Prevalence of dyslipidemia and achievement of low-density lipoprotein cholesterol targets in Chinese adults: A nationally representative survey of 163,641 adults

Background: Elevated serum total cholesterol and low-density lipoprotein cholesterol (LDL-C) levels are established risk factors for cardiovascular diseases, a leading cause of death in China. We sought to assess the latest levels of serum lipids, prevalence of dyslipidemia and achievement of LDL-C lowering targets among Chinese adults.

Methods: Data was obtained from a national representative survey recruited 163,641 adults aged >18years in mainland China between 2013 and 2014. Fasting serum total cholesterol (TC), LDL-C, high-density lipoprotein cholesterol (HDL-C), and triglycerides (TG) were measured by standard methods. Multiple logistic regression was preformed to estimate potential risk factors for dyslipidemias. Proportion of residents not achieve the therapeutic goals for LDL-C by atherosclerotic cardiovascular diseases (ASCVD) risk stratification were evaluated.

Results: Nationally, the population-weighted means of TC, HDL-C, and LDL-C, and median of TG were 4.70, 1.35, 2.88, and 1.49mmol/L, respectively. The prevalence of high TC, high LDL-C, low HDL-C and high TG was 6.9%, 8.1%, 20.4% and 13.8%. Among individuals with high ASCVD risk, 74.5% had uncontrolled LDL-C levels (<2.6mmol/L) and 5.5% of them were treated. For very-high-risk individuals, 93.2% didn't achieve their LDL-lowering goals (<1.8mmol/L) and 14.5% of them were treated.

Conclusions: Chinese adults currently experienced a high prevalence of abnormal serum lipid levels, more common in urban adults or those with obesity or central obesity. A significant proportion of people with high or very high ASCVD risk didn't meet LDL-C targets. Improvements in achievement of lipid-level targets and of LDL-lowering therapy rates based on ASCVD risk stratification were necessary.