Dyslipidemia and Associated Risk Factors in the Elderly Population in Asmara, Eritrea: Results from a Community-Based Cross-Sectional Study

Abstract

Background. The ultimate goal of the study was to approximate the burden and patterns of dyslipidemia in a subset of the elderly population (≥60–85 years) living in Asmara, Eritrea, and to identify modifiable risk drivers. Methods. A total of 319 (145 (45.5%) male vs. 174 (54.5%) female, mean $\text{age}\pm \text{SD}$ (68.06 ± 6.16 years), participants from randomly selected estates within Asmara were enrolled. Demographic and medical information was collected using a standardized questionnaire. Anthropometric, lipid panel, fasting plasma glucose (FPG), and blood pressure (BP) measurements were subsequently taken. Results. The prevalence of dyslipidemia was 70.5%. The proportions of dyslipidemias were (in order of decreasing frequency) high TC (51.2%), LDL-C (43.7%), low HDL-C (28.2%), and TG (27.6%). The average (±SD) concentrations in mg/dL of TC, LDL-C, non-HDL-C, TG, HDL-C, TC/HDL-C, and TG/HDL-C were $202.2\pm 40.63$ , $125.95\pm 33.16$ , $151.72\pm 37.19$ , $129\pm 57.16$ , $50.48\pm 10.91$ , $4.11\pm 0.91$ , and $2.72\pm 1.49$ , respectively. Furthermore, 17.5%, 21.6%, 11.0%, and 5.0% had abnormalities in 1, 2, 3, and 4 lipid disorders with the copresence of TC+LDL-C abnormalities dominating. Regarding National Cholesterol Education Program Third Adult Treatment Panel risk strata, 18.5%, 14.5%, 28.2%, and 12.9% were in high or very high-risk categories for TC, LDL-C, TG, and HDL-C, respectively. The high burden of dyslipidemia coexisted with an equally high burden of abdominal obesity (43.1%), $\text{FPG}\ge 100\text{mg}/\text{dL}$ (16%), hypertension (28.5%), and physical inactivity. Overall, dyslipidemia was associated with sex (females: $\text{aOR}=2.6$ , $95\%\text{CI}=1.1–6.1$ , $p=0.017$ ) and daily physical activity—higher in individuals undertaking physical activity for <1 hour ( $\text{aOR}=2.6$ , $95\%\text{CI}=1.1–6.1$ , $p=0.029$ ), 1-2 hours ( $\text{aOR}=3.2$ , $95\%\text{CI}=1.24–8.5$ , $p=0.016$ ), and 2-3 hours ( $\text{aOR}=2.0$ , $95\%\text{CI}=0.7–5.8$ , $p=0.192$ ) (Ref: >3 hours). Additional associations included increasing FPG ( $\text{aOR}=1.02$ , $95\%\text{CI}=1.0–1.04$ , $p=0.039$ ), and BMI ( $\text{aOR}=1.19$ , $95\%\text{CI}=1.09–1.3$ , $p<0.001$ ). These factors, along with waist circumference (WC), consumption of traditional foods, systolic BP, and diastolic BP, were, with some variations, associated with disparate dyslipidemias. Conclusions. The burden of dyslipidemia in the elderly population in Asmara is high. Modifiable risk drivers included FPG, WC, physical inactivity, and low consumption of traditional food. Overall, efforts directed at scaling up early recognition and treatment, including optimal pharmacological and nonpharmacological therapy, at all levels of care, should be instituted.