Department of Public Health, Shiga University of Medical Science.
Department of Preventive Medicine and Public Health, Faculty of Medicine, Fukuoka University.
J Atheroscler Thromb. 2018 Jul 1;25(7):606-620. doi: 10.5551/jat.42531. Epub 2018 Jan 11.
To investigate associations between socioeconomic status (SES) and the prevalence and treatment status of hypercholesterolemia in a general Japanese population.
In 2010, we established a cohort study of 2417 adults (age 20-91 yr) from 300 randomly selected areas across Japan who participated in the National Health and Nutrition Survey of Japan. We cross-sectionally examined an association between SES and (1) prevalence of hypercholesterolemia in 2417 participants (999 men and 1418 women) and (2) not receiving medication for hypercholesterolemia in 654 participants (215 men and 439 women). SES included employment status, marital status, length of education, and household expenditures. Hypercholesterolemia was defined as a total serum cholesterol level of ≥6.21 mmol/L (240 mg/dL) or the use of lipid-lowering medications.
The overall prevalence of hypercholesterolemia was 21.5% in men and 31.0% in women. In men, the lowest quintile of household expenditures was associated with a higher prevalence of hypercholesterolemia (28.3%) compared with the upper 4 quintiles (19.9%) (multivariable-adjusted odds ratio 1.66; 95% confidence interval [CI] 1.16-2.38). Among participants with hypercholesterolemia, 55.4% of men and 55.1% of women were not receiving medication. Unmarried men were more likely to be untreated (75.0%) than married men (50.9%) (multivariable-adjusted odds ratio 2.53;95%CI 1.05-6.08). SES had no significant effects in women.
In a general population of Japanese men, low household expenditures were associated with a higher prevalence of hypercholesterolemia, and unmarried men with hypercholesterolemia were less likely to receive medication.
调查在日本一般人群中社会经济地位（SES）与高胆固醇血症的患病率和治疗状况之间的关联。
2010 年，我们建立了一项队列研究，纳入了来自日本 300 个随机地区的 2417 名成年人（年龄 20-91 岁），他们参加了日本国民健康和营养调查。我们在 2417 名参与者（999 名男性和 1418 名女性）中横断面检查了 SES 与（1）高胆固醇血症的患病率之间的关系，以及在 654 名参与者（215 名男性和 439 名女性）中未接受高胆固醇血症药物治疗的情况。SES 包括就业状况、婚姻状况、受教育程度和家庭支出。高胆固醇血症定义为血清总胆固醇水平≥6.21mmol/L（240mg/dL）或使用降脂药物。
男性的总体高胆固醇血症患病率为 21.5%，女性为 31.0%。在男性中，与家庭支出最高的 4 个五分位数相比，家庭支出最低五分位数的高胆固醇血症患病率更高（28.3%比 19.9%）（多变量调整后的优势比 1.66；95%置信区间[CI] 1.16-2.38）。在患有高胆固醇血症的参与者中，55.4%的男性和 55.1%的女性未接受药物治疗。与已婚男性（50.9%）相比，未婚男性（75.0%）更有可能未接受治疗（多变量调整后的优势比 2.53；95%CI 1.05-6.08）。SES 对女性没有显著影响。
在日本男性一般人群中，家庭支出较低与高胆固醇血症的患病率较高有关，而患有高胆固醇血症的未婚男性接受药物治疗的可能性较小。
