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 - Archive ouverte HAL Access content directly
Journal Articles International Journal of Epidemiology Year : 2019

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

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Bin Zhou
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Laura Censi
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Fangfang Chen
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Shuohua Chen
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Yumi Cho
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Janine Clarke
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Liufu Cui
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Jiang He
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Jakub Stokwiszewski
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Paibul Suriyawongpaisal
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Abdonas Tamosiunas
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Eng Jootan
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Anne Taylor
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Grethe Tell
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Hannak Tolonen
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Roman Topór-Madry
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Wenbin Wei
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Peterh Whincup
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Johann Willeit
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Andrew Wong
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Aleksander Giwercmanwu
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Frederickc Wu
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Shouling Wu
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Haiquan Xu
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Weili Yan
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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.
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hal-02532973 , version 1 (07-04-2020)

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Attribution - CC BY 4.0

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Cristina Taddei, Rod Jackson, Bin Zhou, Honor Bixby, Goodarz Danaei, et al.. 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, 2019, pp.dyz099. ⟨10.1093/ije/dyz099⟩. ⟨hal-02532973⟩
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