Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Second Floor, No.10, Jalal Al-e-Ahmad Highway, Tehran, 1411713137, Iran.
Social Determinants of Health Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Sci Rep. 2023 Sep 19;13(1):15499. doi: 10.1038/s41598-023-42341-5.
The study aimed to estimate the prevalence of lipid abnormalities in Iranian adults by demographic characterization, geographical distribution, and associated risk factors using national and sub-national representative samples of the STEPs 2021 survey in Iran. In this population-based household survey, a total of 18,119 individuals aged over 25 years provided blood samples for biochemical analysis. Dyslipidemia was defined by the presence of at least one of the lipid abnormalities of hypertriglyceridemia (≥ 150 mg/dL), hypercholesterolemia (≥ 200 mg/dL), high LDL-C (≥ 130 mg/dL), and low HDL-C (< 50 mg/dL in women, < 40 mg/dL in men), or self-reported use of lipid-lowering medications. Mixed dyslipidemia was characterized as the coexistence of high LDL-C with at least one of the hypertriglyceridemia and low HDL-C. The prevalence of each lipid abnormality was determined by each population strata, and the determinants of abnormal lipid levels were identified using a multiple logistic regression model. The prevalence was 39.7% for hypertriglyceridemia, 21.2% for hypercholesterolemia, 16.4% for high LDL-C, 68.4% for low HDL-C, and 81.0% for dyslipidemia. Hypercholesterolemia and low HDL-C were more prevalent in women, and hypertriglyceridemia was more prevalent in men. The prevalence of dyslipidemia was higher in women (OR = 1.8), obese (OR = 2.8) and overweight (OR = 2.3) persons, those residents in urban areas (OR = 1.1), those with inappropriate physical activity (OR = 1.2), patients with diabetes (OR = 2.7) and hypertension (OR = 1.9), and participants with a history (OR = 1.6) or familial history of CVDs (OR = 1.2). Mixed dyslipidemia prevalence was 13.6% in women and 11.4% in men (P < 0.05). The prevalence of lipid abnormalities was highly heterogeneous among provinces, and East Azarbaijan with 85.3% (81.5-89.1) and Golestan with 68.5% (64.8-72.2) had the highest and lowest prevalence of dyslipidemia, respectively. Although the prevalence of high cholesterol and LDL-C had a descending trend in the 2016-2021 period, the prevalence of dyslipidemia remained unchanged. There are modifiable risk factors associated with dyslipidemia that can be targeted by the primary healthcare system. To modify these risk factors and promote metabolic health in the country, action plans should come to action through a multi-sectoral and collaborative approach.
本研究旨在通过人口特征描述、地理分布和使用伊朗 STEPs 2021 调查的国家和次国家代表性样本，估计伊朗成年人脂质异常的流行率。在这项基于人群的家庭调查中，共有 18119 名 25 岁以上的个体提供了血液样本进行生化分析。血脂异常定义为至少存在一种脂质异常，包括高甘油三酯血症（≥150mg/dL）、高胆固醇血症（≥200mg/dL）、高 LDL-C（≥130mg/dL）和低 HDL-C（女性<50mg/dL，男性<40mg/dL），或自述使用降脂药物。混合性血脂异常的特征是 LDL-C 升高与至少一种高甘油三酯血症和低 HDL-C 并存。通过每个人群分层确定每种脂质异常的患病率，并使用多因素逻辑回归模型确定异常血脂水平的决定因素。高甘油三酯血症、高胆固醇血症、高 LDL-C、低 HDL-C 和血脂异常的患病率分别为 39.7%、21.2%、16.4%、68.4%和 81.0%。高胆固醇血症和低 HDL-C 在女性中更为常见，而高甘油三酯血症在男性中更为常见。血脂异常的患病率在女性中更高（OR=1.8）、肥胖（OR=2.8）和超重（OR=2.3）人群、居住在城市地区（OR=1.1）、身体活动不当（OR=1.2）、糖尿病（OR=2.7）和高血压（OR=1.9）患者以及有心血管疾病病史（OR=1.6）或家族史（OR=1.2）的参与者中更高。女性混合性血脂异常的患病率为 13.6%，男性为 11.4%（P<0.05）。脂质异常的患病率在各省之间存在高度异质性，东阿塞拜疆省以 85.3%（81.5-89.1）和戈勒斯坦省以 68.5%（64.8-72.2）的患病率最高和最低，分别为血脂异常。尽管在 2016-2021 年期间，高胆固醇和 LDL-C 的患病率呈下降趋势，但血脂异常的患病率保持不变。存在与血脂异常相关的可改变危险因素，初级卫生保健系统可以针对这些危险因素进行干预。为了改变这些危险因素，促进国家的代谢健康，应通过多部门和协作的方法来实施行动计划。
