Total cholesterol
Searched over 200M research papers for "total cholesterol"
Summary
10 papers analyzed
These studies suggest that while serum total cholesterol levels have generally declined globally, they remain high in certain regions, and high total cholesterol is a strong risk factor for coronary heart disease.
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Trends and Implications of Total Cholesterol Levels
Global Trends in Total Cholesterol
Historical Trends and Regional Variations
Since 1980, global trends in serum total cholesterol have shown significant regional variations. A comprehensive analysis of 199 countries revealed that the age-standardized mean total cholesterol in 2008 was 4.764 mmol/L for men and 4.776 mmol/L for women. Over the decades, total cholesterol levels have decreased in high-income regions such as Australasia, North America, and Western Europe by approximately 0.2 mmol/L per decade for both sexes. Conversely, there has been an increase in total cholesterol levels in East and Southeast Asia and the Pacific by about 0.08-0.09 mmol/L per decade.
Cholesterol Trends in Asian and Western Countries
A more detailed analysis of cholesterol trends in Asian and Western countries indicates that while total cholesterol (TC) levels have increased in Asian countries, this rise is attributed to different factors. In Japan and South Korea, the increase in TC is due to rising high-density lipoprotein (HDL) cholesterol, whereas in China, it is due to rising non-HDL cholesterol. In contrast, Western countries have generally seen a decline in TC, driven by an increase in HDL cholesterol and a decrease in non-HDL cholesterol.
Cholesterol as a Risk Factor for Cardiovascular Disease
Gender Differences in Risk
Raised total cholesterol is a well-established risk factor for cardiovascular disease (CVD), including coronary heart disease (CHD) and stroke. A meta-analysis of 97 cohorts involving over a million individuals found that a 1-mmol/L increase in total cholesterol is associated with a 20% increased risk of CHD in women and a 24% increased risk in men. However, the effect of raised total cholesterol on the risk of stroke is minimal for both sexes.
Implications for Public Health
The findings underscore the importance of nutritional policies and pharmacological interventions to manage cholesterol levels. Regions experiencing a decline in cholesterol levels should continue their efforts, while those with rising levels, particularly in Asia, need to implement measures to curb this trend. Improved population-based surveillance of cholesterol is crucial, especially in low-income and middle-income countries.
Methods for Cholesterol Determination
Simplified and Enzymatic Methods
Accurate measurement of total cholesterol is essential for both clinical and research purposes. A simplified method involves treating serum with alcoholic potassium hydroxide, extracting cholesterol into petroleum ether, and measuring it using the Liebermann-Burchard color reaction. This method is flexible and yields precise results. Additionally, an enzymatic method using cholesterol ester hydrolase and cholesterol oxidase provides a reproducible and specific measurement of total serum cholesterol, correlating well with traditional methods.
Conclusion
Understanding and monitoring total cholesterol levels are vital for managing cardiovascular disease risk. While global trends show regional variations, the overall decline in high-income regions and the rise in some Asian countries highlight the need for targeted public health interventions. Accurate and reliable methods for cholesterol determination are essential for effective surveillance and management strategies.
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