Trends in Apolipoprotein B, Non-high-density Lipoprotein Cholesterol, and Low-density Lipoprotein Cholesterol for Adults Aged 20 and Over, 2005-2016.

Objectives-Guidelines for lowering cholesterol have focused on total and lowdensity lipoprotein cholesterol (LDL-C). Although the emphasis remains on LDL-C, more attention is now being given to apolipoprotein B (apo B) and non-high-density lipoprotein cholesterol (non-HDL-C). This report presents trends in mean apo B, non-HDL-C, and LDL-C in adults aged 20 and over from 2005-2006 through 2015-2016. Methods-Data from the 2005-2016 National Health and Nutrition Examination Surveys were used to conduct trend analyses. Means and standard errors of the mean for apo B (n = 13,802), non-HDL-C (n = 30,921), and LDL-C (n = 13,559) are presented overall and by sex, stratified by age, race and Hispanic origin, and body mass index (BMI) category for each 2-year survey cycle. Trends over time were tested using orthogonal contrast matrices and piecewise and multiple linear regression. Results-In men, apo B declined from 98 mg/dL in 2005-2006 to 93 mg/dL in 2011-2012, but did not change after 2011-2012. Declining trends were also seen for men in non-HDL-C (147 to 141 mg/dL) and LDL-C (116 to 114 mg/dL) from 2005-2006 to 2015-2016. For women, age-adjusted mean apo B declined from 94 mg/dL in 2005-2006 to 91 mg/dL in 2015-2016. Non-HDL-C and LDL-C in women did not change significantly from 2005-2006 to 2011-2012, but non-HDL-C declined from 141 mg/dL in 2011-2012 to 133 mg/dL in 2015-2016, and LDL-C declined from 117 mg/dL in 2011-2012 to 111 mg/dL in 2015-2016. With the exception of LDL-C in men, these trends persisted after controlling for age, race and Hispanic origin, BMI, and lipid-lowering medication use. Conclusions-From 2005-2006 to 2015-2016, significant but different declining trends in apo B, non-HDL-C, and LDL-C were seen in men and women. In general, differences in age, race and Hispanic origin, BMI category, and lipid-lowering medication use did not explain the trends.