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 Academic Article uri icon

abstract

  • 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 non-HDL 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 ∼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 ∼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 ∼0.7 per decade in Swiss men (equivalent 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.

authors

  • Taddei, C
  • Jackson, R
  • Zhou, B
  • Bixby, H
  • Danaei, G
  • Di Cesare, M
  • Kuulasmaa, K
  • Hajifathalian, K
  • Bentham, J
  • Bennett, JE
  • Aekplakorn, W
  • Cifkova, R
  • Dallongeville, J
  • Debacquer, D
  • Giampaoli, S
  • Gudnason, V
  • Khang, YH
  • Laatikainen, T
  • Mann, J
  • Marques-Vidal, P
  • Mensah, G
  • Müller-Nurasyid, M
  • Ninomiya, T
  • Petkeviciene, J
  • Rodríguez-Artalejo, F
  • Servais, J
  • Söderberg, S
  • Stavreski, B
  • Wilsgaard, T
  • Zdrojewski, T
  • Zhao, D
  • Stevens, GA
  • Savin, S
  • Cowan, MJ
  • Riley, LM
  • Ezzati, M
  • Adams, RJ
  • Ahrens, W
  • Amouyel, P
  • Amuzu, A
  • Anderssen, SA
  • Ariansen, I
  • Arveiler, D
  • Aspelund, T
  • Auvinen, J
  • Avdicová, M
  • Banach, M
  • Bandosz, P
  • Banegas, JR
  • Barbagallo, CM
  • Bata, I
  • Baur, LA
  • Beaglehole, R
  • Bernotiene, G
  • Bi, Y
  • Bienek, A
  • Björkelund, C
  • Bo, S
  • Boehm, BO
  • Bonaccio, M
  • Bongard, V
  • Borchini, R
  • Borghs, H
  • Breckenkamp, J
  • Brenner, H
  • Bruno, G
  • Busch, M
  • Cabreradeleón, A
  • Capuano, V
  • Casanueva, FF
  • Casas, JP
  • Caserta, CA
  • Censi, L
  • Chen, F
  • Chen, S
  • Chirlaque, MD
  • Cho, B
  • Cho, Y
  • Chudek, J
  • Claessens, F
  • Clarke, J
  • Clays, E
  • Cooper, C
  • Costanzo, S
  • Cottel, D
  • Cowell, C
  • Crujeiras, AB
  • Cui, L
  • D'Arrigo, G
  • Dauchet, L
  • De Backer, G
  • De Bacquer, D
  • De Gaetano, G
  • De Henauw, S
  • De Smedt, D
  • Dennison, E
  • Deschamps, V
  • Dicastelnuovo, A
  • Dobson, AJ
  • Donfrancesco, C
  • Shaw, Jonathan E

publication date

  • 2020