Prevalence of dyslipidemia and associated risk factors among Turkish adults: Trabzon lipid study

Abstract

The objective of this study was to estimate the prevalence of dyslipidemia as defined by NCEP ATP III criteria in the Trabzon Region of Turkey and to determine its associations with cardiovascular risk factors [hypertension (HT), body mass index (BMI), waist circumference (WC), waist-to-hip ratio (WHR), and fasting serum glucose (FBG)] demographic factors (age, sex, obesity, marital status, reproductive history in women, and level of education), socioeconomic factors (household income and occupation), a family history of selected medical conditions (diabetes, HT, obesity, and cardiovascular disease), and lifestyle factors (smoking habits, physical activity, and alcohol consumption) in the adult population. In this cross-sectional survey, a sample of households was systematically selected from the central province of Trabzon city and its nine towns, namely, Akcaabat, Duzkoy, Vakfikebir, Yomra, Arakli, Of, Caykara, Surmene, and Macka. A total of 4,809 subjects (2,601 women and 2,208 men) were included in the study. Individuals older than 20 years were selected from their family health cards. Demographic and socioeconomic factors, a family history of selected medical conditions, and lifestyle factors were obtained for all participants. Systolic blood pressure (SBP) and diastolic blood pressure (DBP) levels were measured for all subjects. The individuals included in the questionnaire were invited to the local medical centers for blood tests between 08:00 and 10:00 after 12 h of fasting. The levels of serum glucose (FBG), total cholesterol (TC), high-density cholesterol (HDL-C), low-density cholesterol (LDL-C), and trigylcerides were measured with autoanalyzer. Dyslipidemia was defined according to guidelines from the US NCEP ATP III diagnostic criteria. The ratio of TC to HDL-C was calculated. Definition and classification of HT were performed according to guidelines from the US JNC-7 report. The results obtained indicated that the age-adjusted mean values (mg/dl) of TC, LDL-C, HDL-C, [TC/HDL-C ratio], and TG were 190 +/- 0.6, 127.5 +/- 0.5, 50.3 +/- 0.3, 3.96 +/- 0.02, and 137.3 +/- 1.5, respectively. Overall, the mean levels of LDL-C, TG and TC/HDL-C ratio were higher in men than in women, whereas the mean level of HDL-C was higher in women than in men. The prevalences of hypercholesterolemia (> or =200 mg/dl), elevated LDL-C (> or =130 mg/dl), low HDL-C (<40 mg/dl), and hypertriglyceridemia (> or =150 mg/dl) were 37.5, 44.5, 21.1, and 30.4%, respectively. Prevalences of dyslipidemia were higher in men than in women, except for TC (P < 0.0001). The prevalences of high TC, LDL-C, TG, and TC/HDL-C ratio increased with age, with the highest prevalences in the 60-69-year-old group, and declined thereafter. The prevalences of high TC, LDL-C and TG, a high TC/HDL-C ratio and low HDL-C increased steadily in line with BP, BMI, WC, WHR, and FBG (P < 0.0001). Dyslipidemia was positively associated with marital status, parity, cessation of cigarette smoking and current cigarette use, and alcohol consumption, and negatively associated with the level of education, household income, and physical activity. Multiple logistic regression analysis revealed that dyslipidemia was significantly associated with the factors of age, male gender, BMI, WC (except for TC and LDL-C), HT (only for LDL-C and TG), FBG (only for LDL-C and TG), education level, cigarette smoking (only for HDL-C and TC/HDL-C ratio), alcohol consumption (except for HDL-C and TC/HDL-C ratio), occupation (especially housewives), marital status (widows and widowers), and a family history of selected medical conditions (for only TC). In conclusion, Trabzon Lipid Study data indicate that dyslipidemias are very common and an important health problem among the adult population of Trabzon. To control dyslipidemias, effective public health education and urgent measures are essential.