Relations of Lifestyle Behavior Clusters to Dyslipidemia in China: A Compositional Data Analysis

Association of baseline and dynamic arterial stiffness status with dyslipidemia: a cohort study

Background and aims

Dyslipidemia is known to contribute to arterial stiffness, while the inverse association remains unknown. This study aimed to explore the association of baseline arterial stiffness and its changes, as determined by brachial-ankle pulse wave velocity (baPWV), with dyslipidemia onset in the general population.

Methods

This study enrolled participants from Beijing Health Management Cohort using measurements of the first visit from 2012 to 2013 as baseline, and followed until the dyslipidemia onset or the end of 2019. Unadjusted and adjusted Cox proportional regression models were used to evaluate the associations of baseline baPWV and baPWV transition (persistent low, onset, remitted and persistent high) with incident dyslipidemia.

Results

Of 4362 individuals (mean age: 55.5 years), 1490 (34.2%) developed dyslipidemia during a median follow-up of 5.9 years. After adjusting for potential confounders, participants with elevated arterial stiffness at baseline had an increased risk of dyslipidemia (HR, 1.194; 95% CI, 1.050-1.358). Compared with persistent low baPWV, new-onset and persistent high baPWV were associated with a 51.2% and 37.1% excess risk of dyslipidemia.

Conclusion

The findings indicated that arterial stiffness is an early risk factor of dyslipidemia, suggesting a bidirectional association between arterial stiffness and lipid metabolism.

Relationship between Serum Ferritin Level and Dyslipidemia in US Adults Based on Data from the National Health and Nutrition Examination Surveys 2017 to 2020

Previous research has suggested that high serum ferritin (SF) levels may be associated with dyslipidemia. This study investigated the association between SF levels and dyslipidemia in American adults, which held relevance for both clinical and public health areas concerned with screening and prevention. Data from the pre-pandemic National Health and Nutrition Examination Surveys (NHANES), conducted between 2017 and 2020, were utilized for this analysis. Multivariate linear regression models were used to explore the correlation between lipid and SF concentrations, and the connection between SF and the four types of dyslipidemia was further assessed by using multivariate logistic regression analysis. Odds ratios (ORs; 95% CI) for dyslipidemia were calculated for quartiles of SF concentrations, with the lowest ferritin quartile as the reference. The final subjects consisted of 2676 participants (1290 males and 1386 females). ORs for dyslipidemia were the highest in the fourth quartile (Q4) of SF both in males (OR: 1.60, 95% CI: 1.12-2.28) and females (OR: 1.52, 95% CI: 1.07-2.17). The crude ORs (95% CI) for the risk of High TC and High LDL-C increased progressively in both genders. However, after adjusting for covariates, the trend of significance was only present in females. Finally, the association between total daily iron intake and the four types of dyslipidemia was examined, revealing that the risk of High TG in the third quartile of the total daily iron intake was 2.16 times greater in females (adjusted OR: 3.16, 95% CI: 1.38-7.23). SF concentrations were remarkably associated with dyslipidemia. In females, daily dietary iron intake was associated with High-TG dyslipidemia.

Cobalt exposure and dyslipidemia in elderly population: the mediating role of systemic inflammation and lipid peroxidation

Heavy metal exposure has been reported to be correlated with lipid profile alteration and dyslipidemia. While the associations between serum cobalt (Co) with lipid profile levels and risk of dyslipidemia have not been explored in elderly population, and the underlying mechanisms remain unclear. All eligible 420 elderly people were recruited in three communities of Hefei City in this cross-sectional study. Peripheral blood samples and clinical information were collected. The level of serum Co was detected through ICP-MS. The biomarkers for systemic inflammation (TNF-α) and lipid peroxidation (8-iso-PGF2α) were measured with ELISA. Each 1-unit increase of serum Co was related with 0.513 mmol/L, 0.196 mmol/L, 0.571 mmol/L, and 0.303 g/L in TC, TG, LDL-C, and ApoB, respectively. Multivariate linear and logistic regression analyses indicated that the prevalence of elevated TC, elevated LDL-C, and elevated ApoB were gradually increased according to tertiles of serum Co concentration (all P trend < 0.001). The risk of dyslipidemia was positively correlated with serum Co (OR = 3.500; 95% CI 1.630 ~ 7.517). Moreover, the levels of TNF-α and 8-iso-PGF2α were gradually risen in parallel with elevating serum Co. The elevation of TNF-α and 8-iso-PGF2α partially mediated Co-caused elevation of TC and LDL-C. Environmental Co exposure is associated with elevated lipid profile levels and dyslipidemia risk among elderly population. Systemic inflammation and lipid peroxidation partially mediate the associations of serum Co with dyslipidemia.

Associations of Socioeconomic Status and Healthy Lifestyle With Incidence of Dyslipidemia: A Prospective Chinese Governmental Employee Cohort Study

Objective

The purpose of the study was to test whether primary lifestyles mediate associations of SES with incidence of dyslipidemia and to explore interaction relations of lifestyles and SES with incidence of dyslipidemia.

Methods

We included 9,901 individuals at baseline from January 2018 to November 2019, and incidence data were updated to 31 December 2020. Dyslipidemia was defined as total cholesterol (TC) 6.2 mmol/L TC ≥ or triglycerides (TG) ≥2.3 mmol/L or low-density lipoprotein cholesterol (LDL-C) ≥4.1 mmol/L or high-density lipoprotein cholesterol (HDL-C) <1.0 mmol/L; or physician diagnosed dyslipidemia or lipid-lowering drugs use. Lifestyles, socioeconomic factors, and personal characteristics were collected by a questionnaire. A latent class analysis based on education, family income, and occupational position was used to assess the SES. Lifestyle score was calculated using cigarette smoking, alcohol consumption, physical activity, and diet. Cox proportional hazard models and multivariate analyses were used to explore the associations. The mediation effect was evaluated using bootstrap method.

Results

Participant mean age was 36.5 years (SD = 0.11). The cumulative incidence of dyslipidemia was 11.0% over a mean follow-up of 13.4 months. Compared with participants of high SES, those with low SES had higher risk of incidence of dyslipidemia [hazard ratio 1.32, 95% confidence interval (CI): 1.01–1.73], after adjusting for lifestyle scores and other covariates. The proportion mediated by lifestyles was 5.41% (95%CI: 4.17–7.11). A significant additive interaction was found between lifestyles and SES, whereas association between lifestyle and incidence of dyslipidemia was stronger among those of high SES. Additionally, individuals with low SES and no or one healthy lifestyle behavior had a higher risk of developing dyslipidemia than those with high SES and 3 or 4 healthy lifestyles.

Conclusion

Unhealthy lifestyles play a small moderating role in socioeconomic inequity in incidence of dyslipidemia among Chinese governmental employees, suggesting that promoting healthy lifestyles alone may not significantly reduce socioeconomic inequalities in health, and measures to address other social determinants of health should also be considered alongside.