National trends in total cholesterol obscure heterogeneous changes in HDL and non-HDL cholesterol and total-to-HDL cholesterol ratio: a pooled analysis of 458 population-based studies in Asian and Western countries
National trends in total cholesterol obscure heterogeneous changes in HDL and non-HDL cholesterol and total-to-HDL cholesterol ratio: a pooled analysis of 458 population-based studies in Asian and Western countries
Background: although high-density lipoprotein (HDL) and non-HDL cholesterol have opposite associations with coronary heart disease, multi-country reports of lipid trends only use total cholesterol (TC). Our aim was to compare trends in total, HDL and non-HDL cholesterol and the total-to-HDL cholesterol ratio in Asian and Western countries.
Methods: we pooled 458 population-based studies with 82.1 million participants in 23 Asian and Western countries. We estimated changes in mean total, HDL and non-HDL cholesterol and mean total-to-HDL cholesterol ratio by country, sex and age group.
Results: since ∼1980, mean TC increased in Asian countries. In Japan and South Korea, the TC rise was due to rising HDL cholesterol, which increased by up to 0.17 mmol/L per decade in Japanese women; in China, it was due to rising non-HDL cholesterol. TC declined in Western countries, except in Polish men. The decline was largest in Finland and Norway, at ∼0.4 mmol/L per decade. The decline in TC in most Western countries was the net effect of an increase in HDL cholesterol and a decline in non-HDL cholesterol, with the HDL cholesterol increase largest in New Zealand and Switzerland. Mean total-to-HDL cholesterol ratio declined in Japan, South Korea and most Western countries, by as much as ∼0.7 per decade in Swiss men (equivalent to ∼26% decline in coronary heart disease risk per decade). The ratio increased in China.
Conclusions: HDL cholesterol has risen and the total-to-HDL cholesterol ratio has declined in many Western countries, Japan and South Korea, with only a weak correlation with changes in TC or non-HDL cholesterol.
Adult, Age Factors, Aged, Asia, Asian People, Canada, Cholesterol/blood, Cholesterol, HDL, Cholesterol, LDL, Europe, Female, Humans, Lipids/blood, Male, Middle Aged, Population Surveillance/methods, Sex Factors, Triglycerides/blood, United States, White People
173-192
Cooper, Cyrus
e05f5612-b493-4273-9b71-9e0ce32bdad6
Ezzati, Majid
7a7b5aaa-39a1-428c-9dcb-06a4e7c6095f
NCD Risk Factor Collaboration (NCD-RisC)
Cooper, Cyrus
e05f5612-b493-4273-9b71-9e0ce32bdad6
Ezzati, Majid
7a7b5aaa-39a1-428c-9dcb-06a4e7c6095f
NCD Risk Factor Collaboration (NCD-RisC)
(2020)
National trends in total cholesterol obscure heterogeneous changes in HDL and non-HDL cholesterol and total-to-HDL cholesterol ratio: a pooled analysis of 458 population-based studies in Asian and Western countries.
International Journal of Epidemiology, 49 (1), .
(doi:10.1093/ije/dyz099).
Abstract
Background: although high-density lipoprotein (HDL) and non-HDL cholesterol have opposite associations with coronary heart disease, multi-country reports of lipid trends only use total cholesterol (TC). Our aim was to compare trends in total, HDL and non-HDL cholesterol and the total-to-HDL cholesterol ratio in Asian and Western countries.
Methods: we pooled 458 population-based studies with 82.1 million participants in 23 Asian and Western countries. We estimated changes in mean total, HDL and non-HDL cholesterol and mean total-to-HDL cholesterol ratio by country, sex and age group.
Results: since ∼1980, mean TC increased in Asian countries. In Japan and South Korea, the TC rise was due to rising HDL cholesterol, which increased by up to 0.17 mmol/L per decade in Japanese women; in China, it was due to rising non-HDL cholesterol. TC declined in Western countries, except in Polish men. The decline was largest in Finland and Norway, at ∼0.4 mmol/L per decade. The decline in TC in most Western countries was the net effect of an increase in HDL cholesterol and a decline in non-HDL cholesterol, with the HDL cholesterol increase largest in New Zealand and Switzerland. Mean total-to-HDL cholesterol ratio declined in Japan, South Korea and most Western countries, by as much as ∼0.7 per decade in Swiss men (equivalent to ∼26% decline in coronary heart disease risk per decade). The ratio increased in China.
Conclusions: HDL cholesterol has risen and the total-to-HDL cholesterol ratio has declined in many Western countries, Japan and South Korea, with only a weak correlation with changes in TC or non-HDL cholesterol.
Text
dyz099
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More information
Accepted/In Press date: 24 April 2019
e-pub ahead of print date: 18 July 2020
Keywords:
Adult, Age Factors, Aged, Asia, Asian People, Canada, Cholesterol/blood, Cholesterol, HDL, Cholesterol, LDL, Europe, Female, Humans, Lipids/blood, Male, Middle Aged, Population Surveillance/methods, Sex Factors, Triglycerides/blood, United States, White People
Identifiers
Local EPrints ID: 489333
URI: http://eprints.soton.ac.uk/id/eprint/489333
ISSN: 0300-5771
PURE UUID: 21404864-0d95-4cd1-9db3-4e68ed9ee311
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Date deposited: 22 Apr 2024 16:30
Last modified: 23 Apr 2024 01:35
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Author:
Majid Ezzati
Corporate Author: NCD Risk Factor Collaboration (NCD-RisC)
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