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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.

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. Int J Epidemiol, 49 (1). pp. 173-192. ISSN 1464-3685 https://doi.org/10.1093/ije/dyz099
SGUL Authors: Whincup, Peter Hynes

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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.

Item Type: Article
Additional Information: © The Author(s) 2019. Published by Oxford University Press on behalf of the International Epidemiological Association. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted reuse, distribution, and reproduction in any medium, provided the original work is properly cited.
Keywords: HDL cholesterol, LDL cholesterol, Total cholesterol, blood lipids, multi-country study, NCD Risk Factor Collaboration (NCD-RisC), Total cholesterol, LDL cholesterol, HDL cholesterol, blood lipids, multi-country study, 0104 Statistics, 1117 Public Health and Health Services, Epidemiology
SGUL Research Institute / Research Centre: Academic Structure > Population Health Research Institute (INPH)
Journal or Publication Title: Int J Epidemiol
ISSN: 1464-3685
Language: eng
Dates:
DateEvent
1 February 2020Published
8 July 2019Published Online
24 April 2019Accepted
Publisher License: Creative Commons: Attribution 4.0
PubMed ID: 31321439
Web of Science ID: WOS:000536507900023
Go to PubMed abstract
URI: https://openaccess.sgul.ac.uk/id/eprint/112081
Publisher's version: https://doi.org/10.1093/ije/dyz099

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