High prevalence of low high-density lipoprotein cholesterol concentrations and other dyslipidemic phenotypes in an Iranian population

Abstract

Objective: This study was designed to determine the prevalence of different atherogenic dyslipidemic phenotypes, especially decreased serum high-density lipoprotein cholesterol (HDL-C) in an Iranian population and its relationship to other coronary artery disease (CAD) risk factor.

Methods: The prevalence of lipid abnormalities was assessed in 2941 people, including 1396 males and 1545 females, aged more than 20 years. The population is representative of Iranian urban adults living in northwestern Iran. In addition to isolated forms of hypertriglyceridemia, hypercholesterolemia, and hypoalphalipoproteinemia, some dyslipidemic phenotypes including hypertriglyceridemia/low high-density lipoprotein (HDL) combination, mixed dyslipidemias, and severe dyslipidemias were assessed.

Results: The most prevalent abnormality was low HDL cholesterol (HDL-C; 73% including 63% for men and 93.3% for women). Hypertriglyceridemia (>150 mg/dL) was the second most prevalent abnormality (40.6%). Increased total cholesterol (>200 mg/dL) was observed in 35.4% of the subjects. The combination of hypertriglyceridemia and low HDL-C was observed in 9.9% of the population. Fifty eight percent of the low HDL-C cases were not accompanied with hypertriglyceridemia, and 24.4% of hypertriglyceridemic subjects had low HDL-C. Among subjects younger than 30 years, 19% had hypercholesterolemia, 13% had isolated low HDL-C less than 35 mg/dL, and 63% had HDL-C less than 40 mg/dL. Unexpectedly, except for the hypertriglyceridemia/low HDL-C pattern, which was more common in males, the other abnormal lipid profiles were more common in females.

Conclusion: The prevalence of dyslipidemia, especially low HDL cholesterol, in Iranian adults is very high. Urgent preventive programs and changes in lifestyle are needed in this area.