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

Journal Article (Journal Article)

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.

Full Text

Duke Authors

Cited Authors

  • Engeda, JC; Holliday, KM; Hardy, ST; Chakladar, S; Lin, D-Y; Talavera, GA; Howard, BV; Daviglus, ML; Pirzada, A; Schreiner, PJ; Zeng, D; Avery, CL

Published Date

  • February 9, 2018

Published In

Volume / Issue

  • 8 / 1

Start / End Page

  • 2782 -

PubMed ID

  • 29426885

Pubmed Central ID

  • PMC5807429

Electronic International Standard Serial Number (EISSN)

  • 2045-2322

Digital Object Identifier (DOI)

  • 10.1038/s41598-018-20660-2


  • eng

Conference Location

  • England