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      Severe dyslipidemia and concomitant risk factors in the middle-aged Lithuanian adults: a cross-sectional cohort study

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          Abstract

          Background

          Dyslipidemia is highly prevalent and is one of the major risk factors for cardiovascular disease in Lithuania. The purpose of this study was to determine the prevalence of severe dyslipidemia in Lithuanian middle aged primary prevention population and to investigate cardiovascular risk profile.

          Methods

          The group of 83,376 people were examined in the Lithuanian High Cardiovascular Risk primary prevention program (LitHiR), during 2009–2015 years. This study recruited middle aged men and women without overt cardiovascular disease. The prevalence of cardiovascular risk factors was compared between severe dyslipidemia group and control group.

          Results

          Severe dyslipidemia was present in 13.5% (11265) of the subjects; 66.6% (7508) were females. The subjects with severe dyslipidemia had significantly higher rates of arterial hypertension (63.5% vs. 44.2%, p < 0.001), diabetes mellitus (16% vs. 8.1%, p < 0,001), abdominal obesity (51% vs. 30.3%, p < 0.001), body mass index (BMI) > 30 (kg/m 2) (38.8% vs. 24.1%, p < 0.001), metabolic syndrome (47.2% vs. 9.2%, p < 0.001), unbalanced diet (66.5% vs. 53.5%, p < 0.001), insufficient physical activity (56% vs. 44.2%, p < 0.001), family history of cardiovascular disease (29.7% vs. 22.7%, p < 0.001) in comparison with control group. Subjects without dyslipidemia had significantly higher rates of smoking (26.4% vs. 22.7%, p < 0.001).

          The prevalence of familial hypercholesterolemia was 0.1%, very high hypertriglyceridemia - 0.2% and familial mixed dyslipidemia - 0.1% of the subjects examined in the LitHiR programme.

          Conclusions

          High prevalence of dyslipidemia remains a major problem in Lithuania. 9 out of 10 people have dyslipidemia, 1 out of 10 - severe dyslipidemia. Severe dyslipidemia is associated with higher frequency of other cardiovascular risk factors.

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          Most cited references8

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          Abdominal obesity and dyslipidemia in the metabolic syndrome: importance of type 2 diabetes and familial combined hyperlipidemia in coronary artery disease risk.

          Regional body fat distribution has an important influence on metabolic and cardiovascular risk factors. Increased abdominal (visceral) fat accumulation is a risk factor for coronary artery disease (CAD), dyslipidemia, hypertension, stroke, and type 2 diabetes. The recent emphasis on treatment of the dyslipidemia of the metabolic syndrome (hypertriglyceridemia, reduced high-density lipoprotein, and increased small, dense low-density lipoprotein particle number) has compelled practitioners to consider lipid-lowering therapy in a greater number of their patients, as one in two individuals over age 50 has the metabolic syndrome. Individuals with the metabolic syndrome typically have normal low-density lipoprotein cholesterol levels, and current lipid-lowering guidelines may underestimate their cardiovascular risk. Two subgroups of patients with the metabolic syndrome are at particularly high risk for premature CAD. One, individuals with type 2 diabetes, accounts for 20-30% of early cardiovascular disease. The second, familial combined hyperlipidemia, accounts for an additional 10-20% of premature CAD. Familial combined hyperlipidemia is characterized by the metabolic syndrome in addition to a disproportionate elevation of apolipoprotein B levels. The measurement of fasting glucose and apolipoprotein B, in addition to the fasting lipid profile, can help to estimate CAD risk in patients with the metabolic syndrome.
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            Familial hypercholesterolemia and coronary heart disease: a HuGE association review.

            Familial hypercholesterolemia (FH) is an autosomal disorder characterized by increased levels of total cholesterol and low density lipoprotein cholesterol. The FH clinical phenotype has been shown to be associated with increased coronary heart disease and premature death. Mutations in the low density lipoprotein receptor gene (LDLR) can result in the FH phenotype, and there is evidence that receptor-negative mutations result in a more severe phenotype than do receptor-defective mutations. Mutations in the apolipoprotein B-100 gene (APOB) can result in a phenotype that is clinically indistinguishable from familial hypercholesterolemia, and mutations in this gene have also been shown to be associated with coronary heart disease. Preliminary research indicates that the FH phenotype is influenced by other genetic and environmental factors; however, it is not clear if these are synergistic interactions or simply additive effects.
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              • Abstract: found
              • Article: not found

              Prevalence and management of familial hypercholesterolaemia in coronary patients: An analysis of EUROASPIRE IV, a study of the European Society of Cardiology.

              Familial hypercholesterolaemia (FH) is a hereditary disorder predisposing to premature coronary heart disease (CHD) and is until now mainly diagnosed clinically on the basis of a classical phenotype. Its prevalence varies and is estimated around 1 in 200-500; in patients with established CHD the prevalence is less well documented.
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                Author and article information

                Contributors
                sandra.kutkiene@santa.lt
                zaneta.petrulioniene@santa.lt
                cardio@cardiol.lt
                m.petrylaite@gmail.com
                diana.maskeliunaite@santa.lt
                roma.puronaite@santa.lt
                milda.kovaite@santa.lt
                irma.kalibataite@santa.lt
                egidija.rinkuniene@santa.lt
                vilma.dzenkeviciute@santa.lt
                vytautas.kasiulevicius@mf.vu.lt
                Journal
                Lipids Health Dis
                Lipids Health Dis
                Lipids in Health and Disease
                BioMed Central (London )
                1476-511X
                19 April 2018
                19 April 2018
                2018
                : 17
                : 88
                Affiliations
                [1 ]ISNI 0000 0001 2243 2806, GRID grid.6441.7, Vilnius University, Faculty of Medicine, ; Vilnius, Lithuania
                [2 ]ISNI 0000 0001 2243 2806, GRID grid.6441.7, Vilnius University, Faculty of Medicine, Clinic of Cardiac and Vascular Diseases, ; Vilnius, Lithuania
                [3 ]ISNI 0000 0001 2243 2806, GRID grid.6441.7, Vilnius University, Faculty of Medicine, Clinic of Internal Diseases, Family Medicine and Oncology, ; Vilnius, Lithuania
                [4 ]ISNI 0000 0001 2243 2806, GRID grid.6441.7, Vilnius University Hospital Santaros Klinikos, ; Vilnius, Lithuania
                Article
                731
                10.1186/s12944-018-0731-7
                5907700
                29673349
                227b7e24-9fd3-4c9e-ab8f-7460a739c768
                © The Author(s). 2018

                Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

                History
                : 20 March 2017
                : 3 April 2018
                Funding
                Funded by: Statutory Health Insurance Fund
                Categories
                Research
                Custom metadata
                © The Author(s) 2018

                Biochemistry
                severe dyslipidemia,cardiovascular risk factors,primary prevention
                Biochemistry
                severe dyslipidemia, cardiovascular risk factors, primary prevention

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