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Chair in Global Environmental Health



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BibTex format

author = {Taddei, C and Jackson, R and Zhou, B and Bixby, H and Danaei, G and Di, Cesare M and Kuulasmaa, K and Hajifathalian, K and Bentham, J and Bennett, JE and Aekplakorn, W and Cifkova, R and Dallongeville, J and De, Bacquer D and Giampaoli, S and Gudnason, V and Khang, Y-H and Laatikainen, T and Mann, JI and Marques-Vidal, P and Mensah, GA and Müller-Nurasyid, M and Ninomiya, T and Petkeviciene, J and Rodríguez-Artalejo, F and Servais, J and Söderberg, S and Stavreski, B and Wilsgaard, T and Zdrojewski, T and Zhao, D and Stevens, GA and Savin, S and Cowan, MJ and Riley, LM and Ezzati, M},
doi = {ije/dyz099},
journal = {International Journal of Epidemiology},
pages = {173--192},
title = {National trends in total cholesterol obscure heterogeneous changes in HDL and non-HDL cholesterol and total-to-HDL cholesterol ratio: an analysis of trends in Asian and Western countries},
url = {},
volume = {49},
year = {2020}

RIS format (EndNote, RefMan)

AB - Background: Although high-density lipoprotein (HDL) and non-HDL cholesterol have opposite associations with coronary heart disease (CHD), multi-country reports of lipid trends only use total cholesterol (TC). Our aim was to compare trends in total, HDL and non-HDL cholesterol and total-to-HDL cholesterol ratio in Asian and Western countries.Methods: We pooled 458 population-based studies with 82.1 million participants in 23 Asian and Western countries. We estimated changes in mean total, HDL and non-HDL cholesterol, and mean total-to-HDL cholesterol ratio by country, sex and age group.Results: Since ~1980, mean TC increased in Asian countries. In Japan and South Korea, TC rise was due to rising HDL cholesterol, which increased by up to 0.17 mmol/L per decade in Japanese women; in China, it was due to rising non-HDL cholesterol. TC declined in Western countries, except in Polish men. The decline was largest in Finland and Norway, ~0.4 mmol/Lper decade. The decline in TC in most Western countries was the net effect of an increase in HDL cholesterol and a decline in non-HDL cholesterol, with the HDL cholesterol increase largest in New Zealand and Switzerland. Mean total-to-HDL cholesterol ratio declined in Japan, South Korea and most Western countries, by as much as ~0.7 per decade in Swiss men (equivalent to ~26% decline in CHD risk per decade). The ratio increased in China. Conclusions: HDL cholesterol has risen and total-to-HDL cholesterol ratio has declined in many Western countries, Japan and South Korea, with only weak correlation to changes in TC or non-HDL cholesterol.
AU - Taddei,C
AU - Jackson,R
AU - Zhou,B
AU - Bixby,H
AU - Danaei,G
AU - Di,Cesare M
AU - Kuulasmaa,K
AU - Hajifathalian,K
AU - Bentham,J
AU - Bennett,JE
AU - Aekplakorn,W
AU - Cifkova,R
AU - Dallongeville,J
AU - De,Bacquer D
AU - Giampaoli,S
AU - Gudnason,V
AU - Khang,Y-H
AU - Laatikainen,T
AU - Mann,JI
AU - Marques-Vidal,P
AU - Mensah,GA
AU - Müller-Nurasyid,M
AU - Ninomiya,T
AU - Petkeviciene,J
AU - Rodríguez-Artalejo,F
AU - Servais,J
AU - Söderberg,S
AU - Stavreski,B
AU - Wilsgaard,T
AU - Zdrojewski,T
AU - Zhao,D
AU - Stevens,GA
AU - Savin,S
AU - Cowan,MJ
AU - Riley,LM
AU - Ezzati,M
DO - ije/dyz099
EP - 192
PY - 2020///
SN - 1464-3685
SP - 173
TI - National trends in total cholesterol obscure heterogeneous changes in HDL and non-HDL cholesterol and total-to-HDL cholesterol ratio: an analysis of trends in Asian and Western countries
T2 - International Journal of Epidemiology
UR -
UR -
UR -
VL - 49
ER -