Global Burden Attributable to High Low-Density Lipoprotein-Cholesterol From 1990 to 2019

Heyue Du; Qingyang Shi; Peige Song; Xiong-Fei Pan; Xueli Yang; Lingmin Chen; Yazhou He; Geng Zong; Ye Zhu; Baihai Su; Sheyu Li

doi:10.3389/fcvm.2022.903126

Global Burden Attributable to High Low-Density Lipoprotein-Cholesterol From 1990 to 2019

Front Cardiovasc Med. 2022 Jun 9:9:903126. doi: 10.3389/fcvm.2022.903126. eCollection 2022.

Authors

Heyue Du^{1

2}, Qingyang Shi³, Peige Song⁴, Xiong-Fei Pan^{5

6

7}, Xueli Yang^{8

9

10}, Lingmin Chen^{11

12}, Yazhou He¹³, Geng Zong¹⁴, Ye Zhu¹⁵, Baihai Su², Sheyu Li^{1

3}

Affiliations

¹ Department of Endocrinology and Metabolism, West China Hospital, Sichuan University, Chengdu, China.
² Department of Nephrology, West China Hospital, Sichuan University, Chengdu, China.
³ Department of Guideline and Rapid Recommendation, Chinese Evidence-Based Medicine Center, Cochrane China Center and MAGIC China Center, West China Hospital, Sichuan University, Chengdu, China.
⁴ School of Public Health, Zhejiang University School of Medicine, Zhejiang University, Hangzhou, China.
⁵ Division of Epidemiology, Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, United States.
⁶ Ministry of Education Key Laboratory of Environment and Health and State Environmental Protection Key Laboratory of Environment and Health, Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
⁷ The George Institute for Global Health, Faculty of Medicine, University of New South Wales, Sydney, NSW, Australia.
⁸ Department of Occupational and Environmental Health, School of Public Health, Tianjin Medical University, Tianjin, China.
⁹ Tianjin Key Laboratory of Environment, Nutrition and Public Health, Tianjin Medical University, Tianjin, China.
¹⁰ Center for International Collaborative Research on Environment, Nutrition and Public Health, Tianjin, China.
¹¹ Department of Anesthesiology and National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Chengdu, China.
¹² Research Units of West China, Chinese Academy of Medical Sciences, Chengdu, China.
¹³ West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China.
¹⁴ CAS Key Laboratory of Nutrition, Metabolism and Food Safety, Shanghai Institute of Nutrition and Health, University of Chinese Academy of Sciences, Chinese Academy of Sciences, Shanghai, China.
¹⁵ Department of Cardiology, West China Hospital, Sichuan University, Chengdu, China.

Abstract

Background: High low-density lipoprotein-cholesterol (LDL-C) is a public health issue contributing to ischemic heart disease (IHD) and stroke.

Method: In this ecological study, we collected summary exposure values (SEVs), deaths, disability-adjusted life of years (DALYs), and Social Demographic Index (SDI) of high LDL-C from 1990 to 2019 using the query tool from the Global Burden of Disease (GBD) Collaborative Network. Outcomes include SEVs, deaths, and DALYs attributable to high LDL-C stratified by sex, age, region, SDI, countries, and territories. Estimated annual percentage changes (EAPCs) were applied to estimate annual trends of changes in these outcomes. We applied the weighted segmented regression with break-point estimation to detect the linear piecewise relationship between SDI and high LDL-C disease burden.

Results: Globally, 3.00 million (95% uncertainty interval [UI], 2.35-3.76 million) people in 1990 and 4.40 million (95% UI, 3.30-5.65 million) people died from high LDL-C in 2019. The absolute annual burden from deaths and DALYs attributed to high LDL-C increased by 46% (95% UI, 35-56%) and 41% (95% UI, 31-50%) from 1990 to 2019. The age-standardized SEV, death, and DALY was decreased by 9% (95% UI, -11 to -8%), 37% (95% UI, -41-33%), and 32% (95% UI, -37 to -28%), respectively, during the study period. There was a negative association between SDI and high LDL-C-related age-standardized death and DALY rates when SDI surpassed 0.71 and 0.71, respectively.

Conclusion: Although the overall age-standardized burden of high LDL-C is controlled in the past 30 years, it remains increasing in moderate SDI countries, and decreasing trends are disappearing in high SDI countries. New challenges require new actions stratified by countries with different SDI levels.

Keywords: disease burden; dyslipidemia; high LDL-C; ischemic heart disease; stroke.