Transitions from Ideal to Intermediate Cholesterol Levels may vary by Cholesterol Metric

• Published in: Scientific reports Vol. 8; no. 1; pp. 2782 - 8
• Main Authors: Engeda, Joseph C., Holliday, Katelyn M., Hardy, Shakia T., Chakladar, Sujatro, Lin, Dan-Yu, Talavera, Gregory A., Howard, Barbara V., Daviglus, Martha L., Pirzada, Amber, Schreiner, Pamela J., Zeng, Donglin, Avery, Christy L.
• Format: Journal Article
• Language: English
• Published: London Nature Publishing Group UK 09.02.2018; Nature Publishing Group
• Subjects: 692/499; 692/700/478/174; Adult; Aged; Black or African American; Cholesterol; Cholesterol, LDL - blood; Cross-Sectional Studies; Data Analysis; Female; Health promotion; Health Status; Hispanic Americans; Hispanic or Latino; Humanities and Social Sciences; Humans; Low density lipoprotein; Male; Medical Records; Middle Aged; multidisciplinary; Public health; Retrospective Studies; Science; Science (multidisciplinary); White People
• ISSN: 2045-2322; 2045-2322
• DOI: 10.1038/s41598-018-20660-2

To examine the ability of total cholesterol (TC), a low-density lipoprotein cholesterol (LDL-C) proxy widely used in public health initiatives, to capture important population-level shifts away from ideal and intermediate LDL-C throughout adulthood. We estimated age (≥20 years)-, race/ethnic (Caucasian, African American, and Hispanic/Latino)-, and sex- specific net transition probabilities between ideal, intermediate, and poor TC and LDL-C using National Health and Nutrition Examination Survey (2007–2014; N = 13,584) and Hispanic Community Health Study/Study of Latinos (2008–2011; N = 15,612) data in 2016 and validated and calibrated novel Markov-type models designed for cross-sectional data. At age 20, >80% of participants had ideal TC, whereas the race/ethnic- and sex-specific prevalence of ideal LDL-C ranged from 39.2%-59.6%. Net transition estimates suggested that the largest one-year net shifts away from ideal and intermediate LDL-C occurred approximately two decades earlier than peak net population shifts away from ideal and intermediate TC. Public health and clinical initiatives focused on monitoring TC in middle-adulthood may miss important shifts away from ideal and intermediate LDL-C, potentially increasing the duration, perhaps by decades, that large segments of the population are exposed to suboptimal LDL-C.