Supiyev Adil, Nurgozhin Talgat, Zhumadilov Zhaxybay, Peasey Anne, Hubacek Jaroslav A, Bobak Martin
Department of Epidemiology and Public Health, University College London, 1-19 Torrington Place, London, WC1E 6BT, UK.
Laboratory of Epidemiology and Public Health, Center for Life Sciences, PI National Laboratory Astana, Nazarbayev University, Kabanbay Batyr Ave. 53, Astana, Kazakhstan, 010000.
BMC Public Health. 2017 Aug 11;17(1):651. doi: 10.1186/s12889-017-4629-5.
Despite high cardiovascular mortality in Central Asian republics of the former Soviet Union, there is limited information about major risk factors, including blood lipids. We investigated the prevalence of impaired concentrations of blood lipids, the awareness, treatment and control of hypercholesterolemia, and factors associated with these indicators in urban and rural populations in Kazakhstan.
We conducted a cross-sectional study of random urban and rural population samples (the state capital Astana and Akmol village). Men and women aged 50-74 years were examined; a total of 954 adults participated (response rate 59%). Serum concentrations of total, LDL and HDL cholesterol and triglycerides and a range of other cardiovascular risk factors were measured.
The overall prevalence of hypercholesterolemia (total cholesterol ≥6.2 mmol/l) was 37%; among subjects with hypercholesterolemia, 57% were aware of their condition, 41% took medication and 23% had total cholesterol <6.2 mmol/l (4.5% <5 mmol/l). The prevalence, awareness, treatment, and control of hypercholesterolemia were all higher in the urban than the rural area. Similarly, the proportions of subjects with impaired concentrations of specific lipids fractions were also considerably higher in the urban population. Most associations with other covariates were in the expected direction.
This study found relatively high prevalence of dyslipidemia in the Kazakh population, and the blood lipid profile was less favourable in the urban area. These pronounced urban-rural differences may be related to urbanization, the associated nutrition transition and to access to health care.
尽管前苏联中亚各共和国心血管疾病死亡率很高，但关于包括血脂在内的主要危险因素的信息有限。我们调查了哈萨克斯坦城乡居民血脂浓度异常的患病率、高胆固醇血症的知晓率、治疗率和控制率，以及与这些指标相关的因素。
我们对城市和农村的随机人群样本（首都阿斯塔纳和阿克莫尔村）进行了横断面研究。对年龄在50 - 74岁的男性和女性进行了检查；共有954名成年人参与（应答率为59%）。测量了总胆固醇、低密度脂蛋白胆固醇、高密度脂蛋白胆固醇、甘油三酯的血清浓度以及一系列其他心血管危险因素。
高胆固醇血症（总胆固醇≥6.2 mmol/l）的总体患病率为37%；在高胆固醇血症患者中，57%知晓自己的病情（知晓率），41%接受了药物治疗（治疗率），23%的患者总胆固醇<6.2 mmol/l（4.5%<5 mmol/l）（控制率）。高胆固醇血症的患病率、知晓率、治疗率和控制率在城市均高于农村。同样，城市人群中特定血脂成分浓度异常的比例也显著更高。与其他协变量的大多数关联都在预期方向。
本研究发现哈萨克人群中血脂异常的患病率相对较高，且城市地区的血脂谱更不理想。这些明显的城乡差异可能与城市化、相关的营养转变以及获得医疗保健的机会有关。
