Gender and age features of dyslipidemia in the population of the Nizhny Novgorod region

Aim. To study the gender and age characteristics of dyslipidemia in the population of the Nizhny Novgorod region.

Material and methods. A total of 2501 people aged 35-74 among the population of the Nizhny Novgorod region were examined, selected by stratified multi-stage random sampling. The study was performed as part of the third epidemiological study ESSE-RF3. All respondents underwent an anthropometric survey, a questionnaire to identify chronic non-communicable diseases and related risk factors. The following laboratory tests were performed: total cholesterol (TC), low-density lipoproteins (LDL-C), high-density lipoproteins (HDL-C), triglycerides (TG). Among the entire cohort of patients at the time of blood sampling, 276 people (11,0%) were receiving lipid-lowering drugs. They were excluded from further analysis. Hypercholesterolemia (HCL) was recorded with a total cholesterol ≥5,0 mmol/l, an increased level of LDL-C — with a level ≥3,0 mmol/l, hypertriglyceridemia (HTG) — with a TG ≥1,7 mmol/l, a reduced level of HDL-C — with a level in males ≤1,0 mmol/l, in women ≤1,2 mmol/l.

Results. The prevalence of HCL was 65,1%. In the young cohort (40-44 years), men were significantly more likely to have hypercholesterolemia, but in the middle (50-54 years) and older (60 years or more) age groups, this lipid metabolism disorder was observed with greater frequency among females. In addition, 68,9% of the respondents had elevated LDL-C levels. When studying the prevalence of this type of dyslipidemia in different age groups among men and women, a similar trend can be noted with similar TC values, but significant gender differences in the prevalence of elevated LDL-C levels l were revealed only in the 60-64 and 65-69 years groups. The prevalence of HTG among the adult population of the Nizhny Novgorod region was 42,6%. Among the 35-49 years and 55-59 years age groups, the prevalence of elevated TG levels was significantly more common among men. The incidence of decreased HDL-C levels was 13,3%. This type of dyslipidemia was significantly more often detected among men only in the youngest subgroup (35-39 years).

Conclusion. Among the population of the Nizhny Novgorod region, hypercholesterolemia occurred in 65,1% of respondents, an increased level of LDL-C — in 68,9%, a HTG — in 42,6%, a reduced level of HDL-C — in 13,3%. The data obtained determine a high cardiovascular risk and require the development of prevention and treatment measures for lipid metabolism disorders.

1. GBD 2019 Diseases and Injuries Collaborators. Global burden of 369 diseases and injuries in 204 countries and territories, 1990-2019: a systematic analysis for the Global Burden of Disease Study 2019. Lancet. 2020;396(10258):1204-1222. DOI:10.1016/S0140-6736(20)30925-9.

2. Timmis A, Townsend N, Gale CP et al.; European Society of Cardiology. European Society of Cardiology: Cardiovascular Disease Statistics 2019. Eur Heart J. 2020;41(1):12-85. DOI:10.1093/eurheartj/ehz859.

3. Visseren FLJ, Mach F, Smulders YM, et al.; ESC Scientific Document Group. 2021 ESC Guidelines on cardiovascular disease prevention in clinical practice. Eur Heart J. 2021;42(34):3227-3337. DOI:10.1093/eurheartj/ehab484.

4. Jebari-Benslaiman S, Galicia-García U, Larrea-Sebal A, et al. Pathophysiology of Atherosclerosis. Int J Mol Sci. 2022;23(6):3346. DOI:10.3390/ijms23063346.

5. Roth GA, Mensah GA, Johnson CO et al. Global Burden of Cardiovascular Diseases and Risk Factors, 1990-2019: Update From the GBD 2019 Study. J Am Coll Cardiol. 2020;76(25):2982-3021. DOI:10.1016/j.jacc.2020.11.010.

6. Lu Y, Zhang H, Lu J, et al. Prevalence of Dyslipidemia and Availability of Lipid-Lowering Medications Among Primary Health Care Settings in China. JAMA Netw Open. 2021;4(9):e2127573. DOI:10.1001/jamanetworkopen.2021.27573.

7. Du X, Patel A, Anderson CS et al. Epidemiology of Cardiovascular Disease in China and Opportunities for Improvement: JACC International. J Am Coll Cardiol. 2019;73(24):3135-3147. DOI:10.1016/j.jacc.2019.04.036.

8. Metelskaya VA, Shalnova SA, Deev AD, et al. Analysis of atherogenic dyslipidemias prevalence among population of Russian Federation (results of the ESSE-RF Study). Profilakticheskaya Meditsina 2016;19(1):1523 (In Russ.) DOI:10.17116/profmed201619115-23.

9. Drapkina OM, Shalnova SA, Imaeva AE, et al. Epidemiology of Cardiovascular Diseases in Regions of Russian Federation. Third survey (ESSE-RF-3). Rationale and study design. Cardiovascular Therapy and Prevention. 2022;21(5):3246 (In Russ.) DOI:10.15829/1728-8800-2022-3246.

10. Pokrovskaya MS, Borisova AL, Metelskaya VA, et al. Role of biobanking in managing large-scale epidemiological studies. Cardiovascular Therapy and Prevention. 2021;20(5):2958 (In Russ.) DOI:10.15829/1728-8800-2021-2958.

11. Yusuf S, Hawken S, Ounpuu S, et al. Effect of potentially modifiable risk factors associated with myocardial infarction in 52 countries (the INTERHEART study): case-control study. Lancet. 2004;364(9438):937-52. DOI:10.1016/S0140-6736(04)17018-9.

12. Jung E, Kong SY, Ro YS, et al. Serum Cholesterol Levels and Risk of Cardiovascular Death: A Systematic Review and a Dose-Response Meta-Analysis of Prospective Cohort Studies. Int J Environ Res Public Health. 2022;19(14):8272. DOI:10.3390/ijerph19148272.

13. Stamler J, Daviglus ML, Garside DB, et al. Relationship of baseline serum cholesterol levels in 3 large cohorts of younger men to long-term coronary, cardiovascular, and all-cause mortality and to longevity. JAMA. 2000;284(3):311-8. DOI:10.1001/jama.284.3.311.

14. McDonald M, Hertz RP, Unger AN, et al. Prevalence, awareness, and management of hypertension, dyslipidemia, and diabetes among United States adults aged 65 and older. J Gerontol A Biol Sci Med Sci. 2009;64(2):256-63. DOI:10.1093/gerona/gln016.

15. Sun GZ, Li Z, Guo L, et al. High prevalence of dyslipidemia and associated risk factors among rural Chinese adults. Lipids Health Dis. 2014;13:189. DOI:10.1186/1476-511X-13-189.

16. Novella S, Pérez-Cremades D, Mompeón A et al. Mechanisms underlying the influence of oestrogen on cardiovascular physiology in women. J Physiol. 2019;597(19):4873-4886. DOI:10.1113/JP278063.

17. Aryan L, Younessi D, Zargari M et al. The Role of Estrogen Receptors in Cardiovascular Disease. Int J Mol Sci. 2020;21(12):4314. DOI:10.3390/ijms21124314.

18. Lin HQ, Wu JY, Chen ML, et al. Prevalence of dyslipidemia and prediction of 10-year CVD risk among older adults living in southeast coastal regions in China: a cross-sectional study. Clin Interv Aging. 2019;14:1119-1129. DOI:10.2147/CIA.S207665.

19. Ezhov M. V., Bazhan S. S., Ershova A. I., et al. CLINICAL GUIDELINES FOR FAMILIAL HYPERCHOLESTEROLEMIA. Ateroscleroz. 2019;15(1):58-98 (In Russ.)