The Christmas holidays are immediately followed by a period of hypercholesterolemia

Atherosclerosis. 2019 Feb:281:121-127. doi: 10.1016/j.atherosclerosis.2018.12.011. Epub 2018 Dec 19.

Abstract

Background and aims: We aimed to test the hypothesis that levels of total and low-density lipoprotein cholesterol are increased after Christmas and that the risk of hypercholesterolemia is increased after the Christmas holidays.

Methods: We conducted an observational study of 25,764 individuals from the Copenhagen General Population Study, Denmark, aged 20-100 years. Main outcome measures were mean total and LDL cholesterol levels. Hypercholesterolemia was defined as total cholesterol >5 mmol/L (>193 mg/dL) or LDL-cholesterol >3 mmol/L (>116 mg/dL).

Results: Mean levels of total and LDL cholesterol increased in individuals examined in summer through December and January. Compared with individuals examined in May-June, those examined in December-January had 15% higher total cholesterol levels (p < 0.001). The corresponding value for LDL cholesterol was 20% (p < 0.001). Of the individuals attending the study during the first week of January, immediately after the Christmas holidays, 77% had LDL cholesterol above 3 mmol/L (116 mg/dL) and 89% had total cholesterol above 5 mmol/L (193 mg/dL). In individuals attending the Copenhagen General Population Study in the first week of January, the multivariable adjusted odds ratio of hypercholesterolemia was 6.0 (95% confidence interval 4.2-8.5) compared with individuals attending the study during the rest of the year.

Conclusions: Celebrating Christmas is associated with higher levels of total and LDL cholesterol and a higher risk of hypercholesterolemia in individuals in the general population. Thus, a diagnosis of hypercholesterolemia should not be made around Christmas, and our results stress the need for re-testing such patients later and certainly prior to initiation of cholesterol-lowering treatment.

Keywords: Cohort study; Epidemiology; LDL cholesterol; Total cholesterol.

Publication types

  • Comparative Study
  • Observational Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Biomarkers / blood
  • Cholesterol, LDL / blood*
  • Denmark / epidemiology
  • Diet, High-Fat / adverse effects*
  • Female
  • Holidays*
  • Humans
  • Hypercholesterolemia / blood
  • Hypercholesterolemia / diagnosis
  • Hypercholesterolemia / epidemiology*
  • Male
  • Middle Aged
  • Risk Assessment
  • Risk Factors
  • Seasons*
  • Time Factors
  • Up-Regulation
  • Young Adult

Substances

  • Biomarkers
  • Cholesterol, LDL