Determinants of Lipid Parameters in Patients without Diagnosed Cardiovascular Disease—Results of the Polish Arm of the EUROASPIRE V Survey

Abstract

To assess the determinants of lipid parameters in primary care patients without diagnosed cardiovascular disease (CVD), a cross-sectional study was conducted during 2018–2019 with a total of 200 patients. The following lipid parameters were measured: total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), triglycerides (TG), small, dense LDL (sdLDL-C), and lipoprotein (a) (Lp(a)). Predictors of elevated and adequately controlled lipid parameters were assessed with logistic regression analysis. Older age was related to higher risk of TC ≥ 6.2 mmol/L [OR 1.03 (95% CI 1.0–1.05)], sdLDL-C ≥ 1.0 mmol/L [OR 1.05 (95% CI 1.0–1.1)], and decreased risk of Lp(a) ≥ 50 mg/dL [OR 0.97 (95% CI 0.94–0.99)]. Patients with diabetes mellitus (DM) had increased probability of TG ≥ 2.25 mmol/L [OR 3.77 (95% CI 1.34–10.6)] and Lp(a) ≥ 50 mg/dL [OR 2.97 (1.34–6.10)] as well as adequate control of TG and Lp(a). Higher material status was related to lower risk of TC ≥ 6.2 mmol/L [OR 0.19 (95% CI 0.04–0.82)] and LDL-C ≥ 3.6 mmol/L [OR 0.33 (95% CI 0.12–0.92)]. High BMI was related to increased [OR 1.14 (95% CI 1.02–1.29)], and female gender [OR 0.33 (95% CI 0.12–0.96)] and hypertension [OR 0.29 (95% CI 0.1–0.87)] to decreased risk of TG ≥ 2.25 mmol/L [OR 1.14 (95% CI 1.02–1.29)]. Taking lipid-lowering drugs (LLD) was associated with LDL-C < 2.6 mmol/L [OR 2.1 (95% CI 1.05–4.19)] and Lp(a) < 30 mg/dL [OR 0.48 (95% CI 0.25–0.93)]. Physical activity was related to LDL-C < 2.6 mmol/L [OR 2.02 (95% CI 1.02–3.98)]. Higher abdominal circumference was associated with decreased risk of TG < 1.7 mmol/L [OR 0.96 (95% CI 0.93–0.99)]. Elevated lipid parameters were related to age, gender, material status, BMI, history of DM, and hypertension. Adequate control was associated with age, education, physical activity, LLD, history of DM, and abdominal circumference.

Elevated lipoprotein (a) in middle-aged Polish population: preliminary data on genetic background

“…The prevalence of Lp(a) >50 mg/dl was 18.4% in Germany, which is almost identical to our population while in Finland or Greece, it was 6.0% [5,6]. Our result is slightly lower than in the study by Ratajczak et al [3], which evaluated CVD risk factors in subjects aged 18-80 (median, 52 [43-60]) years, while we assessed younger subjects. However, we did not observe a significant correlation between Lp(a) and age in contrast to a previous study in the general population, in which Lp(a) increased slightly with age [2].…”

“…The current guidelines recommend that Lp(a) measurement once in a lifetime should be included in a comprehensive CVD risk evaluation and suggest a global risk underestimation at high or very high Lp(a) concentrations [1,2]. Little is known about Lp(a) levels in the Polish population except for a small sample (n = 200) from the EUROASPIRE V survey, in which the prevalence of Lp(a) >50 mg/dl was 22.5% in patients without diagnosed CVD but with known risk factors [3].…”

Adherence to lipid-lowering therapy

“…poor control of lipid disorders in the primary prevention setting [1][2][3][4][5][6]. The same phenomenon has been observed in patients with acute coronary syndrome [7,8,9].…”

The functioning in chronic illness –— a key determinant of treatment efficacy in patients with metabolic syndrome

“…There is a direct link between the patient's functioning and adherence to treatment, therefore, all activities aimed at supporting cooperation with an obese patient are of key importance for therapy effectiveness [7,[11][12][13][14][15][16][17][18][19][20][21]. Thus, the Adherence in Chronic Disease Scale (ACDS) is also worth validating in MetS patients [22][23][24][25][26][27].…”