Factors associated with elevated low-density lipoprotein cholesterol levels among hill tribe people aged 30 years and over in Thailand: a cross-sectional study

Abstract

Background Low-density lipoprotein cholesterol (LDL-C) is one of the most important types of cholesterol and has an impact on health. Certain lifestyle and dietary habits in different populations may leads to increased levels of LDL-C, particularly among those with poor education and economic statuses, such as hill tribe people in Thailand. This study aimed to estimate the prevalence of and determine the factors associated with high LDL-C levels among hill tribe people in northern Thailand. Methods A cross-sectional study was performed to gather information from six main hill tribe populations: Akha, Lahu, Hmong, Yao, Karen, and Lisu. Individuals who were aged over 30 years and living in 30 selected hill tribe villages were invited to participate in the study. A validated questionnaire and 5-mL blood specimens were used to obtain data. Correlation analyses, chi-square tests, t-tests, and logistic regression were used to detect correlations and associations. Results A total of 2552 participants were recruited into the study; 65.9% were females, and 64.1% were aged younger than 60 years old. Approximately 69.6% of participants had abnormal LDL-C levels; 33.6% had above-optimal levels, 24.3% had borderline high levels, 8.0% had high levels, and 3.7% had very high levels. A total of 17.4% of participants had low high-density lipoprotein cholesterol (HDL-C) and high LDL-C levels, while 14.9% had high triglyceride and LDL-C levels. After controlling for sex, age, religion, education, annual family income, and marital status in the multivariate model, three variables were found to be associated with high LDL-C levels: occupation, the amount of lard used in daily cooking, and glycated hemoglobin (HbA1c). Those who were working as agriculturalists had a 1.34-fold greater chance of having abnormal LDL-C than traders and others (95% CI = 1.09–1.34). Those who used moderate and high quantities of lard in their daily cooking had a 1.45-fold (95% CI = 1.15–1.82) and 1.31-fold (95% CI = 1.04–1.68) greater likelihood of having abnormal LDL-C levels than those who used low quantities, respectively. Those who had abnormal HbA1c levels were less likely to develop abnormal LDL-C levels than those who had normal HbA1c levels (AOR = 0.69, 95% CI = 0.51–92). Conclusions Effective public health programs that do not conflict with the cultures of hill tribes are urgently needed, particularly programs encouraging the use of small quantities of lard for daily cooking practices.

Health Behavior, Level of Hemoglobin A1c, and Quality of Life Among Agricultural Workers of Various Ethnicities in Thai Border Communities

“…A previous study showed that people who obtained incorrect knowledge toward diabetes did so due to language differences ( 38 ). It is consistent with the study which showed one group of people did not have sufficient knowledge to take care of their own health due to lack of communication skills, which prevented them from accessing healthcare information and managing their diabetes ( 35 ).…”

“…They also pointed out that smoking is a risk factor for cardiovascular disease ( 53 ). We showed that the Karen community had lower levels of HbA1c compared with those of the Indigenous group, which is similar to a study showing that racial/ethnic differences can result in higher triglyceride levels ( 35 ). Studies have shown that certain tribes from Lua and Hmong communities carried a significantly higher risk of coronary artery disease compared with that of other ethnic groups, which suggests that differences in racial/ethnic backgrounds can affect triglyceride levels ( 33 ).…”

“…They are unaware of making the correct food choices, which resulted in inappropriate healthcare behaviors in terms of diet. Furthermore, most of their cooking recipes were derived from China and cultural traditions, so some dishes were unhealthy because of extensive use of salt, monosodium glutamate, and oils from animals ( 33 , 35 ). Similar to a previous showed that hill tribes had a higher prevalence of abnormal HbA1c level ( 33 ).…”

Epidemiology of prediabetes mellitus among hill tribe adults in Thailand

“…While smoking behavior is commonly found among Akha men and women, Lisu women and Karen women do not smoke [ 27 ]. Lisu and Akha cooking practices are similar to Chinese cooking practices, which involve oil, while Karen people use less oil in their daily cooking practice [ 28 , 29 ]. Certain health-related behaviors and cooking practices can influence the development of prediabetes in these populations.…”

Histone Methylation Related Therapeutic Challenge in Cardiovascular Diseases

“…As a major trigger of mortality worldwide, the epidemic of cardiovascular diseases (CVDs) is predicted to spread rapidly in developing and developed countries along with the high prevalence of risk factors, including hypertension, diabetes, and obesity (1). In 2016, CVDs caused ∼17.9 million deaths globally (2). The mortality of CVDs worldwide is estimated to reach nearly 23.6 million in 2030 (3).…”