A1 Journal article (refereed)
National trends in total cholesterol obscure heterogeneous changes in HDL and non-HDL cholesterol and total-to-HDL cholesterol ratio : A pooled analysis of 458 population-based studies in Asian and Western countries (2020)


NCD Risk Factor Collaboration (2020). National trends in total cholesterol obscure heterogeneous changes in HDL and non-HDL cholesterol and total-to-HDL cholesterol ratio : A pooled analysis of 458 population-based studies in Asian and Western countries. International Journal of Epidemiology, 49 (1), 173-192. DOI: 10.1093/ije/dyz099


JYU authors or editors


Publication details

All authors or editors: NCD Risk Factor Collaboration

Journal or series: International Journal of Epidemiology

ISSN: 0300-5771

eISSN: 1464-3685

Publication year: 2020

Volume: 49

Issue number: 1

Article number: 173-192

Publisher: Oxford University Press

Publication country: United Kingdom

Publication language: English

DOI: http://doi.org/10.1093/ije/dyz099

Open Access: Open access publication published in a hybrid channel

Publication is parallel published (JYX): https://jyx.jyu.fi/handle/123456789/70871

Publication is parallel published: http://urn.fi/URN:NBN:fi:tuni-202001171378


Abstract

Background: Although high-density lipoprotein (HDL) and non-HDL cholesterol have opposite associations with coronary heart disease, multi-country reports of lipid trends only use total cholesterol (TC). Our aim was to compare trends in total, HDL and nonHDL cholesterol and the total-to-HDL cholesterol ratio in Asian and Western countries.
Methods: We pooled 458 population-based studies with 82.1 million participants in 23 Asian and Western countries. We estimated changes in mean total, HDL and non-HDL cholesterol and mean total-to-HDL cholesterol ratio by country, sex and age group.
Results: Since similar to 1980, mean TC increased in Asian countries. In Japan and South Korea, the TC rise was due to rising HDL cholesterol, which increased by up to 0.17 mmol/L per decade in Japanese women; in China, it was due to rising non-HDL cholesterol. TC declined in Western countries, except in Polish men. The decline was largest in Finland and Norway, at similar to 0.4 mmol/L per decade. The decline in TC in most Western countries was the net effect of an increase in HDL cholesterol and a decline in non-HDL cholesterol, with the HDL cholesterol increase largest in New Zealand and Switzerland. Mean total-to-HDL cholesterol ratio declined in Japan, South Korea and most Western countries, by as much as similar to 0.7 per decade in Swiss men (equivalent to similar to 26% decline in coronary heart disease risk per decade). The ratio increased in China.
Conclusions: HDL cholesterol has risen and the total-to-HDL cholesterol ratio has declined in many Western countries, Japan and South Korea, with only a weak correlation with changes in TC or non-HDL cholesterol.


Keywords: cholesterol; LDL cholesterol; HDL cholesterol; public health; international comparison

Free keywords: total cholesterol; blood lipids; multi-country study


Contributing organizations


Ministry reporting: Yes

Reporting Year: 2020


Last updated on 2020-18-08 at 13:02