Faculty of Medicine, Memorial University of Newfoundland, Center for Rural Health Studies, Room M5M107, Health Sciences Centre, 300 Prince Philip Drive, St. John's, NL, A1B 3V6, Canada.
Lipids Health Dis. 2018 May 2;17(1):99. doi: 10.1186/s12944-018-0752-2.
Dyslipidemia, an increased level of total cholesterol (TC), triglycerides (TG), low-density-lipoprotein cholesterol (LDL-C) and decreased level of high-density-lipoprotein cholesterol (HDL-C), is one of the most important risk factors for cardiovascular disease. We examined the six-year trend of dyslipidemia in Newfoundland and Labrador (NL), a Canadian province with a historically high prevalence of dyslipidemia.
A serial cross-sectional study on all of the laboratory lipid tests available from 2009 to 2014 was performed. Dyslipidemia for every lipid component was defined using the Canadian Guidelines for the Diagnosis and Treatment of Dyslipidemia. The annual dyslipidemia rates for each component of serum lipid was examined. A fixed and random effect model was applied to adjust for confounding variables (sex and age) and random effects (residual variation in dyslipidemia over the years and redundancies caused by individuals being tested multiple times during the study period).
Between 2009 and 2014, a total of 875,208 records (mean age: 56.9 ± 14.1, 47.6% males) containing a lipid profile were identified. The prevalence of HDL-C and LDL-C dyslipidemia significantly decreased during this period (HDL-C: 35.8% in 2009 [95% CI 35.5-36.1], to 29.0% in 2014 [95% CI: 28.8-29.2], P = 0.03, and LDL-C: 35.2% in 2009 [95% CI: 34.9-35.4] to 32.1% in 2014 [95% CI: 31.9-32.3], P = 0.02). A stratification by sex, revealed no significant trend for any lipid element in females; however, in men, the previously observed trends were intensified and a new decreasing trend in dyslipidemia of TC was appeared (TC: 34.1% [95% CI 33.7-34.5] to 32.3% [95%CI: 32.0-32.6], p < 0.02, HDL-C: 33.8% (95%CI: 33.3-34.2) to 24.0% (95% CI: 23.7-24.3)], P < 0.01, LDL-C: 32.9% (95%CI:32.5-33.3) to 28.6 (95%CI: 28.3-28.9), P < 0.001). Adjustment for confounding factors and removing the residual noise by modeling the random effects did not change the significance.
This study demonstrates a significant downward trend in the prevalence of LDL-C, HDL-C, and TC dyslipidemia, exclusively in men. These trends could be the result of males being the primary target for cardiovascular risk management.
血脂异常是心血管疾病最重要的危险因素之一，表现为总胆固醇（TC）、甘油三酯（TG）、低密度脂蛋白胆固醇（LDL-C）水平升高，高密度脂蛋白胆固醇（HDL-C）水平降低。我们检测了加拿大纽芬兰和拉布拉多省（NL）血脂异常的六年趋势，该省血脂异常的患病率历来较高。
对 2009 年至 2014 年期间所有实验室血脂检测进行了一项连续的横断面研究。采用加拿大血脂异常诊断和治疗指南定义各血脂成分的血脂异常。检查了血清脂质各成分的年度血脂异常发生率。采用固定和随机效应模型调整混杂因素（性别和年龄）和随机效应（多年来血脂异常的残余变异和研究期间个体多次检测引起的冗余）。
2009 年至 2014 年间，共确定了 875208 份包含血脂谱的记录（平均年龄：56.9±14.1，47.6%为男性）。在此期间，HDL-C 和 LDL-C 血脂异常的患病率显著下降（HDL-C：2009 年为 35.8%（95%可信区间：35.5-36.1），2014 年为 29.0%（95%可信区间：28.8-29.2），P=0.03），LDL-C：2009 年为 35.2%（95%可信区间：34.9-35.4），2014 年为 32.1%（95%可信区间：31.9-32.3），P=0.02）。按性别分层，女性任何脂质成分均无明显趋势；然而，在男性中，先前观察到的趋势加剧，并出现了 TC 血脂异常的新下降趋势（TC：34.1%（95%可信区间：33.7-34.5）至 32.3%（95%可信区间：32.0-32.6），P<0.02，HDL-C：33.8%（95%可信区间：33.3-34.2）至 24.0%（95%可信区间：23.7-24.3），P<0.01，LDL-C：32.9%（95%可信区间：32.5-33.3）至 28.6%（95%可信区间：28.3-28.9），P<0.001）。调整混杂因素并通过模型随机效应去除残余噪声，并没有改变其显著性。
本研究表明，LDL-C、HDL-C 和 TC 血脂异常的患病率显著下降，仅在男性中如此。这些趋势可能是男性成为心血管风险管理主要目标的结果。
