NCD Risk Factor Collaboration (NCD-RisC), 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, Volume 49, Issue 1, February 2020, Pages 173–192, https://doi.org/10.1093/ije/dyz099
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
|Author:||Taddei, Cristina1; Jackson, Rod2; Zhou, Bin1;|
1Imperial Coll London, London W2 1PG, England.
2Univ Auckland, Auckland, New Zealand.
3Harvard TH Chan Sch Publ Hlth, Boston, MA USA.
4Middlesex Univ, London, England.
5Natl Inst Hlth & Welf, Helsinki, Finland.
6Univ Hong Kong, Hong Kong, Peoples R China.
7New York Presbyterian Weill Cornell Med, New York, NY USA.
8Univ Kent, Canterbury, Kent, England.
9Shanghai Jiao Tong Univ, Sch Med, Shanghai, Peoples R China.
10Charles Univ Prague, Prague, Czech Republic.
11Katholieke Univ Leuven, Leuven, Belgium.
12Inst Pasteur, Lille, France.
13Lille Univ Hosp, Lille, France.
14Univ Ghent, Ghent, Belgium.
15French Publ Hlth Agcy, St Maurice, France.
16Ist Super Sanita, Rome, Italy.
17Univ Insubria, Varese, VA, Italy.
18Iceland Heart Assoc, Reykjavik, Iceland.
19Univ Bergen, Bergen, Norway.
20Seoul Natl Univ, Seoul, South Korea.
21Med Univ Innsbruck, Innsbruck, Austria.
22Univ Otago, Dunedin, New Zealand.
23Univ Padua, Padua, Italy.
24Lausanne Univ Hosp, Lausanne, Switzerland.
25Univ Edinburgh, Edinburgh, Midlothian, Scotland.
26NIH, Bldg 10, Bethesda, MD 20892 USA.
27Helmholtz Zentrum Munchen, Munich, Germany.
28Kobe Univ, Kobe, Hyogo, Japan.
29Kyushu Univ, Fukuoka, Japan.
30Inst Social & Prevent Med, Montreal, PQ, Canada.
31Lithuanian Univ Hlth Sci, Kaunas, Lithuania.
32Cardiovasc Prevent Ctr Udine, Udine, Italy.
33Univ Autonoma Madrid CIBERESP, Madrid, Spain.
34Canarian Hlth Serv, Tenerife, Spain.
35Stat Canada, Ottawa, ON, Canada.
36Kings Coll London, London, England.
37Umea Univ, Umea, Sweden.
38Univ Bari, Bari, Italy.
39Heart Fdn, Docklands, Vic, Australia.
40Univ Bonn, Bonn, Germany.
41UiT Arctic Univ Norway, Tromso, Norway.
42Univ Oxford, Oxford, England.
43Capital Med Univ Beijing, An Zhen Hosp, Beijing, Peoples R China.
44WHO, Geneva, Switzerland.
45Univ Adelaide, Adelaide, SA, Australia.
46Leibniz Inst Prevent Res & Epidemiol BIPS, Bremen, Germany.
47Lille Univ & Hosp, Lille, France.
48London Sch Hyg & Trop Med, London, England.
49Norwegian Sch Sport Sci, Oslo, Norway.
50Norwegian Inst Publ Hlth, Oslo, Norway.
51Strasbourg Univ & Hosp, Strasbourg, France.
52Univ Iceland, Reykjavik, Iceland.
53Univ Oulu, Oulu, Finland.
54Reg Author Publ Hlth, Banska Bystrica, Slovakia.
55Med Univ Lodz, Lodz, Poland.
56Med Univ Gdansk, Gdansk, Poland.
57Univ Autonoma Madrid, Madrid, Spain.
58Univ Palermo, Palermo, Italy.
59Dalhousie Univ, Halifax, NS, Canada.
60Univ Sydney, Sydney, NSW, Australia.
61Publ Hlth Agcy Canada, Ottawa, ON, Canada.
62Univ Gothenburg, Gothenburg, Sweden.
63Univ Turin, Turin, Italy.
64Nanyang Technol Univ, Singapore, Singapore.
65IRCCS Neuromed, Pozzilli, Italy.
66Toulouse Univ, Sch Med, Toulouse, France.
67Univ Hosp Varese, Varese, Italy.
68Katholieke Univ Leuven, Univ Hosp, Leuven, Belgium.
69Bielefeld Univ, Bielefeld, Germany.
70German Canc Res Ctr, Heidelberg, Germany.
71Robert Koch Inst, Berlin, Germany.
72Univ La Laguna, San Cristobal la Laguna, Spain.
73Cardiol Mercato S Severino, Mercato San Severino, Italy.
74Santiago de Compostela Univ, Santiago De Compostela, Spain.
75UCL, London, England.
76Assoc Calabrese Epatol, Cittanova, Italy.
77Council Agr Res & Econ, Rome, Italy.
78Capital Inst Pediat, Beijing, Peoples R China.
79Kailuan Gen Hosp, Tangshan, Peoples R China.
80Murcia Hlth Council, IMIB Arrixaca, CIBERESP, Murcia, Spain.
81Seoul Natl Univ, Coll Med, Seoul, South Korea.
82Korea Ctr Dis Control & Prevent, Cheongju, South Korea.
83Med Univ Silesia, Katowice, Poland.
84Univ Southampton, Southampton, Hants, England.
85CIBEROBN, Madrid, Spain.
86Natl Council Res, Rome, Italy.
87Mediterranea Cardioctr, Naples, Italy.
88Univ Queensland, Brisbane, Qld, Australia.
89Cardinal Wyszynski Inst Cardiol, Warsaw, Poland.
90Inst Hosp del Mar Invest Med, Madrid, Spain.
91Queens Univ Belfast, Belfast, Antrim, North Ireland.
92Univ Zurich, Zurich, Switzerland.
93Ctr Salud Villanueva Norte, Badajoz, Spain.
94Serv Extremeno Salud, Madrid, Spain.
95Univ Manchester, Manchester, Lancs, England.
96Hosp Univ Son Espases, Palma De Mallorca, Spain.
97Kindai Univ, Higashihiroshima, Japan.
98Med Univ Warsaw, Warsaw, Poland.
99Univ Catania, Catania, Italy.
100CIBER Epidemiol & Salud Publ, Madrid, Spain.
101Geneva Univ Hosp, Geneva, Switzerland.
102Australian Bur Stat, Canberra, ACT, Australia.
103Lund Univ, Lund, Sweden.
104McGill Univ, Montreal, PQ, Canada.
105Univ Politecn Madrid, Madrid, Spain.
106Univ Lille 2, Lille, France.
107Inst Clin & Expt Med, Prague, Czech Republic.
108Jagiellonian Univ, Med Coll, Krakow, Poland.
109Natl Ctr Cardiovasc Dis, Beijing, Peoples R China.
110Tulane Univ, New Orleans, LA 70118 USA.
111Chinese Ctr Dis Control & Prevent, Beijing, Peoples R China.
112Oulu Univ Hosp, Oulu, Finland.
113Univ Western Australia, Nedlands, WA, Australia.
114Kingston Hlth Sci Ctr, Kingston, ON, Canada.
115Int Agcy Res Canc, Lyon, France.
116Natl Inst Hlth & Nutr, Tokyo, Japan.
117Niigata Univ, Niigata, Japan.
118Norwegian Univ Sci & Technol, Trondheim, Norway.
119Natl Hlth Insurance Serv, Seoul, South Korea.
120Guangzhou 12th Hosp, Guangzhou, Guangdong, Peoples R China.
121Simon Fraser Univ, Burnaby, BC, Canada.
122Heidelberg Univ, Heidelberg, Germany.
123Univ Opole, Opole, Poland.
124Univ Eastern Finland, Kuopio, Finland.
125Univ Munster, Munster, Germany.
126Res Inst Child Nutr, Dortmund, Germany.
127Natl Canc Ctr, Goyang Si, South Korea.
128Univ Hosp Ulm, Ulm, Germany.
129Univ Jyvaskyla, Jyvaskyla, Finland.
130Sahlgrens Acad, Gothenburg, Sweden.
131Tampere Univ Hosp, Tampere, Finland.
132West Virginia Univ, Morgantown, WV 26506 USA.
133Univ Chinese Acad Sci, Beijing, Peoples R China.
134Uppsala Univ, Uppsala, Sweden.
135Gothenburg Univ, Gothenburg, Sweden.
136Univ Med Greifswald, Greifswald, Germany.
137Consejeria Sanidad Junta Castilla & Leon, Valladolid, Spain.
138Norrbotten Cty Council, Lulea, Sweden.
139Peking Univ, Beijing, Peoples R China.
140Jikei Univ, Sch Med, Tokyo, Japan.
141CNR, Rome, Italy.
142Baker Heart & Diabet Inst, Melbourne, Vic, Australia.
143INSERM, Paris, France.
144Univ Zaragoza, Zaragoza, Spain.
145Int Inst Mol & Cell Biol, Warsaw, Poland.
146Univ Brescia, Brescia, Italy.
147IRCCS Casa Sollievo Sofferenza, San Giovanni Rotondo, Italy.
148Publ Hlth Agcy Catalonia, Catalonia, Spain.
149Univ Turku, Turku, Finland.
150Inst Univ Invest Atencio Primaria Jordi Gol, Barcelona, Spain.
151Univ Valencia, Valencia, Spain.
152Hlth Ctr San Agustin, Maspalomas, Las Palmas, Spain.
153Toulouse Univ Hosp, Toulouse, France.
154Univ Helsinki, Helsinki, Finland.
155Catalan Dept Hlth, Catalonia, Spain.
156South Karelia Social & Hlth Care Dist, Lappeenranta, Finland.
157Sungkyunkwan Univ, Seoul, South Korea.
158Finnish Inst Occupat Hlth, Helsinki, Finland.
159St Vincents Hosp, Darlinghurst, NSW, Australia.
160Univ New South Wales, Sydney, NSW, Australia.
161Karolinska Inst, Solna, Sweden.
162Univ Bordeaux, Bordeaux, France.
163Univ Leuven, Leuven, Belgium.
164Natl Inst Publ Hlth Natl Inst Hyg, Warsaw, Poland.
165Mahidol Univ, Salaya, Thailand.
166Hlth Serv Murcia, Murcia, Spain.
167IB SALUT Area Salut Menorca, Ciutadella De Menorca, Illes Balears, Spain.
168Natl Canc Ctr, Tokyo, Japan.
169Univ Tampere, Tays Eye Ctr, Tampere, Finland.
170Univ Miguel Hernandez, Elche, Spain.
171ISGlobal Ctr Res Environm Epidemiol, Madrid, Spain.
172Univ Strasbourg, Strasbourg, France.
173Hlth Canada, Ottawa, ON, Canada.
174Xinjiang Med Univ, Urumqi, Peoples R China.
175Capital Med Univ, Beijing, Peoples R China.
176St Georges Univ London, London, England.
177Minist Agr, Inst Food & Nutr Dev, Beijing, Peoples R China.
178Beijing Inst Ophthalmol, Beijing, Peoples R China.
179Fudan Univ, Childrens Hosp, Shanghai, Peoples R China.
|Online Access:||PDF Full Text (PDF, 0.7 MB)|
|Persistent link:|| http://urn.fi/urn:nbn:fi-fe2020091769960
Oxford University Press,
|Publish Date:|| 2020-09-17
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.
International journal of epidemiology
|Pages:||173 - 192|
|Type of Publication:||
A1 Journal article – refereed
|Field of Science:||
3141 Health care science
3121 General medicine, internal medicine and other clinical medicine
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).
© The Author(s) 2019. Published by Oxford University Press on behalf of the International Epidemiological Association. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted reuse, distribution, and reproduction in any medium, provided the original work is properly cited.