Factors associated with high LDL-Cholesterol in the Brazilian adult population: National Health Survey

Sá, Ana Carolina Micheletti Gomide Nogueira de; Machado, Ísis Eloah; Bernal, Regina Tomie Ivata; Malta, Deborah Carvalho

doi:10.1590/1413-81232021262.37102020

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ARTICLE • Ciênc. Saúde Colet. 26 (02) • Feb 2021 • https://doi.org/10.1590/1413-81232021262.37102020 copy

Factors associated with high LDL-Cholesterol in the Brazilian adult population: National Health Survey

Authorship SCIMAGO INSTITUTIONS RANKINGS

Abstract

The study analyzed factors associated with high LDL-Cholesterol in Brazilian population. This is a cross-sectional study with laboratory data from 8,534 individuals collected in National Health Survey were analyzed. The prevalence levels of LDL-Cholesterol <130 and ≥ 130 mg/dL were calculated. The outcome variable was high LDL-Cholesterol (≥ 130 mg/dL) and explanatory variables were sociodemographic, anthropometric, lifestyle, chronic diseases and self-rated health. To Poisson regression was used and estimated prevalence ratios (PR) with 95% confidence levels (CI) to verify associations. The prevalence of high LDL-Cholesterol was 18.58%. In the final multivariate model were associated with the outcome: 30 to 44 years (PR 1.99; CI 1.58-2.54), 45 to 59 years (PR 2.89; CI 2.29-3.64), 60 years or more (PR 2.90; CI 2.29-3.68), living in the Northeast Region (PR 1.16; CI 1.02 - 1.32), overweight (PR 1.32; CI 1.15-1.51), obesity (PR 1.41; CI 1.19-1.65) or anemia (PR 0.66; CI 0.54-0.80). The LDL-Cholesterol was associated with aging, overweight, obesity, live in the Northeast and anemia. The monitoring of LDL levels is relevant, due to the increased risk with age, and can guide the adopting healthy lifestyles and diagnosis in places with lower access.

Key words:
Cholesterol; LDL; Dyslipidemias; Health surveys; Risk factors; Laboratory test

LDL-cholesterol		Optimal threshold		High threshold
Variables	n*	%	95% CI	%	95% CI
Total	8,534	81.42	80.34-82.45	18.58	17.55-19.66
Gender	8,534
Male		82.87	81.24-84.38	17.13	15.62-18.76
Female		80.13	78.67-81.52	19.87	18.48-21.33
Age group in years	8,534
18-29		91.19	89.33-92.75	8.81	7.25-10.67
30-44		82.45	80.43-84.30	17.55	15.70-19.55
45-59		74.45	72.10-76.67	25.55	23.33-27.90
60 years and over		75.49	72.97-77.84	24.51	22.16-27.03
Schooling	8,534
Illiterate/Elementary incomplete		78.47	76.83-80.03	21.53	19.97-23.17
Elementary complete/High school incomplete		83.14	80.28-85.66	16.86	14.34-19.72
High school complete and over		83.34	81.64-84.91	16.66	15.10-18.36
Skin color	8,532
White and other		80.06	78.32-81.69	19.94	18.31-21.68
Black and brown		82.74	81.41-83.99	17.26	16.01-18.59
Region	8,534
North		83.78	82.08-85.34	16.22	14.66-17.92
Northeast		80.21	78.71-81.63	19.79	18.37-21.29
Southeast		82.13	80.05-84.04	17.87	15.96-19.95
South		79.98	77.36-82.37	20.02	17.63-22.64
Midwest		82.23	79.5-84.59	17.77	15.41-20.41
Body Mass Index	8,441
Underweight/normal		86.19	84.69-87.57	13.81	12.43-15.31
Overweight		78.90	77.04-80.66	21.10	19.34-22.96
Obesity		76.70	74.07-79.14	23.30	20.86-25.93
Fatty red meat consumption	8,054
Yes		82.03	79.93-83.96	17.97	16.04-20.07
No		81.06	79.73-82.33	18.94	17.60-20.27
Alcoholic beverage consumption	8,534
Light/moderate		82.05	79.26-84.54	17.95	15.46-20.74
Abuse		84.16	79.99-87.59	15.84	12.41-20.01
No		81.04	79.80-82.21	18.96	17.79-20.20
Tobacco use	8,527
Yes		79.75	76.60-82.58	20.25	17.42-23.40
No		81.69	80.53-82.79	18.31	17.21-19.47
Anemia	7,917
Yes		86.71	84.06-88.97	13.29	11.03-15.94
No		80.62	79.40-81.79	19.38	18.21-20.60
Arterial hypertension	8,157
Yes		76.73	74.35-78.96	23.27	21.04-25.65
No		82.61	81.35-83.80	17.39	16.20-18.65
Kidney failure	8,534
Yes		77.33	72.71-81.36	22.67	18.64-27.29
No		81.66	80.55-82.73	18.34	17.27-19.45
Diabetes	8,306
Yes		75.28	71.53-78.68	24.72	21.32-28.47
No		82.03	80.88-83.12	17.97	16.88-19.12
Self-rated health	8,527
Very good/good		83.46	82.12-84.73	16.54	15.27-17.88
Fair		77.95	75.90-79.87	22.05	20.13-24.10
Very poor/poor		75.76	71.47-79.59	24.24	20.41-28.53

Variables	PRcru	95%CI	p	PRadj^a	95%CI	p
Gender
Male	1			1
Female	1.16	1.03-1.30	0.013	1.16	1.03-1.30	0.011
Age group in years
18-29	1			1
30-44	1.99	1.60-2.49	< 0.01	1.98	1.58-2.48	< 0.01
45-59	2.90	2.34-3.59	< 0.01	2.87	2.31-3.56	< 0.01
60 years and over	2.78	2.24-3.46	< 0.01	2.72	2.17-3.41	< 0.01
Schooling
Illiterate/Elementary incomplete	1			1
Elementary complete/High school incomplete	0.78	0.66-0.93	0.006	0.78	0.66-0.93	0.007
High school complete and over	0.77	0.68-0.88	< 0.01	0.75	0.66-0.85	< 0.01
Ethnicity/skin color
White and other	1			1
Black and brown	0.87	0.77-0.97	0.012	0.82	0.73-0.93	0.003
Region
North	1			1
Northeast	1.22	1.08-1.38	0.002	1.18	1.05-1.34	0.007
Southeast	1.10	0.95-1.28	0.208	1.05	0.90-1.22	0.49
South	1.23	1.05-1.45	0.01	1.12	0.94-1.33	0.199
Midwest	1.09	0.92-1.30	0.3	1.07	0.90-1.27	0.412
Body Mass Index
Underweight/normal	1			1
Overweight	1.53	1.34-1.75	< 0.01	1.51	1.32-1.73	< 0.01
Obesity	1.69	1.45-1.96	< 0.01	1.63	1.41-1.91	< 0.01
Fatty red meat consumption
No	1			1
Yes	0.95	0.83-1.08	0.433	0.97	0.85-1.11	0.688
Alcoholic beverage consumption
No	1			1
Light/moderate	0.95	0.81-1.11	0.501	1.01	0.86-1.19	0.897
Abuse	0.84	0.65-1.07	0.154	0.87	0.70-1.12	0.291
Tobacco use
No	1			1
Yes	1.10	0.94-1.29	0.218	1.09	0.92-1.28	0.282
Anemia
No	1			1
Yes	0.69	0.56-0.83	< 0.01	0.66	0.54-0.80	< 0.01
Arterial hypertension
No	1			1
Yes	1.34	1.18-1.51	< 0.01	1.25	1.10-1.42	< 0.01
Kidney failure
No	1			1
Yes	1.24	1.01 -1.51	0.037	1.11	0.91-1.37	0.287
Diabetes
No	1			1
Yes	1.38	1.18-1.61	< 0.01	1.29	1.10-1.50	0.001
Self-rated health
Very good/good	1			1
Fair	1.33	1.18 −1.50	< 0.01	1.26	1.11-1.43	< 0.01
Very poor/poor	1.47	1.22−1.76	< 0.01	1.32	1.09-1.60	0.004

Variable	^PRadjb	95%CI	p
Gender
Male	1
Female	1.08	0.96-1.22	0.177
Age group in years
18-29	1
30-44	1.99	1.58-2.54	< 0.01
45-59	2.89	2.29-3.64	< 0.01
60 years and over	2.90	2.29-3.68	< 0.01
Region
North	1
Northeast	1.16	1.02-1.32	0.028
Southeast	0.94	0.80-1.10	0.474
South	1.06	0.89-1.25	0.5
Midwest	0.97	0.82-1.16	0.762
Body Mass Index
Underweight/normal	1
Overweight	1.32	1.15-1.51	< 0.01
Obesity	1.41	1.19-1.65	< 0.01
Anemia
No	1
Yes	0.66	0.54-0.80	< 0.01

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[1] Collaborations

ACMGN Sá participated in the study design, planning, design, statistical analysis, data interpretation, paper drafting, prepared the first version of the manuscript, and approved the version to be published. IE Machado participated in the planning, statistical analysis, and critical review of the paper. RTI Bernal participated in statistical analysis and data interpretation. DC Malta participated in designing and planning the PNS laboratory study, design, data interpretation, critical review, and approved the final version of the manuscript.