Schlesinger MJ, Rudy A. Incidence and clinical significance of coronary heart disease in diabetes mellitus. Arch Intern Med 1947; 80: 463–466.
Harris MI. Epidemiological correlates of NIDDM in Hispanic, Whites, and Blacks in the US population. Diabetes Care 1991; 14(Suppl.3]: 639–648.
Deubner DC, Wilkinson WE, Helms MJ, et al. Logistic model estimation of death attributable to risk factors for cardiovascular disease in Evans County, Georgia. Am J Epidemiol 1980; 112: 135–143.
Beckles GLA, Miller GJ, Kirkwood B, et al. High total and cardiovascular disease mortality in adults of Indian descent in Trinidad, unexplained by major coronary risk factors. Lancet 1986; i: 1298–1301.
McKeigue PM, Shah B, Marmot MG. Relation of central obesity and insulin resistance with high diabetes prevalence and cardiovascular risk in South Asians. Lancet 1991; 337: 382–386.
Hubert HB, Feinleib M, McNamara PM, et al. Obesity as an indipendent risk factor for cardiovascular disease: A 26 years follow-up of participants in the Framingham Heart Study. Circulation 1983; 67: 968–977.
Van Itallie TB. Health implications of overweight and obesity in the United States. Ann Intern Med 1985; 103: 983–988.
Vague J. The degree of masculine differentiation of obesities: A factor determining predisposition to diabetes, atherosclerosis, gout and uric acid calculous disease. Am J Clin Nutr 1956; 4: 20–34.
Lapidus L, Bengtosson C, Larsson B, et al. Distribution of adipose tissue and risk of cardiovascular disease and death: A 12 year follow up of participants in the population study of women in Gothenburg, Sweden. Br Med J 1984; 289: 1257–1261.
Bjorntorp P. 'Portal' adipose tissue as a generator of risk factors for cardiovascular disease and diabetes. Arteriosclerosis 1990; 10: 493–496.
Zamboni M, Armellini F, Sheiban I, et al. Relation of body fat distribution in men and degree of coronary narrowings in coronary artery disease. Am J Cardiol 1992; 70: 1135–1138.
Miller GJ, Kotecha S, Wilkinson WH, et al. Dietary and other characteristics relevant for coronary heart disease in men of Indian, West Indian and European descent in London. Atherosclerosis 1988; 70: 63–72.
Iscan MY. Assessment of race from pelvis. Am J Physical Antropology 1983; 62: 205–208.
Folsom AR, Burke GL, Ballew C, et al. Relation of body fatness and its distribution to cardiovascular risk factors in young blacks and whites: The role of insulin. Am J Epidemiol 1989; 130: 911–924.
Wing RR, Kuller LH, Bunker C, et al. Obesity, obesity-related behaviors, and coronary heart disease risk factors in black and white premenopausal women. Int J Obesity 1989; 13: 511–519.
Morrison JA, Payne G, Barton BA, et al. Mother– daughter correlations of obesity and cardiovascular risk factors in black and white households: The NHLBI Growth and Health Study. Am J Public Health 1994; 84: 1761–1767.
Kannel WB, Castelli WP, Gordon T, et al. Serum cholesterol, lipoproteins, and the risk of coronary heart disease. The Framingham Study. Ann Intern Med 1971; 74: 1–12.
Keys A. Seven countries: A multivariate analysis of death and coronary heart disease. Cambridge, MA: Harvard University Press, 1980.
Barr DP, Russ EM, Eder HA. Protein–lipid relationships in human plasma.II. In atherosclerosis and related conditions. Am J Med 1951; 11: 480–493.
Miller GJ, Miller NE. Plasma high density lipoprotein concentration and development of ischaemic heart. Lancet 1975; 1: 16–19.
Castelli WP, Doyle JT, Gordon T, et al. HDL cholesterol and other lipids in coronary heart disease. The Cooperative Lipoprotein Phenotyping Study. Circulation 1977; 55[5]: 767–772.
Albrink MJ, Man EB. Serum triglycerides in coronary heart disease. Arch Intern Med 1959; 103: 4–8.
Castelli WP. The triglyceride issue: A view from Framingham. Am Heart J 1986; 112: 432–437.
Kaukola S, Manninen V, Halonen PI. Serum lipids with special references to HDL cholesterol and triglycerides in young male survivors of acute myocardial infarction. Acta Med Scand 1980; 208: 41–43.
Barbir M, Wile D, Trayner I, et al. High prevalence of hypertriglyceridaemia and apolipoprotein abnormalities in coronary hart disease. Br Heart J 1988; 60: 397–403.
Austin MA. Plasma triglyceride as a risk factor for coronary heart disease: The epidemiologic evidence and beyond. Am J Epidemiol 1989; 129: 249–259.
Tall AR. Plasma high density lipoproteins: Metabolism and relationship to atherogenesis. J Clin Invest 1990; 86: 379–384.
Assmann G, Schulte H. Relation of high-density lipoprotein cholesterol and triglycerides to incidence of atherosclerotic coronary heart disease (the PROCAM Experience). Am J Cardiol 1992; 70: 733–737.
Gordon DJ, Rifkind BM. High-density lipoprotein: The clinical implication of recent studies. N Engl J Med 1989; 321: 1311–1316.
Manninen V, Mo E, Frick MH, et al. Lipid alterations and decline in the incidence of coronary heart disease in the Helsinki Heart Study. JAMA 1988; 260: 641–651.
Cooper R, Sempos C, Ghali J, et al. High-density lipoprotein cholesterol and angiographic coronary artery disease in Black patients. Am Heart J 1985; 110: 1006–1011.
Freedman DS, Gruchow HW, Manley JC, et al. Black– White differences in risk factors for arteriographically documented coronary artery disease. Am J Cardiol 1988; 62: 14–19.
Costas RJ, Garcia-Palmieri MR, Sorlie P, et al. Coronary heart disease risk factors in men with light and dark skin in Puerto Rico. Am J Public Health 1981; 71: 614–619.
Walker ARP, Walker BF. High-density lipoprotein cholesterol in African children and adults in a population free of coronary heart disease. Br Med J 1978; 2: 1335–1337.
Holman RL, McGill HC, Strong JP, et al. The natural history of atherosclerosis: The early aortic lesions as seen in New Orleans in the middle of the 20th century. Am J Pathol 1958; 34: 209–212.
McNamara JJ, Molot MA, Stremple JF, et al. Coronary artery disease in combat casualties in Vietnam. JAMA 1971; 216: 1185–1187.
Strong JP, McGill HC. The pediatric aspects of atherosclerosis. J Atheroscler Res 1969; 9: 251–254.
Strong JP, Eggen DA, Oalman MC, et al. Pathology and epidemiology of atherosclerosis. J Am Diet Assoc 1973; 62: 262–265.
Glueck C, Gartside PS, Tsang RC, et al. Black–white similarities in cord blood lipids and lipoproteins: A preliminary report. Metabolism 1977; 26: 347–350.
Frerichs RR, Srinivasan SR, Webber LS, et al. Serum lipids and lipoproteins at birth in a biracial population: The Bogalusa Heart Study. Pediatric Res 1978; 12: 858–863.
Frerichs RR, Srinivasan SR, Webber LS, et al. Serum cholesterol and triglyceride levels in 3446 children from a biracial community. Circulation 1976; 54[2]: 302–309.
Srinivasan SR, Frerichs RR, Webber LS, et al. Serum lipoprotein profile in children from a biracial community. Circulation 1976; 54: 309–318.
Morrison JA, deGroot I, Edwards BK, et al. Lipids and lipoproteins in 927 schoolchildren, ages 6 to 17 years. Pediatrics 1978; 62: 990–995.
Berenson GS, Srinivasan SR, Cresanta JL, et al. Dynamic changes of serum lipoproteins in children during adolescence and sexual maturation. Am J Epidemiol 1981; 113: 157–170.
Belcher JD, Ellison RC, Shepard WE, et al. Lipid and lipoprotein distributions in children by ethnic group, gender and geographic location. Preliminary findings of the Child and Adolescent Trial for Cardiovascular Health (CATCH). Prev Med 1993; 22: 143–153.
Berenson GS, Foster TA, Frank GC, et al. Cardiovascular disease risk factors variables at the preschool age. Circulation 1978; 57: 603–612.
Tyroler HA, Glueck CJ, Christensen B, et al. Plasma high-density lipoprotein cholesterol comparison in black and white populations. Circulation 1980; 62 (Suppl IV): 99–107.
The National Heart Lung and Blood Institute Growth and Health Study Research Group. Obesity and Cardiovascular disease risk factors in black and white girls: The NHLBI Growth and Health Study. Am J Public Health 1992; 82: 1613–1620.
Onitri AC, Sander M, Boyo AE. Serum lipids and lipoproteins in healthy Africans. Clin Chim Acta 1977; 81: 57–61.
Adedeji OO. The plasma lipid concentrations of healthy Nigerians. Trop Geogr Med 1994; 46: 23–26.
Miller GJ, Miller NE, Ascroft MT. Inverse relationship between plasma high-density lipoprotein cholesterol concentration and coronary-disease risk as predicted by multiple risk-factor status. Clin Sci and Mol Med 1976; 51: 475–482.
Miller G, Beckles GLA, Byam N, et al. Serum lipoprotein concentrations in relation to ethnic composition and urbanization in men and women of Trinidad, West Indies. Int J Epidemiol 1984; 13: 413–421.
Slack J, Noble N, Meade TW, et al. Lipid and lipoprotein concentrations in 1604 men and women in working populations in north-west London. Br Med J 1977; 2: 353–356.
Miller NE, Hammet F, Saltissi S, et al. Relation of angiographically defined coronary heart disease to plasma lipoprotein subfractions and apolipoproteins. Br Med J 1981; 282: 1741–1744.
Brugger P, Kostner GM, Kullick WC, et al. Plasma concentrations of high-density lipoprotein (HDL)-2 and HDL-3 in myocardial infarction survivors and in control subjects. Clin Cardiol 1986; 9: 273–276.
Watkins LO, Neaton JD, Kuller LH. Racial differences in high-density lipoprotein cholesterol and coronary heart disease incidence in the usual-care group of the Multiple Risk Factor Intervention Trial. Am J Cardiol 1986; 57: 538–545.
Tyroler HA, Hames CG, Krishan I, et al. Black–white differences in serum lipids and lipoproteins in Evans County. Prev Med 1975; 4: 541–549.
Morrison JA, deGroot I, Kelly KA, et al. Black–white differences in plasma lipids and lipoproteins in adults: The Cincinnati Lipid Research Clinic Population Study. Prev Med 1979; 8: 34–39.
Morrison JA, Khuory P, Mellies M, et al. Lipid and lipoprotein distribution in black adults. The Cincinnati Lipid Research Clinic's Princeton School Study. JAMA 1981; 245: 939–942.
Morrison JA, deGroot I, Kelly KA, et al. Black–white differences in plasma lipoproteins in Cincinnati schoolchildren (one-to-one pair matched by total plasma cholesterol, sex and age). Metabolism 1979; 28: 241–245.
Wilson PWF, Savage DD, Castelli WP, et al. HDL-cholesterol in a sample of black adults: The Framingham Minority Study. Metabolism 1983; 32: 328–332.
Freedman DS, Strogatz DS, Williamson DF, et al. Education, race, and high-density lipoprotein cholesterol among US adults. Am J Public Health 1992; 82: 999–1006.
Srinivasan SR, Freedman DS, Webber LS, et al. Black white differences in cholesterol levels of serum high density lipoprotein subclasses among children: The Bogalusa Heart Study. Circulation 1987; 76: 272–279.
Godsland IF, Wynn V, Crook D, et al. Sex, plasma lipoproteins, and atherosclerosis: Prevailing assumption and outstanding questions. Am Heart J 1987; 114: 1467–1503.
Freedman DS, Srinivasan SR, Webber LS, et al. Black– white differences in serum lipoproteins during sexual maturation; the Bogalusa Heart Study. J Chronic Dis 1987; 40: 309–318.
Steinberger J, Moorehead C, Katch V, et al. Relationship between insulin resistance and abnormal lipid profile in obese adolescents. J Pediatr 1995; 126: 690–695.
Gartside PS, Khoury P, Glueck CJ. Determinants of high-density lipoprotein cholesterol in blacks and whites: The second National Health and Nutrition Examination Survey. Am Heart J 1984; 108: 641–653.
Lip G, Malik I, Luscombe C, et al. Dietary fat purchasing habits in whites, blacks and Asian people in England: Implication for heart disease prevention. Int J Cardiol 1995; 48[3]: 287–293.
Hennekens CH, Willett W, Rosner B, et al. Effects of beer, wine, and liquor in coronary deaths. JAMA 1979; 242: 1793–1796.
Barboriak JJ, Anderson AJ, Rimm A. Alcohol and coronary arteries. Alcoholism 1979; 3: 29–32.
Graig WY, Palomaki GE, Haddow JE. Cigarette smoking and serum lipid and lipoprotein concentrations: An analysis of published data. Br Med J 1989; 298: 784–788.
Freedman DS, Srinivasan SR, Slear CL, et al. Cigarette smoking initiation and longitudinal changes in serum lipids and lipoproteins in early adulthood: The Bogalusa Heart Study. Am J Epidemiol 1986; 124: 207–219.
Wood PD, Klein H, Lewis S, et al. Plasma lipoprotein concentrations in middle-aged male runners. Circulation 1974; 50: 111–115.
Lopez SA, Vial R, Balart L, et al. Effect of exercise and physical fitness on serum lipids and lipoproteins. Atherosclerosis 1974; 20: 1–9.
DuRant RH, Baranowski T, Rhodes T, et al. Association among serum lipid and lipoprotein concentrations and physical activity, physical fitness, and body composition in young children. J Pediatr 1993; 123: 185–192.
Sprafka JM, Norsted SW, Folsom AR, et al. Life-style factors do not explain racial differences in high-density lipoprotein cholesterol: The Minnesota Heart Survey. Epidemiology 1992; 3: 156–163.
Denke MA, Sempos CT, Grundy SM. Excess body weight: An underrecognized contributor to high blood cholesterol levels in white American men. Arch Intern Med 1993; 153: 1093–1103.
Glueck CH, Taylor HL, Jacobs D, et al. Plasma high-density lipoprotein cholesterol: Association with measurements of body max: The Lipid Research Clinics Program Prevalence Study. Circulation 1980; 62(suppl IV): 62–69.
Carson LA, Lindstedt S. The Stockholm Prospective Study: The initial values for plasma lipids. Acta Med Scand Suppl 1968; 493: 1–135.
Foster C, Weinster RL, Birch R, et al. Obesity and serum lipids: An evaluation of the relative contribution of body fat and fat distribution to lipid levels. Int J Obesity 1987; 11: 151–161.
Anderson AJ, Sobocinski KA, Freedman DS, et al. Body fat distribution, plasma lipids and lipoproteins. Arteriosclerosis 1988; 8: 88–94.
Rebuffe-Scrive M, Anderson B, Olbe L, et al. Metabolism of adipose tissue in intraabdominal depots in obese men and women. Metabolism 1989; 38: 453–458.
Coon PJ, Rogus EM, Goldberg AP. Time course of plasma free fatty acid concentrations in response to insulin: Effect of obesity and physical fitness. Metabolism 1992; 41: 711–716.
Havel RJ, Kane JP, Balasse EO, et al. Splanchnic metabolism of free fatty acids and production of triglycerides of very low density lipoproteins in normotriglyceridemic and hypertriglyceridemic humans. J Clin Invest 1970; 49: 2017–2035.
Yki-Jarvinen H, Taskinen MR. Interrelationships among insulin's antilipolytic and glucoregulatory effects and plasma triglycerides in nondiabetic and diabetic patients with endogenous hypertriglyceridemia. Diabetes 1988; 37: 1271–1278.
Eckel RH. Lipoprotein lipase. A multifunctional enzyme relevant to common metabolic diseases. N Engl J Med 1989; 320: 1060–1068.
Peterson J, Bihain BE, Bengtsson-Olivercrona G, et al. Fatty acid control of lipoprotein lipase: A link between energy metabolism and lipid transport. Proc Natl Acad Sci, USA 1991; 87: 909–913.
Miesenbock G, Patsch JR. Postprandial hyperlipidemia: The search for the atherogenic lipoprotein. Curr Opin Lipidol 1992; 3: 196–201.
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Zoratti, R. A review on ethnic differences in plasma triglycerides and high-density-lipoprotein cholesterol: Is the lipid pattern the key factor for the low coronary heart disease rate in people of African origin?. Eur J Epidemiol 14, 9–21 (1998). https://doi.org/10.1023/A:1007492202045
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DOI: https://doi.org/10.1023/A:1007492202045