Trends and risk factors of hypercholesterolemia among Kuwaiti adults: National Nutrition Surveillance Data from 1998 to 2009
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Objective: To determine temporal changes in hypercholesterolemia prevalence and associated factors in Kuwaiti adults. Design: Analysis of nationally representative cross-sectional population survey data from the Kuwait National Nutrition Surveillance. Methods: A total of 15 110 men and 17 701 women, aged 20-69 years, registered for employment or pensions, Hajj Pilgrimage health checkups, or were parents accompanying their children for immunization from 1998 through 2009. Sociodemographic and lifestyle information, height and weight, and blood samples were collected. Results: Hypercholesterolemia (HC; serum cholesterol 5.20 mmol/L) prevalence increased within the time period until 2006-2007 (men, 56.0%; women, 53.6%), except for 2002-2003, and then declined significantly in both men (33.7%) and women (30.6%). Linear and logistic regression adjusted for age, education level, and body mass index (BMI) also showed a significant upward temporal trend for total cholesterol and prevalence of moderate and high HC (except for high HC in men) until 2004-2007 followed by a significant downward trend in 2008-2009 in both men and women. For both genders, age, BMI, education level, and presence of diabetes were significantly independently associated with high HC, whereas only age and BMI were associated with moderate HC. Female smokers, compared with non-smokers, had significantly higher odds ratios for both moderate and high HC. Current exercise or fruit and vegetable intake showed no significant association for either gender. Conclusion: Continued monitoring of serum cholesterol is needed to see if the negative trend observed in 2008-2009 endures and further research of contributing factors is required for the development of targeted intervention strategies.