Burden and risk factors of dyslipidemia-results from a STEPS survey in Punjab India

Dyslipidemia among HIV-infected patients in Ethiopia: a systematic review and meta-analysis

BACKGROUND

Dyslipidemia is responsible for more than half of the global ischemic heart disease (IHD) and more than 4 million deaths annually. Assessing the prevalence of dyslipidemia can be crucial in predicting the future disease development and possible intervention strategies. Therefore, this systematic review and meta-analysis was aimed at assessing the pooled prevalence of dyslipidemia in HIV-infected patients.

METHODS

Electronic databases such as EMBASE, Google Scholar, PubMed, Web of Science, ResearchGate, Cochrane Library, and Science Direct were searched for articles and grey literature. All relevant studies found until our search period of May 24, 2023 were included. The Newcastle-Ottawa Quality Assessment Scale was used to assess the quality of the included studies. The data were extracted in Microsoft Excel. The STATA version 14 software was used to conduct the meta-analysis. I2 and Cochran's Q test were employed to assess the presence of heterogeneity between studies. Due to the presence of heterogeneity, a random effect model was used. The publication bias was assessed using the symmetry of the funnel plot and Egger's test statistics. Moreover, subgroup analysis, and sensitivity analysis were also done.

RESULTS

A total of nine studies that reported the prevalence of dyslipidemia were included. The overall pooled prevalence of dyslipidemia among HIV-infected patients in Ethiopia was 67.32% (95% CI = 61.68%-72.96%). Furthermore, the overall pooled estimates of dyslipidemia among ART-taking and treatment-naïve HIV-infected patients were 69.74% (95% CI: 63.68-75.8, I2 = 87.2) and 61.46% (95% CI: 45.40-77.52, I2 = 90.3), respectively. Based on lipid profile fractionations, the pooled estimates for high total cholesterol (TC) were 39.08% (95% CI: 31.16-46.99), high triglycerides were 38.73% (95% CI: 28.58-48.88), high low density lipoprotein (LDL-c) was 28.40% (95% CI: 17.24-39.56), and low high density lipoprotein (HDL-c) was 39.42% (95% CI: 30.47-48.38).

CONCLUSION

More than two-thirds of HIV-infected patients experienced dyslipidemia. Therefore, it's critical to regularly evaluate lipid alterations in HIV-infected patients in order to prevent the onset of atherosclerosis and other cardiovascular problems.

Association between sensitivity to thyroid hormones and dyslipidemia in patients with coronary heart disease

BACKGROUND

Thyroid hormones affect lipid metabolism via central and peripheral regulation. However, there have been few studies on the association between thyroid hormone sensitivity and dyslipidemia. We aimed to investigate the association between thyroid hormone sensitivity and dyslipidemia in patients with coronary heart disease (CHD).

METHODS

A total of 31,678 patients with CHD were included in this large multicenter retrospective study. Central thyroid hormone sensitivity was evaluated using the thyroid feedback quantile-based index (TFQI), parametric thyroid feedback quantile-based index (PTFQI), thyroid-stimulating hormone index (TSHI), and thyrotropin thyroxine resistance index (TT4RI); peripheral thyroid hormone sensitivity was assessed by the ratio of free triiodothyronine (FT3)/free thyroxine (FT4). Logistic regression analysis was used to analyze the association between thyroid hormone sensitivity and dyslipidemia.

RESULTS

Among 31,678 participants, 21,648 (68.34%) had dyslipidemia. In the multi-adjusted models, the risk of dyslipidemia was positively correlated with TFQI (odds ratio [OR]: 1.04; 95% confidence interval [CI]: 1.03-1.05), PTFQI (OR: 1.09; 95% CI: 1.06-1.12), TSHI (OR: 1.08; 95% CI: 1.06-1.11), and TT4RI (OR: 1.08; 95% CI: 1.05-1.11). Conversely, the risk of dyslipidemia was negatively correlated with FT3/FT4 (OR: 0.94; 95% CI: 0.92-0.97). In stratified analyses, the association between thyroid hormone sensitivity and dyslipidemia was statistically significant for different sexes, glucose levels, and blood pressure states.

CONCLUSION

There is a significant association between sensitivity to thyroid hormones and dyslipidemia, regardless of sex, glucose level, or blood pressure. Graphical abstract.

Prevalence of Hypercholesterolemia and Awareness of Risk Factors, Prevention and Management Among Adults Visiting Referral Hospital in Ethiopia

Background

Unhealthy lifestyles and physical inactivity are among the contributing factors of hypercholesterolemia. This study assessed the prevalence, awareness of risk factors, and prevention and treatment of hypercholesterolemia among adults who visited Woldia referral hospital, Northeast Ethiopia.

Methods

A cross-sectional survey was conducted among adults who visited Woldia referral hospital from May to August 2022. Data was collected using a structured questionnaire through a face-to-face interview and patient medical record review. Logistic regression analysis was employed to determine the association between hypercholesterolemia and other variables. A p-value at a 95% confidence level was statistically significant.

Results

A total of 1180 eligible adults were included in the study. The magnitude of hypercholesterolemia was 26.4%. The majority of the respondents were aware of some risk factors, such as higher fat intake (82.3%), obesity (67.2%), and lack of adequate exercise (56.1%). However, the majority of the respondents were not aware that smoking, alcohol consumption, and age (86.8% for all) had cardiovascular risk. The majority of the respondents were aware that eating a limited amount of saturated fat (56.5%), maintaining a healthy weight (67.2%), and taking prescribed medications properly (86.8%) can prevent the risk of hypercholesterolemia. However, a larger proportion of respondents were unaware that smoking cessation (86.8%), exercise (55.3%), alcohol restriction (86.8%), and stress avoidance (75.3%) can prevent cardiovascular risks. Age (p = 0.036), smoking (p = 0.007), alcohol use (p = 0.013), fruit consumption (p = 0.019), saturated oil use (p = 0.031), level of physical activity (p < 0.001), and body mass index (p = 0.03) were significantly associated with hypercholesterolemia.

Conclusion

This study concluded that more than one-fourth of adults had hypercholesterolemia. The majority of the respondents did not have an awareness of common cardiovascular risk factors and prevention and treatment techniques regarding unhealthy lifestyles and physical inactivity.

The Protective Role of Grape Seed in Obesity and Lipid Profile: An Updated Narrative Overview of Preclinical and Clinical Studies

Obesity and dyslipidemia are common disorders universally. According to the acquired outcomes of recent studies, dietary supplementations which have great content of phenolic compounds exert protective effects against obesity and dyslipidemia. Grape [Vitis vinifera] seeds are considered attractive sources of phenolic compounds with anti-oxidative stress and anti-inflammatory effects. There are also various experimental studies describing hepatoprotective, neuroprotective, anti-aging, cardioprotective, and anti-carcinogenic effects of polyphenols isolated from grape seed, highlighting the therapeutic and biological aspects of proanthocyanidins. The present review article first discusses pharmacological, botanical, toxicological, and phytochemical characteristics of Vitis vinifera seeds and afterward designates the protective properties which are attributed to the intake of grape seeds in obesity and hyperlipidemia. Overall valuable and updated findings of this study display that polyphenol of grape seeds has meaningful impacts on the regulation of lipid profile levels and management of obesity.

Prevalence, awareness, treatment, and control of dyslipidemia and associated factors among adults in Jordan: Results of a national cross-sectional survey in 2019

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The national prevalence of dyslipidemia was 81.6%,

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Among those with dyslipidemia, 9.3% were aware,

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Among those who knew, the proportion of lipid-lowering drug treatment was 50.3%,

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Among those taking lipid-lowering drugs, 25.4% had their dyslipidemia controlled.

Dyslipidaemia is increasing with low awareness and treatment in low resourced countries.

The aim of the study was to evaluate the prevalence, distribution, and correlates of dyslipidaemia and its awareness, treatment, and control among people (18–69 years) in Jordan.

In a national cross-sectional survey, a total of 3,132 individuals (mean age: 41.7 years) that took part in the Jordan cross-sectional STEPS survey in 2019 and had complete lipid measurements. Dyslipidemia was defined using the guidelines of the Adult Treatment Panel III.

The prevalence of dyslipidemia was 81.6%, 74.0% low high-density lipoprotein cholesterol (HDL-C), 28.2% high triglyceride (TG), 10.1% high total cholesterol (TC) and 8.7% high low-density lipoprotein cholesterol (LDL-C). Among those with dyslipidaemia, 9.3% were aware. Among those who knew, the proportion of lipid-lowering drug treatment was 50.3%, and among those taking lipid-lowering drugs, 25.4% had their dyslipidaemia controlled. In adjusted logistic regression, in both sexes, overweight (AOR: 2.14, 95% CI: 1.49–3.36), obesity (AOR: 2.47, 95% CI: 1.55–3.94), diabetes (AOR: 2.63, 95% CI: 1.30–5.34) were positively and moderate physical activity (AOR: 0.60, 95% CI: 0.37–0.95) was negatively associated with prevalence of dyslipidemia. Older age, overweight, obesity, hypertension, diabetes, and cardiovascular disease were positively associated, and moderate physical activity was negatively associated with awareness of dyslipidemia.

Four out of five adults in Jordan had dyslipidaemia and less than one in ten were aware. Several factors associated with the prevalence, awareness, and treatment of dyslipidaemia were identified that can be used to target public health interventions.

National high prevalence, and low awareness, treatment and control of dyslipidaemia among people aged 15-69 years in Mongolia in 2019

The aim of the study was to evaluate the prevalence, distribution and correlates of dyslipidaemia among people (15-69 years) in Mongolia. National data were analyzed from 4,895 individuals (15-69 years, median age = 35 years) that took part in the Mongolia cross-sectional STEPS survey in 2019, and had complete lipid measurements. Dyslipidaemia was defined using the guidelines of the Adult Treatment Panel III. The prevalence of dyslipidaemia was 58.6%, 31.7% high triglycerides (TG), 26.9% high low-density lipoprotein cholesterol (LDL-C), 26.9% high total cholesterol (TC) and 14.6% low high-density lipoprotein cholesterol (HDL-C). Among those with dyslipidaemia, 6.2% were aware. Among those who were aware, the proportion of lipid-lowering drug treatment was 18.9% and among those who took lipid-lowering drugs, 21.5% had their dyslipidaemia controlled. In adjusted logistic regression, older age (40-69 years) (AOR: 1.19, 95% CI 1.02-1.40), urban residence (AOR: 1.24, 95% CI 1.04-1.48), obesity call II (AOR: 2.89, 95% CI 2.29-3.66), hypertension (AOR: 1.33, 95% CI 1.11-1.59), and diabetes (AOR: 1.62, 95% CI 1.20-2.18) were positively, and male sex (AOR: 0.84, 95% CI 0.72-1.00) was negatively associated with dyslipidaemia prevalence. Six in ten Mongolians 15 years and older had dyslipidaemia. Several factors associated with dyslipidaemia that can be used to target public health interventions were identified.

Determinants of Dyslipidemia in Africa: A Systematic Review and Meta-Analysis

Background

Dyslipidemia is a common public health problem in Africa. It has emerged as an important cardiovascular risk factor. It has been steadily increasing due to economic growth, urbanization, and unhealthy dietary pattern. Therefore, it is essential to identify determinants of dyslipidemia to prevent the condition and reduce its long-term sequel.

Methods

Combinations of search terms with Boolean operators were used to retrieve studies from PubMed, EMBASE, Cochrane Database, Cinahl, Scopus, Mednar, and Google Scholar. The methodological quality of each article was evaluated based on the 2017 Joanna Briggs Institute (JBI) Critical Appraisal checklist for prevalence studies. After evaluation of each study against these criteria, studies with a minimum score of 7 or above out of 9 JBI checklists were included. We included articles presented in the English language. The Cochrane Q test was used to assess the heterogeneity across studies. The visual assessment of publication bias was done by creating a funnel plot. The possible causes of heterogeneity were explored by subgroup analyses. Egger's weighted regression test was used to assess the presence of publication bias. Statistical analyses were done by using the STATA software version 14.

Result

A total of 24 articles involving 37,902 participants from 10 African countries were included. The overall pooled prevalence of dyslipidemia was 52.8 (95% CI 40.8–64.9). Individuals with a body mass index (BMI) >25.0 kg/m² and waist circumference (WC) >94 cm were, respectively, 2.36 (95% CI (1.33–4.18), p < 0.001) and 2.33 (95% CI (0.75–0.29) p < 0.001) times more likely to develop dyslipidemia than those with lower values. Furthermore, patients with diabetes mellitus (DM) and hypertension (HTN) were 2.32 (95% CI (0.89–6.05) p < 0.001) and 2.05 (95% CI (1.31–3.21), p < 0.001) times more likely to present with dyslipidemia than non-diabetic patients and those without HTN.

Conclusion

This study revealed that the prevalence of dyslipidemia is relatively high among study participants in African countries and the independent predictors of dyslipidemia were BMI >25.0 kg/m², WC > 94 cm, raised blood glucose level, and raised blood pressure. Therefore, there should be a pressing public health measure to prevent, identify, and treat dyslipidemia with the special emphasis on obese, diabetic, and hypertensive patients.

Monitoring of risk factors of cardiovascular diseases in adult men

The study aims to evaluate the monitoring of risk factors of cardiovascular diseases in the young population, which significantly contribute to the origin and development of cardiovascular diseases, such as peripheral artery diseases, atherosclerosis, stroke, and others. We focused on a group of young adult men (n = 110) in the age range of 30 to 50 years, which we selected from the database of 800 patients hospitalized in the Cardio Center in Nitra during 2010 – 2020. When evaluating the influence of meat products consumption frequency on biochemical parameters and BMI, we recorded a statistically significant effect at the level of p <0.05 in the evaluation of meat products such as salami, brawn, and sausages. When consuming sausages, BMI values also increased with increasing frequency of consumption. The effect on BMI was also observed when eating salami, between consuming 1 – 2 times a week and not at all. We recorded a statistically significant effect (p <0.05) in frequent consumption of brawn (1 – 2 weeks) on the level of HDL cholesterol. The most frequent fish consumption was 1 – 2 times a month for freshwater (51.8%) and marine fish (56.3%). Daily consumption of fruit was reported in 64.6% of men, while daily consumption of vegetables was recorded in only 44.6% of men. In the lifestyle assessment, we focused on probands' time spent on physical activity. Only 35.5% of men stated that they spend more than an hour a day on physical activity. 40% of men from the surveyed respondents were active smokers. Another risk factor for cardiovascular diseases is stress, which significantly affected up to 42.7% of respondents. Nutrition and lifestyle play an important role in the prevention of cardiovascular diseases, which significantly affect blood lipid parameters, vascular endothelial elasticity, and factors determining the etiopathogenesis of cardiovascular diseases.

Dyslipidemia and its associated factors in southern Iranian women, Bandare-Kong Cohort study, a cross-sectional survey

Dyslipidemia, a major risk factor for cardiovascular diseases, has become a global issue. Due to the variations in the prevalence of dyslipidemia, this study aimed to evaluate dyslipidemia and its associated factors in women of the Bandare-Kong Cohort Study (BKNCD). This study was conducted on women from the population-based BKNCD, as part of the Prospective Epidemiological Research Studies in IrAN (PERSIAN). Sociodemographic data, medical history, and anthropometric indices were collected. Dyslipidemia was defined as any lipid abnormality including low-density lipoprotein (LDL) ≥ 160, total cholesterol (TC) ≥ 240, high-density lipoprotein (HDL) < 40, or triglyceride > 200 mg/dl. From the 2223 women in this study (mean age: 48.28 ± 9.26 years), dyslipidemia was observed in 851 (38.3%). High TC was the most common lipid abnormality (18.5%) followed by high LDL (17.7%). Dyslipidemia was most prevalent among women aged 55-70 years, the married, those with < 6 years of education, the unemployed, the overweight or obese, with low socioeconomic status, diabetes, hypertension, and high waist circumference, those using the hookah and living in urban areas. Logistic regression revealed that women with high waist-to-hip ratio (WHR) (OR = 2.22, 95% CI 1.60-3.08), those aged 45-54 years (OR = 1.34, 95% CI 1.07-1.68) and 55-70 years (OR = 1.33, 95% CI 1.03-1.72), and those living in urban areas (OR = 1.35, 95% CI 1.05-1.73) were at significantly increased risk of dyslipidemia. In addition, the results were confirmed using deep neural network models. Dyslipidemia was highly prevalent in Iranian women in the southern coastal region. Central obesity, age over 45 years, and living in urban areas appear to be relatively significant risk factors for dyslipidemia among women.

Epidemiology of dyslipidemia and associated cardiovascular risk factors in northeast China: A cross-sectional study

BACKGROUND AND AIMS

Management of dyslipidemia remains the cornerstone for prevention of cardiovascular diseases. We aimed to evaluate the epidemiology of dyslipidemia in northeast China.

METHODS AND RESULTS

This cross-sectional survey was administered on 18,796 participants aged ≥40 years from September 2017 to March 2019 through a multistage, stratified, and cluster random sampling method. Lipid profiles were proposed by National Cholesterol Education Program Adult Treatment Panel III. The crude prevalence of dyslipidemia was 35.8%, higher in urban and women than their counterparts (49.5% vs 30.2%, 37.6% vs 33.0%, p < 0.001). The age-standardized prevalence of dyslipidemia was 34.0% (urban 47.9%, and rural 28.9%; men 36.2%, and women 33.4%). The prevalence of high total cholesterol (TC), high triglyceride (TG), high low-density lipoprotein cholesterol (LDL-C) and low high-density lipoprotein cholesterol (HDL-C) were 14.2%, 17.7%, 5.7% and 11.4% respectively. Noticeably, the prevalence of high LDL-C and low HDL-C in urban areas showed a 2.2-fold and 6.3-fold increase over the rural areas (9.3% vs 4.2% and 28.4% vs 4.5%, respectively). Among participants with dyslipidemia, 14.7% were aware of their condition; 5.9% were taking lipid-regulating medications; and only 2.9% had their dyslipidemia controlled. Comorbidities including hypertension (63.6%), and diabetes (25.2%) were highly prevalent in patients with dyslipidemia, however, the control rates of those comorbidities were only 40.0% and 6.6%.

CONCLUSIONS

Patients with dyslipidemia showed high cardiovascular burden with low control rates of dyslipidemia, high prevalence of coexisting risk factors. Therefore, region- and sex-specific strategies to manage dyslipidemia and related risk factors should be highlighted.

Structural equation modeling to identify the risk factors of diabetes in the adult population of North India

Background

A non-communicable disease risk factor survey (based on World Health Organization STEP approach to Surveillance, i.e., WHO-STEPS) was done in the state of Punjab, India in a multistage stratified sample of 5127 individuals. The study subjects were administered the WHO STEPS questionnaire and also underwent anthropometric and biochemical measurements. This study aimed at exploring the risk factors of diabetes using a Structural Equation Modeling (SEM) approach in the North Indian state of Punjab.

Results

Overall prevalence of diabetes mellitus among the study participants was found out to be 8.3% (95% CI 7.3-9.4%). The final SEM had excellent fit considering the model parameters. The following risk factors deemed to have a direct statistically significant effect on blood sugar status: family history of diabetes (4.5), urban residence (3.1), triglycerides (0.46), increasing waist circumference (0.18), systolic blood pressure (0.11), and increasing age (0.05). There are specific indirect effects of alcohol use (1.43, p = 0.001), family h/o diabetes (0.844, p = 0.001), age (0.156, p < 0.001), waist circumference (0.028, p = < 0.001) and weekly fruit intake (- 0.009, p = 0.034) on fasting blood glucose. Indirect effects of waist circumference, alcohol intake and age on blood sugar levels are mediated by raised blood pressure. Waist circumference mediates the indirect effects of age, family h/o of diabetes, alcohol intake and weekly fruit intake on blood sugar levels. Triglycerides also mediated the indirect effects between age and diabetes.

Conclusions

Family history of diabetes, urban residence, alcohol use, increasing age, and waist circumference are the key variables affecting diabetes status in the Indian population. The results of this study further strengthens the evidence that lifestyle changes in the form of physical activity and healthy diet are required to prevent and control diabetes. Those with family h/o diabetes constitute a high risk group and should be targeted with regular screening and lifestyle intervention package.