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Published in: Journal of Diabetes & Metabolic Disorders 2/2020

01-12-2020 | Obesity | Research article

NDSP 05: Prevalence and pattern of dyslipidemia in urban and rural areas of Pakistan; a sub analysis from second National Diabetes Survey of Pakistan (NDSP) 2016–2017

Authors: Abdul Basit, Sobia Sabir, Musarrat Riaz, Asher Fawwad, NDSP members

Published in: Journal of Diabetes & Metabolic Disorders | Issue 2/2020

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Abstract

Objectives

Dyslipidemia is a major risk issue for the development of cardiovascular disease. The aim of our study was to observe the pattern and prevalence of dyslipidemia in Pakistani population.

Methodology

This is a sub analysis of a population based second National Diabetes Survey of Pakistan (NDSP) 2016–2017 in adults aged 20 years or above, carried out from February 2016 to August 2017 across Pakistan. Multi stage sampling technique was used for the stratification of population, based on rural and urban domains. District wise clusters and sub clusters were selected i.e. 27 and 46 in number. Subjects, consented to participate were requested to come after an overnight fast for anthropometric measurements, oral glucose tolerance test and fasting lipid profile (except for subjects with self-reported diabetes). Dyslipidemia was identified using Adult Treatment Panel III guidelines.

Results

A total of 10,834 subjects (43.8% male and 56.2% female) having mean age of 43.8 ± 14.0 years, participated in the survey. Of the subjects studied, 39.3% had hypercholesterolemia, 48.9% had hypertriglyceridemia, 39.7% had high LDL-C levels while 83.9% men and 90% women had low HDL levels. High cholesterol and triglyceride levels were highest in 50–59 years age group, while high LDL and low HDL was most common in 40–49 years age group. Diabetes, obesity and hypertension were found to be the significant determinants for dyslipidemia.

Conclusion

Prevalence of dyslipidemia seems to be very high in Pakistan, necessitating an urgent call for early screening and effective management through lifestyle intervention and appropriate lipid lowering drugs to prevent this important cardiovascular risk factor.
Literature
1.
go back to reference Lee JS, Chang PY, Zhang Y, Kizer JR, Best LG, Howard BV. Triglyceride and HDL-C dyslipidemia and risks of coronary heart disease and ischemic stroke by glycemic dysregulation status: the strong heart study. Diabetes Care. 2017;40(4):529–37.CrossRef Lee JS, Chang PY, Zhang Y, Kizer JR, Best LG, Howard BV. Triglyceride and HDL-C dyslipidemia and risks of coronary heart disease and ischemic stroke by glycemic dysregulation status: the strong heart study. Diabetes Care. 2017;40(4):529–37.CrossRef
2.
go back to reference Enas EA, Yusuf S, Mehta JL. Prevalence of coronary artery disease in asian Indians. Am J Cardiol. 1992;70:945–9.CrossRef Enas EA, Yusuf S, Mehta JL. Prevalence of coronary artery disease in asian Indians. Am J Cardiol. 1992;70:945–9.CrossRef
3.
go back to reference Nishiyama Y, Otsuka T, Ueda M, Kimura K. Dyslipidemia should be associated with an increased risk of hypertension in a working-age Japanese male population. Stroke. 2016;47:ATP197. Nishiyama Y, Otsuka T, Ueda M, Kimura K. Dyslipidemia should be associated with an increased risk of hypertension in a working-age Japanese male population. Stroke. 2016;47:ATP197.
4.
go back to reference Cicero AF, Rosticci M, Baronio C, Morbini M, Parini A, Grandi E, et al. Serum LDL cholesterol levels and new onset of arterial hypertension: an 8-year follow-up. Eur J Clin Investig. 2014;44(10):926–32.CrossRef Cicero AF, Rosticci M, Baronio C, Morbini M, Parini A, Grandi E, et al. Serum LDL cholesterol levels and new onset of arterial hypertension: an 8-year follow-up. Eur J Clin Investig. 2014;44(10):926–32.CrossRef
5.
go back to reference Alshamiri M, Ghanaim MMA, Barter P, Chang KC, Li JJ, Matawaran BJ, et al. Expert opinion on the applicability of dyslipidemia guidelines in Asia and the Middle East. Int J Gen Med. 2018;11:313–22.CrossRef Alshamiri M, Ghanaim MMA, Barter P, Chang KC, Li JJ, Matawaran BJ, et al. Expert opinion on the applicability of dyslipidemia guidelines in Asia and the Middle East. Int J Gen Med. 2018;11:313–22.CrossRef
6.
go back to reference Jacobs DR Jr, Mebane IL, Bangdiwala SI, Criqui MH, Tyroler HA. High density lipoprotein cholesterol as a predictor of cardiovascular disease mortality in men and women: the follow-up study of the lipid research clinics prevalence study. Am J Epidemiol. 1990;131(1):32–47.CrossRef Jacobs DR Jr, Mebane IL, Bangdiwala SI, Criqui MH, Tyroler HA. High density lipoprotein cholesterol as a predictor of cardiovascular disease mortality in men and women: the follow-up study of the lipid research clinics prevalence study. Am J Epidemiol. 1990;131(1):32–47.CrossRef
7.
go back to reference Barter P, Gotto AM, LaRosa JC, Maroni J, Szarek M, Grundy SM, et al. HDL cholesterol, very low levels of LDL cholesterol, and cardiovascular events. N Engl J Med. 2007;357(13):1301–10.CrossRef Barter P, Gotto AM, LaRosa JC, Maroni J, Szarek M, Grundy SM, et al. HDL cholesterol, very low levels of LDL cholesterol, and cardiovascular events. N Engl J Med. 2007;357(13):1301–10.CrossRef
8.
go back to reference Chang WT, Yin WH, Lin FJ, Tseng WK, Wu YW, Li YH, et al. Non-high-density-lipoprotein cholesterol is an important residual risk factor in the secondary prevention for patients with established atherosclerotic cardiovascular diseases. Circulation. 2016;134:A16414. Chang WT, Yin WH, Lin FJ, Tseng WK, Wu YW, Li YH, et al. Non-high-density-lipoprotein cholesterol is an important residual risk factor in the secondary prevention for patients with established atherosclerotic cardiovascular diseases. Circulation. 2016;134:A16414.
9.
go back to reference Al-Nozha MM, Abdullah M, Arafah MR, Khalil MZ, Khan NB, Al-Mazrou YY, et al. Hypertension in saudi arabia. Saudi Med J. 2007;28(1):77–84.PubMed Al-Nozha MM, Abdullah M, Arafah MR, Khalil MZ, Khan NB, Al-Mazrou YY, et al. Hypertension in saudi arabia. Saudi Med J. 2007;28(1):77–84.PubMed
10.
go back to reference Al-Dahi S, Al-Khashan H, Al Madeer MA, Al-Saif K, Al-Amri MD, Al-Ghamdi O, et al. Assessment of framingham cardiovascular disease risk among militaries in the Kingdom of Saudi Arabia. Mil Med. 2013;178(3):299–305.CrossRef Al-Dahi S, Al-Khashan H, Al Madeer MA, Al-Saif K, Al-Amri MD, Al-Ghamdi O, et al. Assessment of framingham cardiovascular disease risk among militaries in the Kingdom of Saudi Arabia. Mil Med. 2013;178(3):299–305.CrossRef
11.
go back to reference Alwan AA (1993) Cardiovascular diseases in the eastern Mediterranean region. World health statistics quarterly Rapport trimestriel de statistiques sanitaires mondiales 46[2]: 97–100. Alwan AA (1993) Cardiovascular diseases in the eastern Mediterranean region. World health statistics quarterly Rapport trimestriel de statistiques sanitaires mondiales 46[2]: 97–100.
12.
go back to reference Basit A, Fawwad A, Qureshi H, Shera AS (2018) NDSP Members. Prevalence of diabetes, pre-diabetes and associated risk factors: second National Diabetes Survey of Pakistan [NDSP], 2016–2017. BMJ Open 8:e020961. Basit A, Fawwad A, Qureshi H, Shera AS (2018) NDSP Members. Prevalence of diabetes, pre-diabetes and associated risk factors: second National Diabetes Survey of Pakistan [NDSP], 2016–2017. BMJ Open 8:e020961.
15.
go back to reference Joshi SR, Anjana RM, Deepa M, Pradeepa R, Bhansali A, Dhandania VK, et al. Prevalence of dyslipidemia in urban and rural India: the ICMR-INDIAB study. PLoS One. 2014;9(5):e96808.CrossRef Joshi SR, Anjana RM, Deepa M, Pradeepa R, Bhansali A, Dhandania VK, et al. Prevalence of dyslipidemia in urban and rural India: the ICMR-INDIAB study. PLoS One. 2014;9(5):e96808.CrossRef
16.
go back to reference Anjana RM, Pradeepa R, Deepa M, Datta M, Sudha V, Unnikrishnan R, et al. The Indian Council of Medical Research-India diabetes (ICMR-INDIAB) study: methodological details. J Diabetes Sci Technol. 2011;5(4):906–14.CrossRef Anjana RM, Pradeepa R, Deepa M, Datta M, Sudha V, Unnikrishnan R, et al. The Indian Council of Medical Research-India diabetes (ICMR-INDIAB) study: methodological details. J Diabetes Sci Technol. 2011;5(4):906–14.CrossRef
18.
go back to reference Kawamoto R, Tabara Y, Kohara K, Miki T, Kusunoki T, Takayama S, et al. Relationships between lipid profiles and metabolic syndrome, insulin resistance and serum high molecular adiponectin in Japanese community-dwelling adults. Lipids Health Dis. 2011;10:79–85.CrossRef Kawamoto R, Tabara Y, Kohara K, Miki T, Kusunoki T, Takayama S, et al. Relationships between lipid profiles and metabolic syndrome, insulin resistance and serum high molecular adiponectin in Japanese community-dwelling adults. Lipids Health Dis. 2011;10:79–85.CrossRef
19.
go back to reference Fawwad A, Sabir R, Riaz M, Moin H, Basit A. Measured versus calculated LDL-cholesterol in subjects with type 2 diabetes. Pak J Med Sci. 2016;32(4):955–60.PubMedPubMedCentral Fawwad A, Sabir R, Riaz M, Moin H, Basit A. Measured versus calculated LDL-cholesterol in subjects with type 2 diabetes. Pak J Med Sci. 2016;32(4):955–60.PubMedPubMedCentral
20.
go back to reference Fawwad A, Sabir R, Riaz M, Moin H, Basit A. Measured versus calculated LDL-cholesterol in subjects with type 2 diabetes. Pak J Med Sci. 2016;32(4):955–60.PubMedPubMedCentral Fawwad A, Sabir R, Riaz M, Moin H, Basit A. Measured versus calculated LDL-cholesterol in subjects with type 2 diabetes. Pak J Med Sci. 2016;32(4):955–60.PubMedPubMedCentral
21.
go back to reference Executive Summary of The Third Report of The National Cholesterol Education Program [NCEP] Expert Panel on Detection, Evaluation, And Treatment of High Blood Cholesterol In Adults [Adult Treatment Panel III]. JAMA. 2001; 285[19]:2486–97. Executive Summary of The Third Report of The National Cholesterol Education Program [NCEP] Expert Panel on Detection, Evaluation, And Treatment of High Blood Cholesterol In Adults [Adult Treatment Panel III]. JAMA. 2001; 285[19]:2486–97.
22.
go back to reference American Diabetes Association [ADA]. Standards of medical care in diabetes - 2018. Diabetes Care. 2016; 41 [1]: 1–106. American Diabetes Association [ADA]. Standards of medical care in diabetes - 2018. Diabetes Care. 2016; 41 [1]: 1–106.
23.
go back to reference WHO Western Pacific Region, International Association for the Study of obesity, international obesity task force. The Asia Pacific perspective: redefining obesity and its treatment. Health Communications Australia Pty Limited: St Leonards, 2000. WHO Western Pacific Region, International Association for the Study of obesity, international obesity task force. The Asia Pacific perspective: redefining obesity and its treatment. Health Communications Australia Pty Limited: St Leonards, 2000.
24.
go back to reference Lim JU, Lee JH, Kim JS, Hwang YI, Kim TH, Lim SY, et al. Comparison of World Health Organization and Asia-Pacific body mass index classifications in COPD patients. Int J Chron Obstruct Pulmon Dis. 2017;12:2465–75.CrossRef Lim JU, Lee JH, Kim JS, Hwang YI, Kim TH, Lim SY, et al. Comparison of World Health Organization and Asia-Pacific body mass index classifications in COPD patients. Int J Chron Obstruct Pulmon Dis. 2017;12:2465–75.CrossRef
25.
go back to reference Shera AS, Rafique G, Khwaja IA, Ara J, Baqai S, King H. Pakistan national diabetes survey: prevalence of glucose intolerance and associated factors in Shikarpur. Sindh Province Diabet Med. 1995;12(12):1116–21.CrossRef Shera AS, Rafique G, Khwaja IA, Ara J, Baqai S, King H. Pakistan national diabetes survey: prevalence of glucose intolerance and associated factors in Shikarpur. Sindh Province Diabet Med. 1995;12(12):1116–21.CrossRef
26.
go back to reference Shera AS, Basit A, Fawwad A, Hakeem R, Ahmedani MY, Hydrie MZI, et al. Pakistan National Diabetes Survey: prevalence of glucose intolerance and associated factors in the Punjab Province of Pakistan. Prim Care Diabetes. 2010;4:79–83.CrossRef Shera AS, Basit A, Fawwad A, Hakeem R, Ahmedani MY, Hydrie MZI, et al. Pakistan National Diabetes Survey: prevalence of glucose intolerance and associated factors in the Punjab Province of Pakistan. Prim Care Diabetes. 2010;4:79–83.CrossRef
27.
go back to reference Basit A, Tanveer S, Fawwad A, Naeem N. NDSP members. Prevalence and contributing risk factors for hypertension in urban and rural areas of Pakistan; a study from second National Diabetes Survey of Pakistan (NDSP) 2016-2017. Clin Exp Hypertens. 2020;42(3):218–24.CrossRef Basit A, Tanveer S, Fawwad A, Naeem N. NDSP members. Prevalence and contributing risk factors for hypertension in urban and rural areas of Pakistan; a study from second National Diabetes Survey of Pakistan (NDSP) 2016-2017. Clin Exp Hypertens. 2020;42(3):218–24.CrossRef
28.
go back to reference Sarfraz M, Sajid S, Ashraf MA. Prevalence and pattern of dyslipidemia in hyperglycemic patients and its associated factors among Pakistani population. Saudi J Biol Sci. 2016;23(6):761–6.CrossRef Sarfraz M, Sajid S, Ashraf MA. Prevalence and pattern of dyslipidemia in hyperglycemic patients and its associated factors among Pakistani population. Saudi J Biol Sci. 2016;23(6):761–6.CrossRef
29.
go back to reference Florez H, Silva E, Fernandez V, Ryder E. Prevalence and risk factors associated with the metabolic syndrome and dyslipidemia in white, black, Amerindian and mixed Hispanics in Zulia state, Venezuela. Diabetes Res Clin Pract. 2005;69(1):63–77.CrossRef Florez H, Silva E, Fernandez V, Ryder E. Prevalence and risk factors associated with the metabolic syndrome and dyslipidemia in white, black, Amerindian and mixed Hispanics in Zulia state, Venezuela. Diabetes Res Clin Pract. 2005;69(1):63–77.CrossRef
30.
go back to reference Tabatabaei-Malazy O, Qorbani M, Samavat T, Sharifi F, Larijani B, Fakhrzadeh H. Prevalence of dyslipidemia in Iran: a systematic review and meta-analysis study. Int J Prev Med. 2014;5(4):373–93.PubMedPubMedCentral Tabatabaei-Malazy O, Qorbani M, Samavat T, Sharifi F, Larijani B, Fakhrzadeh H. Prevalence of dyslipidemia in Iran: a systematic review and meta-analysis study. Int J Prev Med. 2014;5(4):373–93.PubMedPubMedCentral
31.
go back to reference Ajay Raj S, Sivakumar K, Sujatha K. Prevalence of dyslipidemia in south Indian adults: an urban-rural comparison. Int J Community Med Public Health. 2016;3(8):2201–10. Ajay Raj S, Sivakumar K, Sujatha K. Prevalence of dyslipidemia in south Indian adults: an urban-rural comparison. Int J Community Med Public Health. 2016;3(8):2201–10.
32.
go back to reference Zaid M, Hasnain S. Plasma lipid abnormalities in Pakistani population: trends, associated factors, and clinical implications. Braz J Med Biol Res. 2018;51(9):e7239.CrossRef Zaid M, Hasnain S. Plasma lipid abnormalities in Pakistani population: trends, associated factors, and clinical implications. Braz J Med Biol Res. 2018;51(9):e7239.CrossRef
33.
go back to reference Zahid N, Claussen B, Hussain A. High prevalence of obesity, dyslipidemia and metabolic syndrome in a rural area in Pakistan. Diabetes & Metabolic Syndrome: Clinical Research & Reviews. 2008;2:13–9.CrossRef Zahid N, Claussen B, Hussain A. High prevalence of obesity, dyslipidemia and metabolic syndrome in a rural area in Pakistan. Diabetes & Metabolic Syndrome: Clinical Research & Reviews. 2008;2:13–9.CrossRef
34.
go back to reference Mohammadbeigi A, Moshiri E, Mohammadsalehi N, Ansari H, Ahmadi A. Dyslipidemia prevalence in Iranian adult men: the impact of population-based screening on the detection of undiagnosed patients. World J Mens Health. 2015;33(3):167–73.CrossRef Mohammadbeigi A, Moshiri E, Mohammadsalehi N, Ansari H, Ahmadi A. Dyslipidemia prevalence in Iranian adult men: the impact of population-based screening on the detection of undiagnosed patients. World J Mens Health. 2015;33(3):167–73.CrossRef
35.
go back to reference Gilani SYH, Bibi S, Ahmed N, Shah SRA. Gender differences of dyslipidemia in type 2 diabetics. J Ayub Med Coll Abbottabad. 2010;22(3):146–8.PubMed Gilani SYH, Bibi S, Ahmed N, Shah SRA. Gender differences of dyslipidemia in type 2 diabetics. J Ayub Med Coll Abbottabad. 2010;22(3):146–8.PubMed
36.
go back to reference Souza LJ, Souto Filho JT, Souza TF, Reis AF, Gicovate Neto C, Bastos DA, et al. Prevalence of dyslipidemia and risk factors in Campos dos Goytacazes, in the Brazilian state of Rio de Janeiro. Arq Bras Cardiol. 2003;81(3):257–64.CrossRef Souza LJ, Souto Filho JT, Souza TF, Reis AF, Gicovate Neto C, Bastos DA, et al. Prevalence of dyslipidemia and risk factors in Campos dos Goytacazes, in the Brazilian state of Rio de Janeiro. Arq Bras Cardiol. 2003;81(3):257–64.CrossRef
37.
go back to reference Feng RN, Zhao C, Wang C, Niu YC, Li K, Guo FC, et al. BMI is strongly associated with hypertension, and waist circumference is strongly associated with type 2 diabetes and dyslipidemia, in northern Chinese. J Epidemiol. 2012;22(4):317–23.CrossRef Feng RN, Zhao C, Wang C, Niu YC, Li K, Guo FC, et al. BMI is strongly associated with hypertension, and waist circumference is strongly associated with type 2 diabetes and dyslipidemia, in northern Chinese. J Epidemiol. 2012;22(4):317–23.CrossRef
38.
go back to reference Brown CD, Higgins M, Donato KA, Rohde FC, Garrison R, Obarzanek E, et al. Body mass index and the prevalence of hypertension and dyslipidemia. Obes Res. 2000;8(9):605–19.CrossRef Brown CD, Higgins M, Donato KA, Rohde FC, Garrison R, Obarzanek E, et al. Body mass index and the prevalence of hypertension and dyslipidemia. Obes Res. 2000;8(9):605–19.CrossRef
39.
go back to reference Rodriguez CJ, Daviglus ML, Swett K, et al. Dyslipidemia patterns among Hispanics/Latinos of diverse background in the United States. Am J Med. 2014;127(12):1186–94.e1. Rodriguez CJ, Daviglus ML, Swett K, et al. Dyslipidemia patterns among Hispanics/Latinos of diverse background in the United States. Am J Med. 2014;127(12):1186–94.e1.
40.
go back to reference Tangvarasittichai S. Oxidative stress, insulin resistance, dyslipidemia and type 2 diabetes mellitus. World J Diabetes. 2015;6(3):456–80.CrossRef Tangvarasittichai S. Oxidative stress, insulin resistance, dyslipidemia and type 2 diabetes mellitus. World J Diabetes. 2015;6(3):456–80.CrossRef
Metadata
Title
NDSP 05: Prevalence and pattern of dyslipidemia in urban and rural areas of Pakistan; a sub analysis from second National Diabetes Survey of Pakistan (NDSP) 2016–2017
Authors
Abdul Basit
Sobia Sabir
Musarrat Riaz
Asher Fawwad
NDSP members
Publication date
01-12-2020
Publisher
Springer International Publishing
Published in
Journal of Diabetes & Metabolic Disorders / Issue 2/2020
Electronic ISSN: 2251-6581
DOI
https://doi.org/10.1007/s40200-020-00631-z

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