Low HDL-C risk factors identified
MedWire News: Researchers suggest that a prevention policy that focuses on reducing smoking and abdominal obesity, particularly in deprived individuals, could increase levels of high-density lipoprotein (HDL) cholesterol and reduce risk for cardiovascular (CV) disease.
Pierre Lecomte (Centre Hospitalier Régional et Universitaire, Breteonneau, France) and colleagues show that low levels of HDL cholesterol are associated with CV risk factors, the metabolic syndrome, and social deprivation in a large population of French men and women.
They add that patients with very low levels of HDL cholesterol (less than or equal to the 5th percentile) were more likely to live a sedentary lifestyle and be socially deprived than those with higher levels, and that abdominal obesity, smoking, hypertriglyceridemia, hyperleucocytosis, and low alcohol consumption were also associated with very low levels in both genders.
The team asked over 40,000 French men and women (aged 16-79 years) to complete a questionnaire about their socioeconomic and family status, personal and familial medical histories, and lifestyle behaviors.
According to the National Cholesterol Education Program Adult Treatment Panel III guidelines, 11.1% of men and 26.4% of women in the study population had low (<40.0 mg/dl [1.04 mmol/l] for men and <50 mg/dl [1.3 mmol/l] for women) HDL cholesterol levels.
Mean HDL cholesterol levels increased with age, while the prevalence of low HDL cholesterol gradually decreased with age. In their 20s, 21.2% and 42.4% of men and women had low HDL compared with 7.6% and 16.3% of those in their 60s, respectively.
The researchers found that a sedentary lifestyle (defined as taking part in physical activity less than once a week), smoking, and diabetes were more frequent in individuals with very low HDL cholesterol levels.
For both genders, waist circumference, triglyceride levels, fatty liver index, white blood cell count, and deprivation score (Evaluation de la Précarité et des Inégalités de Santé dans les Centres d'Examens de Santé [EPICES]) were higher in individuals with very low HDL cholesterol compared with those who had higher levels, while, in men only, alcohol consumption and total energy intake were lower.
Notably, there was a huge proportion of patients with very low HDL levels who lived a sedentary lifestyle, at 71% of men and 76% of women.
Writing in the Annals of Epidemiology, Lecomte's team says: "Despite the complexity of lifestyle modifications, patients with low levels of HDL cholesterol should be encouraged to increase physical activity on a regular basis, to stop smoking and achieve stable weight reduction, and to follow the calcium and sucrose intake recommendations."
They add that increasing HDL cholesterol levels should be a major target for the prevention of CV risk, as well as for the correction of other components of the metabolic syndrome.
MedWire (www.medwire-news.md) is an independent clinical news service provided by Current Medicine Group, a trading division of Springer Healthcare Limited. © Springer Healthcare Ltd; 2011
By Nikki Withers