Trends in Lipids and Lipoproteins in US Adults, 1988-2010
Have levels of serum lipids changed over the past several decades among American adults?
Data from the National Health and Nutrition Examination Surveys, 1988-1994 (n = 16,573), 1999-2002 (n = 9,471), and 2007-2010 (n = 11,766) were used for this analysis. The primary outcomes of interest were mean total cholesterol, low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), non–HDL-C, and geometric mean triglyceride levels. Trends in the prevalence of lipid-lowering medication use were also assessed.
Mean total cholesterol declined from 206 (95% confidence interval [CI], 205-207) mg/dl in 1988-1994, to 196 (95% CI, 195-198) mg/dl in 2007-2010 (p < 0.001 for linear trend). Declines were also observed in mean LDL-C from 129 (95% CI, 127-130) mg/dl to 116 (95% CI, 114-117) mg/dl (p < 0.001 for linear trend). Mean non–HDL-C declined from 155 (95% CI, 153-157) mg/dl in 1988-1994, to 144 (95% CI, 143-145) mg/dl in 2007-2010 (p < 0.001 for linear trend). Mean HDL-C increased from 50.7 (95% CI, 50.0-51.0) mg/dl during 1988-1994 to 52.5 (95% CI, 51.8-53.2) mg/dl in 2007-2010 (p = 0.001 for linear trend). Geometric mean serum triglyceride levels increased from 118 (95% CI, 114-121) mg/dl in 1988-1994 to 123 (95% CI, 119-127) mg/dl in 1999-2002, and then decreased to 110 (95% CI, 107-113) mg/dl in 2007-2010 (p < 0.001 for quadratic trend). The prevalence of lipid-lowering medication use increased from 3.4% (95% CI, 2.9%-3.9%) in 1988-1994, to 15.5% (95% CI,14.7%-16.3%) in 2007-2010 (p < 0.001 for linear trend). Among adults not receiving lipid-lowering medications, trends in lipids were similar to those reported for adults overall. Among obese adults, mean total cholesterol, non–HDL-C, LDL-C, and geometric mean triglycerides declined between 1988 and 2010.
The authors concluded that between 1988 and 2010, favorable trends in lipid levels have occurred among adults in the United States.
These trends demonstrate encouraging reductions in serum lipids, including among both men and women, and among adults not taking lipid-lowering therapy. Efforts to understand the factors associated with such trends will help inform future public health policy.
Keywords: Cholesterol, Lipids, Lipoproteins, Triglycerides, Nutrition Surveys, United States
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