Abstract 1189: Changes in the Prevalence of Abnormal Lipid Fractions among US Adults: Results from the National Health and Nutrition Examination Survey II, III, and 1999–2006
Objective To examine the prevalence of abnormal lipid fractions among US adults from 1976 through 2006, with a focus on the relationship of dyslipidemia and obesity.
Methods Adults aged 20 to 74 years who took the blood lipid examination were selected from the National Health and Nutrition Examination Surveys (NHANES): NHANES II (1976 –1980), NHANES III (1988 –1994), and NHANES 1999 –2006. Obesity was defined as BMI ≥ 30 kg/m2. Dyslipidemia was defined as presence of one or more abnormal lipid fractions: low density lipoprotein cholesterol (LDL-C) ≥ 100 mg/dL, high density lipoprotein cholesterol (HDL-C) < 40 mg/dL, and triglycerides (TG) ≥ 150 mg/dL. Crude and age-stratified proportions of abnormal lipid fractions for US adults and for those with obesity were estimated. Multivariate analysis was used to assess the association between dyslipidemia and obesity, controlling for age, gender, race/ethnicity, NHANES wave, and comorbidities (heart attack, diabetes and smoking status).
Results The prevalence of abnormal LDL-C decreased from 43.5% in NHANES II to 36.3% in NHANES 1999–2006; however, during this period, the prevalence of abnormal TG and HDL-C combined doubled from 2.1% to 4.8% and the abnormal TG more than tripled within the elderly population (from 1.8% to 11.3%). It was estimated that antidyslipidemic medication use was less than 2.6% for adults with dyslipidemia throughout study period. With the increased prevalence of obesity between NHANES II and NHANES 1999 –2006, the prevalence of abnormal TG and HDL-C combined increased from 3.8% in NHANES II to 6.5% in NHANES 1999 –2006 within obese adults. Multivariate analyses of BMI with dyslipidemia were significant (p< 0.001). Adults with obesity were more likely to have dyslipidemia than those with BMI < 25 kg/m2 [OR=2.9, (95% CI: 2.7–3.2)].
Conclusions Prevalence of abnormal TG and/or HDL-C increased between NHANES II and NHANES 1999–2006 although the abnormal LDL-C shows an optimistic trend. This was paralleled by a shift in the distribution of BMI toward the obese category. As the US population is aging and becoming more obese, this analysis underscores the need for renewed public health efforts with focus on treating multiple abnormal lipid fractions and preventing dyslipidemia via body mass control.