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

An application of the Bayesian network model based on the EN-ESL-GA algorithm: Exploring the predictors of heart disease in middle-aged and elderly people in China

BACKGROUND

The morbidity and mortality of heart disease are increasing in middle-aged and elderly people in China. It is necessary to explore relationships and interactive associations between heart disease and its risk factors in order to prevent heart disease.

OBJECTIVE

To establish a Bayesian network model of heart disease and its influencing factors in middle-aged and elderly people in China, and explore the applicability of the elite-based structure learner using genetic algorithm based on ensemble learning (EN-ESL-GA) algorithm in etiology analysis and disease prediction.

METHODS

Based on the 2013 national tracking survey data from China Health and Retirement Longitudinal Study (CHARLS) database, EN-ESL-GA algorithm was used to learn the Bayesian network structure. Then we input the data and the learned network structure into the Netica software for parameter learning and inference analysis.

RESULTS

The Bayesian network model based on the EN-ESL-GAalgorithm can effectively excavate the complex network relationships and interactive associations between heart disease and its risk factors in middle-aged and elderly people in China.

CONCLUSIONS

The Bayesian network model based on the EN-ESL-GA algorithm has good applicability and application prospect in the prediction of diseases prevalence risk.

The impact of dyslipidemia on prognosis of patients after endovascular abdominal aortic aneurysm repair

Introduction

Dyslipidemia is common in patients with abdominal aortic aneurysm (AAA). However, there is insufficient research on the impact of dyslipidemia on the postoperative outcomes of patients with AAA after endovascular aortic aneurysm repair (EVAR). This study aimed to determine the impact of dyslipidemia on the prognosis of patients with AAA treated with EVAR.

Method

We retrospectively reviewed patients with AAA who underwent EVAR at our hospital between 2010 and 2020. The baseline characteristics and prognoses of patients in the dyslipidemia and non-dyslipidemia groups were analyzed.

Results

A total of 641 patients were included; the prevalence of dyslipidemia in patients with AAA was 42.3% (271/641), and the mean follow-up time was 63.37 ± 26.49 months. The prevalence of diabetes (10.0% vs. 15.1%, P = 0.050), peripheral arterial disease (17.3% vs. 25.8%, P = 0.018), and chronic kidney disease (3.0% vs. 6.3%, P = 0.043) was higher in the dyslipidemia group. The three-year all-cause mortality rate after EVAR was 9.98% (64/641), and there was no difference in the incidence of all-cause mortality (10.27% vs. 9.59%, P = 0.778) between the two groups. A total of 36 (5.62%) major adverse cardiovascular and cerebrovascular events (MACCEs) were observed within 3 years and were more common in patients with dyslipidemia (2.97% vs. 9.59%, P < 0.001). The incidence of stent-related complications in all patients was 19.97% (128/641), and there was no difference in the incidence of stent-related complications between the two groups (22.16% vs. 16.97%, P = 0.105); however, the incidence of type I endoleak in the dyslipidemia group was lower than that in the non-dyslipidemia group (9.19% vs. 4.06%, P = 0.012). Cox-regression analysis showed that high level of high-density lipoprotein cholesterol (HDL-C) was the protective factor (HR, 0.203, 95% CI, 0.067-0.616, P = 0.005) for MACCES, but it was the risk factor for type I endoleak (HR, 2.317, 95% CI, 1.202-4.466, P = 0.012).

Conclusion

Dyslipidemia did not affect the mortality of patients with AAA who underwent EVAR; however, it may increase the incidence of MACCEs. Dyslipidemia may decrease the incidence of type I endoleaks after EVAR; however, further studies are warranted. We should strengthen the postoperative management of patients with dyslipidemia, prevent the occurrence of MACCEs.

Neck circumference as an additional predictor of cardiovascular disease mortality: A multi-center prospective population-based study in northeastern China

BACKGROUND AND AIMS

This study aimed to assess the potential of neck circumference (NC) and neck-to-height ratio (NHR) as predictors of future cardiovascular disease (CVD) mortality in a general population from Northeastern China.

METHODS

A multi-center prospective study was conducted in Northeastern China, involving 18, 796 participants. The associations between NC or NHR and the incidence of overall CVD mortality, stroke mortality, and coronary heart disease (CHD) mortality were examined using multivariate Cox regression models. Hazard ratios (HRs) and the corresponding 95% confidence intervals (CIs) were calculated. Reclassification analyses were conducted to determine the incremental predictive value of NC or NHR.

RESULTS

NC was significantly associated with the risk of CVD mortality, independent of other anthropometric measurements for obesity. Individuals in the highest quartile of NC had a 1.83-fold (95% CI 1.29 to 2.61) and a 2.40-fold (95% CI 1.45 to 4.00) higher risk of overall CVD mortality and CHD mortality, respectively. Larger NC was significantly related to a heightened risk of ischemic stroke mortality, although no such association was observed with hemorrhagic stroke mortality. Furthermore, the risk of overall CVD mortality, stroke mortality, and CHD mortality increased by approximately 1.21 to 1.25 times per 1-SD change in NC. Similar findings were observed for NHR. The percentages of correct classification of overall CVD mortality improved by 12.1% and 16.3% after the addition of NC or NHR into established models, respectively.

CONCLUSIONS

NC and NHR might be promising predictors of CVD mortality, with higher values indicating greater risk.

Estimating the prevalence of dyslipidemia by measuring fenofibrate in 33 cities in China

Dyslipidemia, recognized as a predominant risk factor for atherosclerotic cardiovascular disease (CVD), remains a pressing health concern worldwide, particularly in China with nearly 40 % of the population adversely suffering. Fenofibrate, as one of the most commonly used drugs for dyslipidemia therapy, excreted as the format of fenofibrate-acid, which showed considerable stability in sewage samples and could be detected as WBE-biomarkers to monitor the prevalence of dyslipidemia. In this work, we reported the first research on estimating the prevalence of dyslipidemia by WBE approach. 527 sewage samples from 33 cities in China were extracted by solid phase and analyzed by LC-MS/MS. The detected concentration of fenofibrate acid in sewage was on an average of 120.5 ± 59.9 ng/L, and the reverse-calculated consumption of fenofibrate based on fenofibrate acid was 77.8 ± 25.0 mg/day/1000inh. Detailed analysis unveiled an average prevalence of fenofibrate at 0.056 % ± 0.018 %, and the dyslipidemia prevalence among the population aged over 15 was ultimately estimated to be 37.9 % ± 9.3 % and was in accordance with the China Cardiovascular research result of 40.4 %, which proves that WBE is a substitutable approach of traditional epidemiological investigation methods due to its timeliness and cost-effectiveness. This study demonstrated that estimating dyslipidemia prevalence by WBE with metabolite fenofibrate acid as a biomarker is feasible in most Chinese cities.

A tryst of 'blood pressure control- sex- comorbidities': the odyssey of basic public health services in Yunnan in quest for truth

BACKGROUND

The Basic Public Health Service (BPHS), a recently announced free healthcare program, aims to combat the most prevalent Noncommunicable Disease-"Hypertension" (HTN)-and its risk factors on a nationwide scale. In China, there is a rife that HTN less impacts women during their lifetime. We, therefore, aimed to evaluate the sex disparity in hypertension patients with comorbidities among south-west Chinese and the contribution of BPHS to address that concern.

METHODS

We have opted for a multistage stratified random sampling method to enroll hypertensive patients of 35 years and older, divided them into BPHS and non-BPHS groups. We assessed the sex disparity in HTN patients with four major comorbidities- Dyslipidemia, Diabetes Mellitus (DM), Cardiovascular Disease (CVD), and Chronic Kidney Disease (CKD), and descriptive data were compiled. Odds ratios from logistic regression models estimated the effectiveness of BPHS in the management of HTN with comorbidities.

RESULTS

Among 1521 hypertensive patients,1011(66.5%) were managed in the BPHS group. The proportion of patients who had at least one comorbidity was 70.7% (95% confidence interval [CI]: 66.3-76.8%), patients aged 65 years and older were more likely to have coexisting comorbidities. Participants who received the BPHS showed significant blood pressure (BP) control with two comorbidities (odds ratio [OR] = 2.414, 95% CI: 1.276-4.570), three or more (OR = 5.500, 95%CI: 1.174-25.756). Patients with dyslipidemia and DM also benefited from BPHS in controlling BP (OR = 2.169, 95% CI: 1.430-3.289) and (OR = 2.785, 95%CI: 1.242-6.246), respectively. In certain high-income urban survey centers, there was sex differences in the HTN management provided by BPHS, with men having better BP control rates than women.

CONCLUSIONS

Perhaps this is the first study in China to succinctly show the effectiveness and sex disparity regarding "management of hypertensive comorbidities". This supports that the BPHS program plays a pivotal role in controlling BP, therefore should recommend the national healthcare system to give women a foremost priority in BPHS, especially to those from low-socioeconomic and low-scientific literacy regions.

Joint association of physical activity and diet quality with dyslipidemia: a cross-sectional study in Western China

OBJECTIVE

This study aims to investigate the prevalence of dyslipidemia and assess the joint association of physical activity (PA) and diet quality on dyslipidemia risk in urban areas of Xinjiang.

METHODS

Conducted from July 2019 to September 2021 in Xinjiang, China, this cross-sectional study involved 11,855 participants (mean age 47.1 ± 9.4 years, 53.1% male). Standard methods were used to measure plasma cholesterol levels, and validated questionnaires were employed to evaluate dietary habits and PA. The definition of dyslipidemia is based on 2023 Chinese guidelines for lipid management. PA was divided into guideline-recommended moderate-to-vigorous physical activity (MVPA) and non-MVPA, following World Health Organization guidelines. The Food Frequency Questionnaire was used to obtain the intake frequency of each dietary term. Each item was scored based on consumption frequency and divided into three groups (good, intermediate, and poor) based on total dietary score. Multivariate logistic regression analysis was performed to identify dyslipidemia risk factors, as well as the joint association of PA and diet quality.

RESULTS

Dyslipidemia prevalence among urban adults in Xinjiang was 39.3%, with notable sex disparities (52.6% in males vs. 24.3% in females, P < 0.001). Among participants with dyslipidemia, the awareness, treatment and control rates were 6.9%, 3.1%, and 1.9%, respectively. A significant multiplicative interaction between PA and diet quality is associated with dyslipidemia (P for interaction < 0.05). Less PA and poor diet quality were associated with an increased odds of dyslipidemia. Even individuals with poor (OR = 1.464, 95% CI: 1.106-1.939) or intermediate (OR = 1.229, 95% CI: 1.003-1.505) diet quality but adhering to recommended MVPA had lower odds of dyslipidemia compared to those with good diet quality but inadequate MVPA (OR = 1.510, 95% CI: 1.252-1.821).

CONCLUSIONS

Dyslipidemia prevalence was 39.3% in urban adults in Xinjiang, with limited awareness, treatment, and control. Following guideline-recommended MVPA and maintaining good diet quality were protective against dyslipidemia. Low levels of PA associated with a higher prevalence of dyslipidemia, even in individuals with good diet quality.

Prevalence, awareness, treatment and control of dyslipidaemia and their determinants: results from a population-based survey of 60 283 residents in eastern China

OBJECTIVES

To investigate the prevalence, awareness, treatment and control of dyslipidaemia and its associated factors in eastern China.

DESIGN

Cross-sectional study.

SETTING

Data were collected from the 2017 Nanjing Chronic Disease and Risk Factor Surveillance.

PARTICIPANTS

This study included 60 283 participants aged ≥18 years.

OUTCOME MEASURES

Prevalence of dyslipidaemia was defined as self-reported history of dyslipidaemia and/or the use of lipid-lowering medication, and/or meeting at least one of the following during on-site investigation: total cholesterol ≥6.2 mmol/L, triglyceride ≥2.3 mmol/L, low-density lipoprotein cholesterol ≥4.1 mmol/L and high-density lipoprotein cholesterol <1.0 mmol/L. Dyslipidaemia awareness was defined as the proportion of patients with dyslipidaemia who explicitly indicate their awareness of having a diagnosis of dyslipidaemia. Treatment was based on medication use among individuals with dyslipidaemia. Control was defined as having dyslipidaemia, receiving treatment and achieving serum lipid control to the standard level.

ANALYSIS

Complex weighting was used to calculate weighted prevalence. A two-level logistic regression model determined the influencing factors for dyslipidaemia prevalence, awareness, treatment and control.

RESULTS

The crude prevalence rate of dyslipidaemia was 28.4% (17 093 of 60 283). Among 17 093 patients with dyslipidaemia, the crude rates of awareness, treatment and control were 40.0% (n=6830), 27.5% (n=4695) and 21.9% (n=3736), respectively. The corresponding weighted prevalence rates were 29.8%, 41.6%, 28.9% and 22.9%. Older age (OR 2.03, 95% CI 1.82 to 2.23), urban residence (1.24, 1.19 to 1.31), higher education level (1.31, 1.21 to 1.42), current smoking (1.22, 1.15 to 1.29), alcohol consumption (1.20, 1.14 to 1.26), obesity (2.13, 1.99 to 2.29), history of hypertension (1.64, 1.56 to 1.71) and diabetes (1.92, 1.80 to 2.04) were identified as independent risk factors for dyslipidaemia (all p<0.001). Participants who were older, female, living in urban areas, had higher education levels, did not smoke or drink alcohol, had central obesity, had hypertension or had diabetes were more likely to be aware of their dyslipidaemia conditions, receive treatment and achieve serum lipid control to a standard level than their comparators (all p<0.05).

CONCLUSIONS

The prevalence of dyslipidaemia is relatively high in eastern China; however, awareness, treatment and control levels are relatively low.

Population-based stroke risk profile from a West-African community

Objectives

To determine the stroke risk profile of dwellers of Nnewi community in Nigeria.

Methods

This was a cross-sectional survey involving consecutively recruited community-dwelling adults without a previous history of stroke. The Modified Framingham Stroke Risk Score (MFSRS) was used to evaluate the stroke risk profile of the participants. Data was analysed using descriptive and inferential statistics at an alpha level of 0.05.

Result

310 individuals (mean age = 37.21 ± 15.84 years; 68.7% females) participated in this study. The mean MFSRS (6.79 ± 5.21) of the participants was minimal with 16% having a moderate-to-high risk. Dyslipidaemia (100.0%), meat (88.1%) and sugar (70.6%) consumption, hypertension (37.7%), physical inactivity (43.2%), and psychological stress (41.3%) were the most prevalent risk factors in the population. Participants' MFSRS significantly and positively correlated with their body mass index (BMI), waist circumference (WC), and waist-hip ratio (WHR) and significantly differed across their gender, educational, and occupational categories (p < 0.05).

Conclusion

According to MFSRS, the risk of stroke among the sampled community was minimal and was significantly influenced by their BMI, WC, WHR, gender, education, and occupation. However, results revealed that stroke risk might be higher in the population than was depicted by the MFSRS. Enlightenment on the risk of stroke is needed in the community.

Periodontitis in individuals with few remaining teeth and a high gingival bleeding index increases the probability of dyslipidemia

BACKGROUND

Dyslipidemia, a silent multifactorial condition, is characterized by changes in blood lipid levels, affecting all socioeconomic strata, increasing the risk for atherosclerotic diseases. This study investigated whether there is an association between dyslipidemia and the combined exposure of periodontitis plus the number of remaining teeth, gingival bleeding, or caries.

METHODS

A two-center cross-sectional study was conducted involving 1270 individuals, with a minimum age of 18 years. Socioeconomic and demographic data, health conditions, lifestyle parameters, and anthropometric, biochemical, and oral clinical examinations were performed. The exposures considered were the presence of periodontitis, dental caries, number of remaining teeth, and gingival bleeding. The outcome was dyslipidemia as defined by the Brazilian Guidelines on Dyslipidemia and Prevention of Atherosclerosis. The combined associations between periodontitis plus other oral health conditions and dyslipidemia were estimated using confounder-adjusted prevalence ratios (PRsingle , PRmultiple , for single and multiple covariable adjustments) with 95% confidence intervals (95% CIs), in a Poisson regression model with robust variance.

RESULTS

The occurrence of dyslipidemia was 70.1% and periodontitis was 84.1%. A positive association between periodontitis and dyslipidemia existed: PRsingle  = 1.13; 95% CI: 1.01-1.26. Combined exposure of periodontitis plus <11 remaining teeth (PRmultiple  = 1.23; 95% CI: 1.05-1.43), as well as combined exposure of periodontitis plus ≥10% gingival bleeding and <11 remaining teeth (PRmultiple  = 1.22; 95% CI: 1.03-1.44), represented greater probabilities of 23% and 22% of individuals having a diagnosis of dyslipidemia.

CONCLUSION

Periodontitis combined with fewer than 11 teeth doubled the likelihood of being diagnosed with dyslipidemia.

Adherence to Atrial Fibrillation Better Care (ABC) Pathway Management of Chinese Community Elderly Patients with Atrial Fibrillation: A Cross-Sectional Study

Background

Investigating adherence to the Atrial Fibrillation Better Care (ABC) pathway management and identifying gaps between the real world and established guidelines can lead to better integrated management of AF. Current data on adherence to ABC pathway management among community elderly patients with atrial fibrillation (AF) in Chinese communities is limited.

Aim

To investigate the adherence to ABC pathway management among community elderly patients with AF in China.

Methods

In this cross-sectional study, data were collected from the 2020 National Basic Public Health Service Program database that includes health examination information for all residents >65 years of age in Yuexiu, Guangzhou, Guangdong Province. Demographic and clinical characteristics data from 197 community AF patients were obtained.

Results

Among the 197 AF patients, 103 (52.3%) were male, 117 (59.4%) were ≥75 years of age, 127 (64.5%) had a senior middle school education or above, 84.3% were married, and 195 (99.0%) had medical insurance. The most common comorbidities were hypertension (72.1%, 142/197), dyslipidaemia (28.4%, 56/197), CAD (28.9%, 57/197), and diabetes (24.9%, 49/197). In terms of the ABC management pathway, 21.8% (43/197), 82.7% (163/197), and 31.5% (62/197) of AF patients were classified into the A-adherent group, B-adherent group, and C-adherent group, respectively. The level of adherence to ABC pathway management was very low (9.1%, 18/197) and independently associated with age and multimorbidity.

Conclusion

The level of adherence to ABC pathway management in community elderly patients with AF was unsatisfactory. Further research is warranted to improve the integrated management of AF.

Prevalence, awareness, treatment, and control of dyslipidemia in Chinese adults: a systematic review and meta-analysis

Background

Researchers have conducted a considerable number of epidemiological studies on dyslipidemia in China over recent years. Nevertheless, a representative study to comprehensively appraise for the epidemiological status of dyslipidemia is still lacked. This meta-analysis is intended to explore the pooled prevalence, rates of awareness, treatment, and control of dyslipidemia among adults in Chinese Mainland.

Materials and methods

A systematic review was performed on relevant cross-sectional studies published since January 2012 by searching six authoritative literature databases. Meta-analyses were conducted in included studies based on a random-effect model to summarize the epidemiological status of dyslipidemia in China. A potential source of heterogeneity was detected by subgroup analysis and meta-regression. Publication bias was assessed by Egger's test and funnel plots. A sensitivity analysis was conducted to examine the study quality's influence on the pooled estimate of prevalence and rates of awareness, treatment, and control.

Results

Forty-one original researches with a total of 1,310,402 Chinese participants were finally included in the meta-analysis. The prevalence, rates of awareness, treatment, and control of dyslipidemia were 42.1%, 18.2%, 11.6%, and 5.4%, respectively. With a pooled prevalence estimate at 24.5%, low HDL-C was the most prevalent among various dyslipidemia types, followed by hypertriglyceridemia (TG) (15.4%), hypercholesterolemia (TC) (8.3%), and high LDL-C (7.1%). The pooled prevalence of elevated serum lipoprotein(a) [Lp(a)] was 19.4%. By gender, the prevalence of dyslipidemia was 47.3% in males and 38.8% in females. Subgroup analyses revealed that the prevalence in southern and urban areas were higher than their counterparts. Females and population in urban areas tended to possess higher rates of awareness, treatment, and control. Meta-regression analyses suggested that the year of screening influenced prevalence estimates for dyslipidemia. The impact of the study's quality on the pooled estimates is insignificant.

Conclusion

Our study suggested a severe epidemic situation of dyslipidemia among adults in Chinese Mainland. More importantly, the awareness, treatment, and control rates were extremely low, revealing that dyslipidemia is a grave health issue. Consequently, we should attach more importance to the management of dyslipidemia, especially in economically underdeveloped areas.

Systematic review registration

PROSPERO [CRD42022366456].

Circadian rhythm sleep-wake disorders and the risk of dyslipidemia among railway workers in southwest China: A cross-sectional study

Railway workers are more likely to have an irregular work schedule, which had an effect on their circadian rhythm of sleep, and may lead to circadian rhythm sleep-wake disorders (CRSWDs). The association between CRSWDs and dyslipidemia in railway workers is poorly understood. The objective of this research is to study the association between CRSWDs and the risk of dyslipidemia. This cross-sectional study was conducted among railway workers in Southwest China. CRSWDs were assessed by the morningness-eveningness questionnaire self-assessment version (MEQ-SA). The blood samples were collected in the morning and the lipids of participants were measured. Associations of CRSWDs with dyslipidemia and its components were analyzed. A total of 8079 participants were enrolled in this study, and the results revealed that shift work sleep disorder (SWD) and advanced sleep-wake phase disorder (ASWPD) were associated with a higher risk of dyslipidemia (OR 1.17, 95%CI 1.06-1.29, P < 0.01; OR 1.68, 95%CI 1.09-2.64, P < 0.05) after adjusting for sociodemographic characteristics and lifestyles, in comparison with the control group. As for its components, the SWD group was associated with a higher risk of elevated total cholesterol, triglycerides, and low-density lipoprotein than the control group, while the ASWPD group was associated with a higher risk of elevated total cholesterol, and low-density lipoprotein (P < 0.05). In summary, SWD and ASWPD participants were associated with a higher risk of dyslipidemia in railway workers in Southwest China.Abbreviation: TG: triglyceride; TC: Total cholesterol; LDL-C: low-density lipoprotein cholesterol; HDL-C: high-density lipoprotein cholesterol; FPG: fasting plasma glucose. MEQ-SA: morningness-eveningness questionnaire self-assessment version; IPW: inverse-probability weighting; HDS: healthy diet scores; FFQ: food frequency; PA: physical activity; IQAP-SF: international physical activity questionnaire short form; MET-min/wk: metabolic equivalent task minutes per week; BMI: body mass index; SBP: systolic blood pressure; DBP: diastolic blood pressure; HBP: hypertension; DM: diabetes; CVD: cerebrovascular disease; OR: odds ratios; CI: confidence intervals.

Association of serum lipid levels and clinical outcomes in early breast cancer patients

Background

The association between dyslipidaemia and breast cancer remains controversial, especially regarding the dynamic changes in lipid levels.

Objectives

This study aimed to elucidate the role of serum lipid levels and the changes in disease outcomes in patients with breast cancer.

Methods

The lipid profiles of patients with breast cancer who underwent surgery between 2013 and 2017 were retrospectively reviewed. The lipid profiles comprised triglyceride (TG), total cholesterol, high-density lipoprotein (HDL), and low-density lipoprotein. Serum lipid levels were categorized into three groups based on the tertiles. The Wilcoxon test was used to compare changes in serum lipid levels during follow-up. Hazard ratios (HRs) for survival outcomes were estimated using a multivariate Cox regression analysis.

Results

A total of 3499 women diagnosed with nonmetastatic invasive breast cancer were included in this study, with a median follow-up of 60.4 months. We confirmed that each 1-tertile increased TG at baseline [HR = 1.19, 95% confidence interval (CI) 1.02-1.39] and 1-year follow-up (HR = 1.46, 95% CI 1.07-1.98) led to worse relapse-free survival (RFS). A lower risk of disease relapse was observed with each 1-tertile upregulation in HDL at 1-year follow-up (HR = 0.72, 95% CI 0.56-0.92). Receiving systemic therapies tends to induce an elevation in plasma lipid levels 1 year after surgery, especially in terms of TG. Regarding the prognostic value of dynamic changes in lipid levels, patients with sustained high levels of TG had poorer RFS (HR = 1.90, 95% CI 1.16-3.11), whereas maintaining high levels of HDL led to better survival (HR = 0.60, 95% CI 0.37-0.97).

Conclusion

High TG at baseline and during follow-up was associated with worse disease outcome in early breast cancer patients. Systemic treatment would lead to an elevation of serum lipid levels. Patients with sustained high HDL level at 1-year follow-up after surgery had a superior prognosis, warranting further clinical evaluation.

Systematic literature review and meta-analysis of cardiovascular risk factor management in selected Asian countries

Aim: There is a need to understand the management status of hypertension, dyslipidemia/hypercholesterolemia, and diabetes mellitus in the Asia-Pacific region (APAC). Methods: We conducted a systematic literature review and meta-analysis to summarize the awareness, treatment, and/or control rates of these risk factors in adults across 11 APAC countries/regions. Results: We included 138 studies. Individuals with dyslipidemia had the lowest pooled rates compared with those with other risk factors. Levels of awareness with diabetes mellitus, hypertension, and hypercholesterolemia were comparable. Individuals with hypercholesterolemia had a statistically lower pooled treatment rate but a higher pooled control rate than those with hypertension. Conclusion: The management of hypertension, dyslipidemia, and diabetes mellitus was suboptimal in these 11 countries/regions.

The global syndemic of metabolic diseases in the young adult population: A consortium of trends and projections from the Global Burden of Disease 2000-2019

BACKGROUND

A significant proportion of premature deaths globally are related to metabolic diseases in young adults. We examined the global trends and mortality of metabolic diseases in individuals aged below 40 years using data from the Global Burden of Diseases, Injuries and Risk Factors Study (GBD) 2019.

METHODS

From 2000 to 2019, global estimates of deaths and disability-adjusted life years (DALYs) were described for metabolic diseases (type 2 diabetes mellitus [T2DM], hyperlipidemia, hypertension, obesity, non-alcoholic fatty liver disease [NAFLD]). Subgroup analyses were performed based on sex, geographical regions and Socio-Demographic Index (SDI). Age-standardised death and DALYs were presented per 100,000 population with 95 % uncertainty intervals (UI). Projections of mortality and DALYs were estimated using regression models based on the GBD 2019 data and combining them with Institute for Health Metrics and Evaluation projection counts for years up to 2050.

RESULTS

In 2019, the highest age-standardised death rates were observed in hypertension (133·88 [121·25-155·73]), followed by obesity (62·59 [39·92-89·13]), hyperlipidemia (56·51 [41·83-73·62]), T2DM (18·49 [17·18-19·66]) and NAFLD (2·09 [1·61-2·60]). Similarly, obesity (1932·54 [1276·61-2639·74]) had the highest age-standardised DALYs, followed by hypertension (2885·57 [2580·75-3201·05]), hyperlipidemia (1207·15 [975·07-1461·11]), T2DM (801·55 [670·58-954·43]) and NAFLD (53·33 [40·73-68·29]). Mortality rates decreased over time in hyperlipidemia (-0·6 %), hypertension (-0·47 %), NAFLD (-0·31 %) and T2DM (-0·20 %), but not in obesity (1·07 % increase). The highest metabolic-related mortality was observed in Eastern Mediterranean and low SDI countries. By 2050, obesity is projected to contribute to the largest number of deaths (102·8 % increase from 2019), followed by hypertension (61·4 % increase), hyperlipidemia (60·8 % increase), T2DM (158·6 % increase) and NAFLD (158·4 % increase), with males continuing to bear the greatest burden across all metabolic diseases.

CONCLUSION

The growing burden of metabolic diseases, increasing obesity-related mortality trends, and the sex-regional-socioeconomic disparities evident in young adulthood, underlie the concerning growing global burden of metabolic diseases now and in future.

Hypolipidemic effect of ethanol extract from Chimonanthus nitens Oliv. leaves in hyperlipidemia rats via activation of the leptin/JAK2/STAT3 pathway

BACKGROUND

This study aims to explore the protective role of ethanol extract from Chimonanthus nitens Oliv. leaf (COE) in hyperlipidemia via the leptin/Janus kinase 2 (JAK2)/signal transducer and activator of transcription 3 (STAT3) pathway.

METHODS

Male Sprague‒Dawley rats were randomly divided into 6 groups (n = 8): normal-fat diet (NMD), high-fat diet (HFD), HFD treated with simvastatin (SIM, 5 mg/kg/day), and HFD treated with COE (40, 80, 160 mg/kg/day). Lipid parameters, oxidative stress factors, serum leptin, body weight, hepatic wet weight and liver index were measured. Proteins in the leptin/JAK2/STAT3 pathway in liver tissues were determined using western blotting. Additionally, the expression levels of cytochrome P450 family 7 subfamily A member 1 (CYP7A1) and 3-hydroxy-3-methylglutaryl-CoA reductase (HMGCR) were quantified using western blotting and quantitative real-time polymerase chain reaction (qPCR).

RESULTS

COE decreased HFD-induced increases in body weight, hepatic wet weight and the liver index. HFD-induced hyperlipidemia and oxidative stress were observed in rat serum and livers. Additionally, COE repressed these two symptoms in rats fed a HFD. Moreover, COE caused CYP7A1 upregulation and HMGCR downregulation in HFD-fed rats. Mechanistically, COE induced the expression of leptin receptor (OB-Rb) and JAK2 and STAT3 phosphorylation in HFD-treated rats.

CONCLUSION

COE activates the leptin/JAK2/STAT3 pathway, leading to an improvement in liver function and lipid metabolism and ultimately alleviating hyperlipidemia in rats. Therefore, COE may be a potential hypolipidemic drug for the treatment of hyperlipidemia.

Ethyl acetate extract of Caesalpinia sappan L. for the treatment of atherosclerosis in ApoE-/- mice and its mechanism

The ethyl acetate extract of Caesalpinia sappan L. is a traditional Chinese medicine extract commonly used in the treatment of atherosclerosis. However, the mechanism of its use in the treatment of AS is not yet clear, which seriously affects the wide-scale application of this drug. In this study, a combination of metabolomics and lipidomics was used to analyze cardiac tissue to obtain differential metabolites and differential lipid molecules, bioinformatic analysis was performed on the significantly different metabolites and subclass analysis, cluster analysis, and chain length and chain saturation analyses were performed on screened lipid molecules showing significant differences. A correlation network diagram of the screened differential metabolites and differential lipid molecules was constructed. Hematoxylin and eosin staining of thoracic aorta in rats confirmed its therapeutic effect. This study found that the ethyl acetate extract of C. sappan L. upregulates D-mannose through the lysosome pathway, enhances lysosomal function, mediates autophagy, and indirectly regulates the levels of lipid subtypes such as lysophosphatidylinositol and phosphatidylserine, thereby improving AS.

The effects of olive oil consumption on blood lipids: a systematic review and dose-response meta-analysis of randomised controlled trials

We performed a systematic review and dose-response meta-analysis of randomised trials on the effects of olive oil consumption on blood lipids in adults. A systematic search was performed in PubMed, Scopus and Web of Science databases until May 2021. Randomised controlled trials (RCT) evaluating the effect of olive oil intake on serum total cholesterol (TC), TAG, LDL-cholesterol and HDL-cholesterol in adults were included. The mean difference (MD) and 95 % CI were calculated for each 10 g/d increment in olive oil intake using a random-effects model. A total of thirty-four RCT with 1730 participants were included. Each 10 g/d increase in olive oil consumption had minimal effects on blood lipids including TC (MD: 0·79 mg/dl; 95 % CI (-0·08, 1·66); I² = 57 %; n 31, GRADE = low certainty), LDL-cholesterol (MD: 0·04 mg/dl, 95 % CI (-1·01, 0·94); I² = 80 %; n 31, GRADE = very low certainty), HDL-cholesterol (MD: 0·22 mg/dl; 95 % CI (-0·01, 0·45); I² = 38 %; n 33, GRADE = low certainty) and TAG (MD: 0·39 mg/dl; 95 % CI (-0·33, 1·11); I² = 7 %; n 32, GRADE = low certainty). Levels of TC increased slightly with the increase in olive oil consumption up to 30 g/d (MD_{30 g/d}: 2·76 mg/dl, 95 % CI (0·01, 5·51)) and then appeared to plateau with a slight downward curve. A trivial non-linear dose-dependent increment was seen for HDL-cholesterol, with the greatest increment at 20 g/d (MD_{20 g/d}: 1·03 mg/dl, 95 % CI (-1·23, 3·29)). Based on existing evidence, olive oil consumption had trivial effects on levels of serum lipids in adults. More large-scale randomized trials are needed to present more reliable results.

Risk Prediction Performance of the Thai Cardiovascular Risk Score for Mild Cognitive Impairment in Adults with Metabolic Risk Factors in Thailand

Individuals with metabolic risks are at high risk of cognitive impairment. We aimed to investigate whether the Thai Cardiovascular Risk (TCVR) score can be used to predict mild cognitive impairment (MCI) in Thai adults with metabolic risks. The study was conducted using secondary data of patients with metabolic risks from Maharaj Nakorn Chiang Mai Hospital. MCI was indicated by an MoCA score of less than 25. Six different TCVR models were used with various combinations of ten different variables for predicting the risk of MCI. The area under the receiver operator characteristic curve (AuROC) and Hosmer–Lemeshow goodness of fit tests were used for determining discriminative performance and model calibration. The sensitivity of the discriminative performance was further evaluated by stratifying by age and gender. From a total of 421 participants, 348 participants had MCI. All six TCVR models showed a similar AuROC, varying between 0.58 and 0.61. The anthropometric-based model showed the best risk prediction performance in the older age group (AuROC 0.69). The laboratory-based model provided the highest discriminative performance for the younger age group (AuROC 0.60). There is potential for the development of an MCI risk model based on values from routine cardiovascular risk assessments among patients with metabolic risks.

Association of healthy lifestyles on the risk of hypertension, type 2 diabetes mellitus, and their comorbidity among subjects with dyslipidemia

Background

Adherence to a healthy lifestyle could reduce the risk of hypertension and diabetes in general populations; however, whether the associations exist in subjects with dyslipidemia remains unclear. This study aimed to investigate the integrated effect of lifestyle factors on the risk of hypertension, type 2 diabetes mellitus (T2DM), and their comorbidity among subjects with dyslipidemia.

Methods

In total of 9,339 subjects with dyslipidemia were recruited from the baseline survey of the Guangzhou Heart Study. A questionnaire survey and medical examination were performed. The healthy lifestyle score (HLS) was derived from five factors: smoking, alcohol drinking, diet, body mass index, and leisure-time physical activity. Odds ratios (ORs) with 95% confidence interval (95% CI) were calculated by using the logistic regression model and the multinomial logistic regression after adjusting for confounders.

Results

The prevalence of hypertension, T2DM, and their comorbidity was 47.65, 16.02, and 10.10%, respectively. Subjects with a higher HLS were associated with a lower risk of hypertension, T2DM, and their comorbidity. In comparison to the subjects with 0–2 HLS, the adjusted ORs for subjects with five HLS was 0.48 (95% CI: 0.40–0.57) and 0.67 (95% CI: 0.54–0.84) for hypertension and T2DM. Compared with subjects with 0-2 HLS and neither hypertension nor T2DM, those with five HLS had a lower risk of suffering from only one disease (OR: 0.48, 95% CI: 0.40–0.57) and their comorbidity (OR: 0.35, 95% CI: 0.26–0.47).

Conclusions

The results suggest that the more kinds of healthy lifestyle, the lower the risk of hypertension, T2DM, and their comorbidity among subjects with dyslipidemia. Preventive strategies incorporating lifestyle factors may provide a more feasible approach for the prevention of main chronic diseases.

The underlying mechanisms of cold exposure-induced ischemic stroke

Growing evidence suggests that cold exposure is to some extent a potential risk factor for ischemic stroke. At present, although the mechanism by which cold exposure induces ischemic stroke is not fully understood, some potential mechanisms have been mentioned. First, the seasonal and temperature variability of cerebrovascular risk factors (hypertension, hyperglycemia, hyperlipidemia, atrial fibrillation) may be involved. Moreover, the activation of sympathetic nervous system and renin-angiotensin system and their downstream signaling pathways (pro-inflammatory AngII, activated platelets, and dysfunctional immune cells) are also major contributors. Finally, the influenza epidemics induced by cold weather are also influencing factors that cannot be ignored. This article is the first to systematically and comprehensively describe the underlying mechanism of cold-induced ischemic stroke, aiming to provide more preventive measures and medication guidance for stroke-susceptible individuals in cold season, and also provide support for the formulation of public health policies.

Dyslipidemia research landscape and socioeconomic facilitators of scientific productivity in Southeast Asia

BACKGROUND

The growing prevalence of lipid disorder in Southeast Asia (SEA) resulted in an increase in clinical and epidemiological studies on dyslipidemia in the region. Thus, there is a need to summarize the existing evidence from the literature.

AIMS

This paper determined the research landscape of dyslipidemia in SEA. This study also identified the socioeconomic facilitators of scientific productivity in dyslipidemia research in SEA.

METHODS

A database search of dyslipidemia literature in SEA countries was performed using the Scopus database. Bibliographic information was obtained, and network visualization of collaboration among countries and keywords was created using VOSviewer software.

RESULTS

This bibliometric analysis showed a continuous increase in published articles in SEA, most of which were from universities and hospitals in Thailand, Singapore, Malaysia, and Indonesia. The usual topics of dyslipidemia research in SEA include epidemiology, pathophysiology, comorbidities and complications, and treatment options for dyslipidemia. Research & development expenditure (total citations: p = 0.037; h-index: p = 0.031) and researchers in R&D (total citations: p = 0.005; h-index: p = 0.017) were positively correlated with citations and h-index for dyslipidemia publications from SEA countries. Moreover, the number of research collaborations within SEA and worldwide was positively correlated with the total publications, citations, and h-index of SEA countries for their dyslipidemia research outputs.

CONCLUSION

In summary, this bibliometrics study showed an increasing trend of dyslipidemia research in SEA countries. Policymakers and administrators should invest more in dyslipidemia studies to propose better strategies in curbing the prevalence of this condition in SEA.

Incremental significance and sex discrepancies of neck circumference on the odds of ischaemic stroke: a multistage, population-based, cross-sectional study from Northeast China

OBJECTIVES

Accumulated evidence suggests that neck circumference (NC) is associated with cardiometabolic risk factors. However, limited studies are available regarding the association between NC or height normalised NC (neck-to-height ratio (NHR)) and risk of ischaemic stroke (IS) in the Chinese population. Therefore, we aimed at examining the associations between NC or NHR and odds of IS and exploring the discrepancies between men and women.

DESIGN

A multistage cluster cross-sectional study.

SETTING

A population-based study carried out in Northeast China.

METHODS

A cross-sectional study was undertaken in Northeast China between September 2017 and March 2019, involving 7236 men and 11 352 women, respectively. The median age of participants was 60.30 years, ranging from 40 to 97 years. The associations between NC or NHR and odds of IS were calculated using multiple logistic regression models. Dose-response relationships were depicted using restricted cubic spline functions. Reclassification analyses were carried out to determine the incremental significance of NC or NHR on the odds of IS.

RESULTS

In women, NC and NHR were significantly associated with the odds of IS, independent of traditional risk factors and other anthropometric parameters for obesity. The highest quartile of NC and NHR had a 1.60 (95% CI 1.16 to 2.22)-and 1.72 (95% CI 1.23 to 2.41) times higher odds of IS compared with the lowest quartile. Furthermore, the odds of IS increased by 1.10 (95% CI 1.01 to 1.20) and 1.12 (95% CI 1.02 to 1.22) times per 1 SD increase in NC and NHR, respectively. Reclassification analyses showed that the proportion of correct classification increased by 11.5% (95% CI 2.2% to 20.7%) and 22.8% (95% CI 13.5% to 32.0%) after the addition of NC or NHR into established models, respectively. However, the findings could not be replicated in men.

CONCLUSION

NC and NHR might be promising independent indicators for women IS. Their incremental value in the risk stratification of IS enables the individualised prevention of IS in women.

Potential of the Compounds from Bixa orellana Purified Annatto Oil and Its Granules (Chronic®) against Dyslipidemia and Inflammatory Diseases: In Silico Studies with Geranylgeraniol and Tocotrienols

Some significant compounds present in annatto are geranylgeraniol and tocotrienols. These compounds have beneficial effects against hyperlipidemia and chronic diseases, where oxidative stress and inflammation are present, but the exact mechanism of action of such activities is still a subject of research. This study aimed to evaluate possible mechanisms of action that could be underlying the activities of these molecules. For this, in silico approaches such as ligand topology (PASS and SEA servers) and molecular docking with the software GOLD were used. Additionally, we screened some pharmacokinetic and toxicological parameters using the servers PreADMET, SwissADME, and ProTox-II. The results corroborate the antidyslipidemia and anti-inflammatory activities of geranylgeraniol and tocotrienols. Notably, some new mechanisms of action were predicted to be potentially underlying the activities of these compounds, including inhibition of squalene monooxygenase, lanosterol synthase, and phospholipase A₂. These results give new insight into new mechanisms of action involved in these molecules from annatto and Chronic^®.

Sex-specific prediction value of common carotid artery diameter for stroke risk in a hypertensive population: a cross-sectional study

BACKGROUND

The importance of sex as a risk factor for stroke has been established. This study aimed to assess sex-related disparities in carotid artery diameter and stroke in a hypertensive population.

METHODS

The cross-sectional survey was conducted in rural areas of northeast China. A multistage cluster sampling method was employed to select a representative population. The study comprised 3,245 individuals with hypertension. The common carotid artery (CCA) interadventitial diameter was measured by ultrasound. A linear model of restricted cubic spline function was used to characterize the concentration-response (C-R) relationship between CCA diameter and stroke.

RESULTS

The overall prevalence of stroke was 8.9% among hypertensive individuals, with a higher rate in men than in women (10.8% vs. 7.6%). When the women's CCA diameters were divided into quartiles, the top quartile (>8.10 mm) had a 2.49 (95% CI: 1.36-4.56) times greater risk of stroke compared to the bottom quartile (≤6.80 mm) after adjustment was made for other variables. The C-R relationship further confirmed a positive association between CCA diameter and stroke prevalence in women. Moreover, a category-free net reclassification index (0.325; 95% CI: 0.173-0.476; P<0.001) and an integrated discrimination index (0.008; 95% CI: 0.004-0.012, P<0.001) showed improvement in predicting the probability of stroke from CCA diameter. However, no significant relationship between CCA diameter and prevalence of stroke was found in men.

CONCLUSIONS

The risk of stroke increased proportionally with the enlargement of the CCA diameter in women, supporting the sex-specific value of CCA diameter in optimizing the risk stratification of stroke.

Job stress and satisfaction in southwest Chinese hospitals: A cross-sectional study

This paper discusses the job characteristics, satisfaction, and stress levels experienced by clinical neurologists in Guizhou Province, China.A questionnaire survey was conducted associated with the 2021 Annual Meeting of Neurology in Guizhou province. After obtaining ethical approval to conduct the study, the target group was asked to complete an anonymous online survey that included sociodemographic data, followed by questions related to job stress and satisfaction as well as future aspirations.Four hundred sixty people participated in the study, including 179 (38.9%) men and 281 (61.1%) women. About 407 (88.5%) felt stress in their job. Three hundred and seventeen (68.9%) experienced depression, 307 (66.7%) experienced anxiety, and 273 (59.3%) had some degree of sleep disturbance. Three hundred fifty-three (76.7%) were disappointed with their wages, 239 (52.0%) were bored with their jobs, and 353 (76.7%) considered their jobs to be somewhat dangerous. Interestingly, 250 (54.3%) would consider becoming doctors again, but 354 (77.0%) preferred their child not to become doctors. While 338 (73.5%) said they were proud to be a neurologist, only 123 (26.7%) indicated they were optimistic concerning doctor-patient relationships.Neurologists have significant emotional factors associated with their careers, which are more likely to lead to job burnout and decreased job satisfaction. Attention should be paid to these stresses to improve the retention and job satisfaction of neurologists.

Lipoprotein Profile in Populations from Regions of the Russian Federation: ESSE-RF Study

This study aimed to describe the dyslipidemia prevalence and pattern among adult populations from different regions (n = 13) of the Russian Federation (RF). Randomly selected samples (n = 22,258, aged 25-64) were studied according to the ESSE-RF protocol. Lipoprotein parameters were estimated by routine methods. Statistical analyses were performed using R software (v.3.5.1). The overall dyslipidemia prevalence was 76.1% (76.9/75.3% for men/women). In women, total cholesterol (TC) and low-density lipoprotein (LDL)-C levels gradually increased with age (from 4.72 to 5.93 and from 2.76 to 3.79 mmol/L, respectively); in men, they reached a maximum by 45-54 (5.55 and 3.55 mmol/L, respectively) and then decreased. No differences in high-density lipoprotein (HDL)-C in men of different ages were found, but slight decreases in HDL-C and apo AI were observed in women by 55-64 years. No pronounced associations between education and lipid levels in men were observed; higher-educated women showed significantly better lipoprotein profiles. Similar associations between lipids and income level were detected. Women from rural areas had higher TC and triglycerides than urban residents. Regardless of sex, rural residents had higher HDL-C and apo AI, and reduced apo B/apo AI. Conclusion: Information on the peculiarities of dyslipidemia prevalence and lipoprotein profile depending on sex, age, residential place, and socioeconomic status is useful for assessing the global ASCVD risk, and for risk modeling based on national data.

Factors Determining the Three-Year Dynamics of Lipid Metabolism Indicators in Residents of a Large Industrial Region of Siberia

Aim. To assess the contribution of traditional and socio-economic factors to the development and dynamics of dyslipidemia based on the results of an epidemiological study in a large region of Siberia.

Material and methods. Clinical and epidemiological prospective study of the population 35-70 years old was carried out. At the basic stage, 1600 participants were examined, including 1124 women and 476 men, the prospective stage included 807 respondents (the response was 84.1%). A survey was carried out to find out the state of health (presence of diseases, taking medications), socio-economic status (level of education and income, marital status) and the presence of behavioral risk factors (tobacco and alcohol use).

Results. The proportion of people with hypercholesterolemia increased 1.2 times, low LDL – 1.1 times, and hypertriglyceridemia and low HDL – 1.7 times. In persons with hypertriglyceridemia, the frequency of detected obesity and hypertension decreased by 7.9% and 4.6%, respectively (p = 0.046). Obesity was associated with an increased risk of developing hypercholesterolemia (OR = 1.49, CI: 1.0-2.2), hypertriglyceridemia (OR = 2.14, CI: 1.5-3.0), high LDL cholesterol (OR = 2.16, CI: 1.3-3.6) and low HDL cholesterol (OR = 2.07, CI: 1.5-2.9). The presence of hypertension - with an increased risk of developing hypertriglyceridemia (OR = 2.19, CI: 1.5-3.1) and low HDL (OR = 2.49, CI: 1.8-3.5). Among people with low HDL levels, the number of smokers and drinkers decreased (by 7.0% and 5.7%, respectively), as well as those with obesity by 8.6%. The prevalence of dyslipidemia increased in all socioeconomic groups.

Conclusion. Over 3 years of follow-up, there was a statistically significant increase in the proportion of persons with dyslipidemia in all socio-economic groups. There was a significant decrease in such risk factors as obesity, hypertension, smoking, alcohol consumption and an increase in the number of respondents taking lipid-lowering therapy.

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.

Time series decomposition into dyslipidemia prevalence among urban Chinese population: secular and seasonal trends

BACKGROUND

Previous epidemiological studies have indicated the seasonal variability of serum lipid levels. However, little research has explicitly examined the separate secular and seasonal trends of dyslipidemia. The present study aimed to identify secular and seasonal trends for the prevalence of dyslipidemia and the 4 clinical classifications among the urban Chinese population by time series decomposition.

METHODS

A total of 306,335 participants with metabolic-related indicators from January 2011 to December 2017 were recruited based on routine health check-up systems. Multivariate direct standardization was used to eliminate uneven distributions of the age, sex, and BMI of participants over time. Seasonal and trend decomposition using LOESS (STL decomposition) was performed to break dyslipidemia prevalence down into trend component, seasonal component and remainder component.

RESULTS

A total of 21.52 % of participants were diagnosed with dyslipidemia, and significant differences in dyslipidemia and the 4 clinical classifications were observed by sex (P <0.001). The secular trends of dyslipidemia prevalence fluctuated in 2011-2017 with the lowest point in September 2016. The dyslipidemia prevalence from January to March and May to July was higher than the annual average (λ = 1.00, 1.16, 1.06, 1.01, 1.02, 1.03), with the highest point in February. Different seasonal trends were observed among the 4 clinical classifications. Compared to females, a higher point was observed among males in February, which was similar to participants aged < 55 years (vs. ≥ 55 years) and participants with a BMI ≤ 23.9 (vs. BMI > 23.9).

CONCLUSIONS

There were significant secular and seasonal features for dyslipidemia prevalence among the urban Chinese population. Different seasonal trends were found in the 4 clinical classifications of dyslipidemia. Precautionary measures should be implemented to control elevated dyslipidemia prevalence in specific seasons, especially in the winter and during traditional holidays.

A cohort study on risk factors of high-density lipoprotein cholesterol hypolipidemia among urban Chinese adults

Background

High-density lipoprotein cholesterol (HDL-C) hypolipidemia, a major type of dyslipidemia, has been associated with many kinds of diseases, such as stroke, coronary heart disease, obesity and diabetes, and has displayed an increasing prevalence in China. This study explores the risk factors of HDL-C hypolipidemia and makes recommendations for controlling and preventing HDL-C hypolipidemia and the diseases caused by it.

Methods

Using a retrospective cohort study design, 26,863 urban adults without dyslipidemia, diabetes, cardiovascular and cerebrovascular diseases, hepatosis, renal insufficiency and thyroid diseases were enrolled in the study between 2010 and 2015. Data on each individual were collected at the 2010 baseline year and at a follow-up medical check. A Cox regression model was constructed to evaluate the influence of potential risk factors on the outcome event- HDL-C hypolipidemia.

Results

The incidence of HDL-C hypolipidemia was 5.7% (1531/26863). Sex, age, body mass index (BMI), HDL-C, triglyceride (TG) and urea nitrogen (UN) were significant risk factors of HDL-C hypolipidemia. Men were more likely to develop HDL-C hypolipidemia than women during follow-up medical checks (HR = 1.258, P = 0.014). The incidence of HDL-C hypolipidemia in the over 65 years old group was higher than that of the ≤65 age group (HR = 1.276, P = 0.009). The incidence of HDL-C hypolipidemia increased with increasing BMI (HR = 1.030, P = 0.002), TG (HR = 1.321, P = 0.001) and UN (HR = 1.054, P = 0.019), while falling with increasing HDL-C in the baseline year (HR = 0.002, P < 0.001).

Conclusions

Men, aged over 65, with high BMI were at the highest risk of developing HDL-C hypolipidemia. Measures should be taken to prevent HDL-C hypolipidemia even for healthy urban adults whose blood biochemical indicators were in the normal range when their level of TG, UN and HDL-C are closed to the border of the normal value range.