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

TitleTransitions from Ideal to Intermediate Cholesterol Levels may vary by Cholesterol Metric.
Publication TypePublication
Year2018
AuthorsEngeda JC, Holliday KM, Hardy ST, Chakladar S, Lin D-Y, Talavera GA, Howard BV, Daviglus ML, Pirzada A, Schreiner PJ, Zeng D, Avery CL
JournalSci Rep
Volume8
Issue1
Pagination2782
Date Published2018 02 09
ISSN2045-2322
KeywordsAdult, African Americans, Aged, Cholesterol, LDL, Cross-Sectional Studies, Data Analysis, European Continental Ancestry Group, Female, health status, Hispanic Americans, Humans, Male, Medical Records, Middle Aged, Retrospective Studies
Abstract

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.

DOI10.1038/s41598-018-20660-2
Alternate JournalSci Rep
PubMed ID29426885
PubMed Central IDPMC5807429
Grant ListR21 HL121580 / HL / NHLBI NIH HHS / United States
T32 ES007018 / ES / NIEHS NIH HHS / United States
T32 HL007055 / HL / NHLBI NIH HHS / United States
HHSN268201300025C / HL / NHLBI NIH HHS / United States
HHSN268201300026C / HL / NHLBI NIH HHS / United States
HHSN268201300027C / HL / NHLBI NIH HHS / United States
HHSN268201300028C / HL / NHLBI NIH HHS / United States
HHSN268201300029C / HL / NHLBI NIH HHS / United States
HHSN268200900041C / HL / NHLBI NIH HHS / United States
MS#: 
0364
Manuscript Lead/Corresponding Author Affiliation: 
Coordinating Center - Collaborative Studies Coordinating Center - UNC at Chapel Hill
ECI: 
Yes
Manuscript Status: 
Published