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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
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2020 (Engelska)Ingår i: International Journal of Epidemiology, ISSN 0300-5771, E-ISSN 1464-3685, Vol. 49, nr 1, s. 173-192Artikel i tidskrift (Refereegranskat) Published
Abstract [en]

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.

Ort, förlag, år, upplaga, sidor
Oxford University Press, 2020. Vol. 49, nr 1, s. 173-192
Nyckelord [en]
HDL cholesterol, LDL cholesterol, Total cholesterol, blood lipids, multi-country study
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Identifikatorer
URN: urn:nbn:se:umu:diva-162084DOI: 10.1093/ije/dyz099ISI: 000536507900023PubMedID: 31321439Scopus ID: 2-s2.0-85074478745OAI: oai:DiVA.org:umu-162084DiVA, id: diva2:1342361
Projekt
NCD Risk Factor Collaboration (NCD-RisC)
Forskningsfinansiär
Wellcome trust, 101506/Z/13/ZWellcome trust, 203616/Z/16/ZTillgänglig från: 2019-08-13 Skapad: 2019-08-13 Senast uppdaterad: 2023-03-24Bibliografiskt granskad

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Söderberg, StefanForslund, Ann-SofieForsner, MariaLundqvist, Robert

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Söderberg, StefanForslund, Ann-SofieForsner, MariaLundqvist, Robert
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KardiologiInstitutionen för kirurgisk och perioperativ vetenskapInstitutionen för omvårdnad
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