ABC | Volume 110, Nº1, January 2018

Original Article González-Rivas et al Dyslipidemias in Venezuela Arq Bras Cardiol. 2018; 110(1):30-35 Table 1 – Subject Characteristics Men Women Total Significance Participants (n, %) 412 (31.2) 908 (68.8) 1320 (100) Age (years) 45.8 ± 14.8 44.4 ± 14.0 44.8 ± 14.3 NS Body mass index (kg/m 2 ) 27.7 ± 5.0 27.6 ± 5.3 27.6 ± 5.2 NS Waist circumference (cm) 96.6 ± 13.2 89.8 ± 12.3 91.9 ± 13.0 < 0.0001 High density lipoprotein (HDL-c) (mg/dL) * 43.2 ± 10.4 47.2 ± 10.9 45.9 ± 10.9 NS Triglycerides (mg/dL) 175.3 ± 154.7 140.0 ± 87.3 151.0 ± 114.3 < 0.0001 Total cholesterol (mg/dL) 207.7 ± 46.5 206.3 ± 47.6 206.7 ± 47.2 NS Low density lipoprotein (LDL-c) (mg/dL) 131.0 ± 43.4 131.4 ± 43.8 131.3 ± 43.7 NS Data are mean ± SD. Gender differences according t-test. Table 2 – Prevalence of Dyslipidemias by Gender Men Women Total Significance 412 908 1320 Low HDL-c (< 40 mg/dL in men and < 50 mg/dL in women) 42.2 (38.6 – 45.8) 66.0 (62.5 – 69.4) 58.6 (54.9 – 62.1) < 0.0001 Elevated triglycerides (≥ 150 mg/dL) 49.5 (45.8 – 53.1) 35.2 (31.7 – 38.7) 39.7 (36.1 – 43.2) < 0.0001 Hypercholesterolemia (≥ 240 mg/dL) 23.8 (20.7 – 26.8) 21.5 (18.5 – 24.5) 22.2 (19.2 – 25.2) NS Elevated LDL-c (≥ 160 mg/dL) 22.8 (19.8 – 25.9) 23.5 (20.5 – 26.6) 23.3 (20.2 – 26.4) NS Atherogenic dyslipidemia (triglycerides ≥ 150 mg/dL + low HDL-c) 25.2 (22.1 28.0) 26.2 (23.0 – 29.4) 25.9 (22.7 – 29.1) NS Mixed dyslipidemia (triglycerides ≥ 150 + cholesterol ≥ 240 mg/dL) 12.4 (9.9 – 14.7) 7.4 (5.5 – 9.3) 8.9 (6.8 – 11.0) 0.002 Data are showed in percentage (95% CI). Gender differences according to the Chi-square test. 48.4% and high triglycerides 42.3%). 14 Using a cut-off point similar to that in our study, an extremely high prevalence of hypoalphalipoproteinemia has been also observed in Valencia city (90%) 15 and the Junquito municipality (81.1%), 16 both in the central region of Venezuela. Similarly to the observed in men in our study (49.5%), the aforementioned studies in Valencia and Junquito also reported high prevalence of elevated triglycerides (51%). 15,16 Most of these results are consistent with previous findings in the Latin America region. In a systematic review of metabolic syndrome in Latin America, themost frequent change was low HDL-c in 62.9% of the subjects. 17 Although hypercholesterolemia (22.2%) is significantly less common compared with the aforementioned alterations, it was higher than the CARMELA study (5.7%) in Barquisimeto, 6 and similar to that observed in Valencia (19.0%). 15 Therefore, hypercholesterolemia remains as a cardiovascular risk factor to be considered when implementing public health measures in the Venezuelan population. Other of our findings are consistent with previous studies reporting that the prevalence of dyslipidemia increases with adiposity, and subjects with overweight/obesity 14,18 and abdominal obesity 18 show worse lipid profiles than subjects of normal weight. As in our study, higher figures of elevated triglycerides in male, 14,18 and no differences between overweight and obese subjects when grouped according to BMI, 14 have been reported. Dyslipidemias can be caused by both genetic and environmental factors (obesity, smoking, low physical activity). In our study, the prevalence of low HDL-c without other lipid abnormalities was 29.2% (male 15%, female 35.7%). Of these, those with low HDL-c and normal weight (total 10.6%, male 5.3%, female 13.0%) could suggest the proportion of cases of hypoalphalipoproteinemia that could be associated with genetic factors. Also, part of the prevalence of low HDL-c in this population can be explained by metabolic factors (i.e., insulin resistance), a condition that produces modifications in more than one lipid sub-fraction. In fact, the prevalence of atherogenic dyslipidemia (25.9%) in our study was significant and remarkably similar to that reported by Florez et al. 7 in the Zulia region (24.1%). Atherogenic dyslipidemia is the patternmost frequently observed in subjects with metabolic syndrome and insulin resistance, and both abnormalities are components of the metabolic syndrome definition. Besides genetic or metabolic factors, environmental adverse conditions are also important in Venezuela. The factors involving nutritional transition promoted inappropriate eating and lifestyle patterns inVenezuela and other LatinAmerican countries, clearly contributing with the incidence of non-communicable diseases, especially those related to obesity and diabetes. 19 A follow-up survey of food consumption, based on the food purchase, reported that caloric intake and the selection of foods with lower quality have increased in Venezuela. 20 A high rate of physical inactivity (68%) has also been reported in Venezuela in two studies involving 3,422 adults. 5 32