Lifetime Trends of LDL-C and Non-HDL-C Levels in Chinese: A Large-Scale Cross-Sectional Study

Background: Evaluation of the lifetime trends of blood-lipid levels is needed to understand the role of dyslipidemia in the development and progression of diseases. Methods: The biannual physical examination results of 54,322 males and 37,851 females, comprising 167,542 data sets, were collected. Age-related trends in LDL-C and non-HDL-C levels were explored by age stratifications and valid by fitted linear logistic regression modeling. Findings: Among pooled females, age associated with LDL-C and non-HDL-C levels positively with coefficients of 0·016 and 0·026, respectively. After age stratification, age was positively associated with LDL-C and non-HDL-C levels with coefficients of 0·020 (95%CI: 0·020~0·021) and 0·033 (0·033~0·034), respectively in females aged 18 to 56 years; and negatively with coefficients of −0·013 (−0·010~−0·007) and −0·014 (−0·017~−0·011), respectively in females aged ≥57 years. Among pooled males, age associated with LDL-C and non-HDL-C levels positively with coefficients of 0·003 and 0·005, respectively. After age stratification, the LDL-C and non-HDL-C levels increased with age in males aged 18 to 33 years with coefficients of 0·026 (0·023~0·029) and 0·052 (0·049~0·055), respectively; plateaued between 34 to 56 years old with coefficients of 0·002 (0·001~0·003) and 0·005 (0·004~0·006), respectively; and subsequently decreased in males aged ≥57 years with coefficients of −0·008 (−0·010~−0·007) and −0·017 (−0·019~−0·015), respectively. Adjustments for covariates had little effect on the linear correlation patterns between age and lipids levels. Interpretation: In males and females, the LDL-C and non-HDL-C levels showed two (increase and decrease) and three (increase, plateau, and decrease) phases, respectively, with age. Funding Statement: The Major Projects of the Shanghai Municipal Commission of Health and Family Planning; the Shanghai Medical Key Specialty Construction Projects. Declaration of Interests: The authors declare no competing interests. Ethics Approval Statement: This study was conducted in accordance with the statement of ethical principles for medical research involving human subjects of the World Medical Association Declaration of Helsinki, and was approved by the Internal Review Board of Minhang Hospital, Fudan University, Shanghai, China. Written informed consent was obtained according to the guidelines of the National Ethics Regulation Committee.