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.
| Original language | English |
|---|---|
| Pages (from-to) | 173-192 |
| Number of pages | 20 |
| Journal | International Journal of Epidemiology |
| Volume | 49 |
| Issue number | 1 |
| DOIs | |
| Publication status | Published - 1 Feb 2020 |
Bibliographical note
This work was supported by the Wellcome Trust (grant numbers101506/Z/13/Z and Research Training Fellowship 203616/Z/16/Z).
R.C. acknowledges funding from the Ministry of Health of the
Czech Republic (grant number 15-27109A).
Publisher Copyright:
© 2019 The Author(s) 2019. Published by Oxford University Press on behalf of the International Epidemiological Association.
Other keywords
- Blood lipids
- HDL cholesterol
- LDL cholesterol
- Multi-country study
- Total cholesterol
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In: International Journal of Epidemiology, Vol. 49, No. 1, 01.02.2020, p. 173-192.
Research output: Contribution to journal › Article › peer-review
TY - JOUR
T1 - National trends in total cholesterol obscure heterogeneous changes in HDL and non-HDL cholesterol and total-to-HDL cholesterol ratio
T2 - A pooled analysis of 458 population-based studies in Asian and Western countries
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AU - Di Cesare, Mariachiara
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AU - Bentham, James
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AU - Wagner, Aline
AU - Wagner, Anne
AU - Wang, Ming Dong
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AU - Wannamethee, S. Goya
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AU - Wiecek, Andrzej
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AU - Willeit, Peter
AU - Wojtyniak, Bogdan
AU - Wong, Andrew
AU - Woodward, Mark
AU - Giwercmanwu, Aleksander
AU - Wu, Frederick C.
AU - Wu, Shouling
AU - Xu, Haiquan
AU - Xu, Liang
AU - Yan, Weili
AU - Yang, Xiaoguang
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N1 - This work was supported by the Wellcome Trust (grant numbers 101506/Z/13/Z and Research Training Fellowship 203616/Z/16/Z). R.C. acknowledges funding from the Ministry of Health of the Czech Republic (grant number 15-27109A). Publisher Copyright: © 2019 The Author(s) 2019. Published by Oxford University Press on behalf of the International Epidemiological Association.
PY - 2020/2/1
Y1 - 2020/2/1
N2 - 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.
AB - 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.
KW - Blood lipids
KW - HDL cholesterol
KW - LDL cholesterol
KW - Multi-country study
KW - Total cholesterol
UR - http://www.scopus.com/inward/record.url?scp=85074478745&partnerID=8YFLogxK
U2 - 10.1093/ije/dyz099
DO - 10.1093/ije/dyz099
M3 - Article
C2 - 31321439
AN - SCOPUS:85074478745
SN - 0300-5771
VL - 49
SP - 173
EP - 192
JO - International Journal of Epidemiology
JF - International Journal of Epidemiology
IS - 1
ER -