Association of non-high-density lipoprotein hypercholesterol with metabolic syndrome, diabetes and arterial hypertension in the population of 45–69 years adults

Abstract

Objective. To study the prevalence of non-high-density lipoprotein hypercholesterol (non-HDL–C) and the average levels of non-HDL–C in metabolic syndrome (MS), type 2 diabetes mellitus (DM2), arterial hypertension (AH) and other cardiometabolic risk factors in the Siberian population aged 45–69 years.Design and methods. The evaluation of atherogenic dyslipidemia among persons with AН, MS, T2D was based on the materials of Siberian branch of HAPIEE project in the random sample n = 9360 surveyed in 2003–2005 HAPIEE. The study program included questionnaire survey, blood pressure (BP) measurement, anthropometry, biochemical screening. The value ≥ 3,4 mmol/l was considered as hypercholesterol-non-HDL. AH was diagnosed at systolic BP levels ≥ 140 mm hg. art. or diastolic BP ≥ 90 mm hg. art. and/or taking antihypertensive drugs within the last 2 weeks. Persons with previously diagnosed AH, but with normotonia at screening in cases of taking drugs that reduce BP, were also counted as patients with AH. DM2 was diagnozed — according to WHO criteria, 1999, ADA, 2013 — at fasted plasma glucose level ≥ 7,0 mmol/l and persons with previously diagnosed DM2. MS and its components were diagnosed according to IDF criteria (2005).Results. The mean value of non-HDL cholesterol in the general population of Novosibirsk aged 45–69 were 4,7 ± 1,3 mmol/l and were higher in women than in men — 4,9 ± 1,3 mmol/l and 4,5 ± 1,2 mmol/l, (p < 0,0001). The prevalence of hypercholesterol-non-HDL in women varies from 84,7 to 94,3% — and is significantly higher than in men — 80,6 to 84,1%. The level of non-HDL cholesterol ≥ 3,4 mmol/l was observed in 86,8% of the examined, 11% — in the range of 2,6–3,39 and only 2,2% — less than 2,6 mmol/l. The average values of non-HDL–C in men and women in three cohorts (with DM2, MS and AH) were found to be the highest in DM2, lower in MS than in DM, and lower in AH than in MS and DM2. In the cohort with DM2, non-HDL–C, according to the criterion of non-HDL–C ≥ 3,4 mmol/l, was determined in 89,4% of men and 95,7% of women; in persons with MS, it was found in 92,4% of men and 95,1% of women, with AH — in 85,2% of men and 92,5% of women of the Siberian population aged 45–69 years. The frequencies of AH, MS and DM2 in the 5th quintile of the distribution of non-HDL–C are higher compared to the first quintile (p < 0,0001), with a predominance of these indicators in the female population.Conclusions. According to study, the content of non-HDL–C, and its prevalence of elevated levels in the population is high, especially in people with DM2, MS, AH. In terms of developing a platform for prevention of cardiovascular diseases, MS and DM2, the non-HDL–C ratio deserves attention as a target for further research.