Gender differences in 7 years trends in cholesterol lipoproteins and lipids in India: Insights from a hospital database

Abstract

Objective:To determine gender differences and secular trends in total, low-density lipoprotein (LDL) and high DL (HDL) cholesterol and triglycerides using a large hospital database in India.Methods:All blood lipid tests evaluated from July 2007 to December 2014 were analyzed. Details of gender and age were available. Statin therapy was obtained at two separate periods. Trends were calculated using linear regression and Mantel-Haenszel X2.Results:Data of 67395 subjects (men 49,904, women 17,491) aged 51 ± 12 years were analyzed. Mean levels (mg/dl) were total cholesterol 174.7 ± 45, LDL cholesterol 110.7 ± 38, non-HDL cholesterol 132.1 ± 44.8, HDL cholesterol 44.1 ± 10, triglycerides 140.8 ± 99, and total: HDL cholesterol 4.44 ± 1.5. Various dyslipidemias in men/women were total cholesterol ≥200 mg/dl 25.4/36.4%, LDL cholesterol ≥130 mg/dl 28.1/35.0% and ≥100 mg/dl 54.4/66.4%, non-HDL cholesterol ≥160 mg/dl 25.5/29.6%, HDL cholesterol <40/50 mg/dl 54.4/64.4%, and triglycerides ≥150 mg/dl 34.0/26.8%. Cholesterol lipoproteins declined over 7 years with greater decline in men versus women for cholesterol (Blinearregression = −0.82 vs. −0.33, LDL cholesterol (−1.01 vs. −0.65), non-HDL cholesterol (−0.88 vs. −0.52), and total: HDL cholesterol (−0.02 vs. −0.01). In men versus women there was greater decline in prevalence of hypercholesterolemia (X2trend 74.5 vs. 1.60), LDL cholesterol ≥130 mg/dl (X2trend 415.5 vs. 25.0) and ≥100 mg/dl (X2trend 501.5 vs. 237.4), non-HDL cholesterol (X2trend 77.4 vs. 6.85), total: HDL cholesterol (X2trend 212.7 vs. 10.5) and high triglycerides (X2trend 10.8 vs. 6.15) (P < 0.01). Use of statins was in 2.6% (36/1405) in 2008 and 9.0% (228/2527) in 2014 (P < 0.01). Statin use was significantly lower in women (5.8%) than men (10.3%).Conclusions:In a large hospital - database we observed greater hypercholesterolemia and low HDL cholesterol in women. Mean levels and prevalence of high total, LDL, non-HDL and total: HDL cholesterol declined over 7 years. A lower decline was observed in women. This was associated with lower use of statins.

Are the Levels of Lipid Parameters Associated with Biometeorological Conditions?

“…The described differences are usually small. Gupta et al [44] presented very similar correlations, simultaneously stressing that higher mean TC values in females appear after the age of 45 years. Since in our study the average age of females is statistically significantly higher than in males (e.g., in 2018, 55.71 versus 53.05 at p < 0.001), we consider these values as consistent with data from the available literature [1,45].…”

Recent trends in epidemiology of dyslipidemias in India

“…In a study utilizing hospital administrative database of more than 67,000 participants we reported prevalence of various dyslipidemias using a fasting sample. 38 In this cohort of mostly middle class men and women there was a high prevalence of various dyslipidemias ( Fig. 4 ).…”

“…Participants (n = 5350, men 2935, women 2415) were evaluated for demographic, biophysical, and fasting biochemical risk factors. In the hospital-based study, all consecutive fasting blood lipid tests performed over a seven-year period were analyzed (n = 67347, men 49866, women 17481) 38 . The age-adjusted prevalence of severe hypercholesterolemia in population vs hospital based studies was total cholesterol 240–269 mg/dl in 5.0% vs 5.5%, 270–309 mg/dl in 2.3% vs 1.8% and ≥310 mg/dl in 0.3% vs 0.0.5%.…”

Risk factors for low high-density lipoprotein among Asian Indians in the United States

“…More importantly, it highlights, which components of the MetS are more closely correlated with diabetes in this population. Previous studies in India have found that women have lower HDL than men and that cardiovascular risk factors (RFs) such as diabetes, hypertension, and smoking are highly prevalent[ 6 , 7 ]. Herein we report that a greater percent of AI males have increased fasting glucose, blood pressure, and triglycerides compared to females and that a greater percent of AI females have increased waist circumference and decreased HDL compared to males.…”