Level and trend of total plasma cholesterol in national and subnational of Iran: a systematic review and age-spatio-temporal analysis from 1990 to 2016

Parinaz Mehdipour; Esmaeil Mohammadi; Sadaf G Sepanlou; Alireza Ahmadvand; Niloofar Peykari; Shirin Djalalinia; Ehsan Rezaei-Darzi; Farnam Mohebi; Yousef Moradi; Mehrnoosh Samaei; Ardeshir Khosravi; Hamidreza Jamshidi; Farshad Farzadfar; NASBOD Risk Collaborating Group

doi:10.1007/s40200-022-01052-w

Level and trend of total plasma cholesterol in national and subnational of Iran: a systematic review and age-spatio-temporal analysis from 1990 to 2016

J Diabetes Metab Disord. 2022 May 30;21(2):1301-1315. doi: 10.1007/s40200-022-01052-w. eCollection 2022 Dec.

Authors

Parinaz Mehdipour^#^{1

2}, Esmaeil Mohammadi^#¹, Sadaf G Sepanlou³, Alireza Ahmadvand⁴, Niloofar Peykari^{1

5}, Shirin Djalalinia^{1

6}, Ehsan Rezaei-Darzi⁷, Farnam Mohebi⁸, Yousef Moradi⁹, Mehrnoosh Samaei¹, Ardeshir Khosravi¹⁰, Hamidreza Jamshidi¹¹, Farshad Farzadfar^{1

12}; NASBOD Risk Collaborating Group

Collaborators

NASBOD Risk Collaborating Group:
Fereydoun Azizi, Davood Khalili, Masoud Khoshnia, Jalil Kouhpayehzadeh, Reza Malekzadeh, Shahin Merat, Ali Mirzazadeh, Kazem Mohammad, Noushin Mohammadifard, Iraj Nabipour, Mahboubeh Parsaeian, Akram Pourshams, Hossein Poustchi, Nizal Sarrafzadegan

Affiliations

¹ Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, No. 10, Al-e-Ahmad and Chamran Highway intersection, Tehran, 1411713137 Iran.
² Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Australia.
³ Digestive Diseases Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran.
⁴ School of Medicine, Griffith University, Gold Coast, Queensland Australia.
⁵ Ministry of Health and Medical Education, Tehran, Iran.
⁶ Deputy of Research and Technology, Ministry of Health and Medical Education, Tehran, Iran.
⁷ Monash University Accident Research Centre, Monash University, Clayton, Victoria Australia.
⁸ Haas School of Business, University of Berkeley, Berkeley, CA USA.
⁹ Social Determinants of Health Research Center, Research Institute for Health Development, Kurdistan University of Medical Sciences, Sanandaj, Iran.
¹⁰ Deputy for Public Health, Ministry of Health and Medical Education, Tehran, Iran.
¹¹ School of Medicine, Department of Pharmacology, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
¹² Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran.

^# Contributed equally.

Abstract

Purpose: We aimed to estimate the level and trend of plasma cholesterol and raised total cholesterol (TC > 200 mg/dl) prevalence at national and subnational level of Iran.

Methods: Nine national surveys and 27 studies, encompassing 3,505 unique points on over 500,000 adults, aged > 25 years with a report of laboratory measurement of TC were found. Age-spatio-temporal model and Gaussian Process Regression were used to estimate mean TC for each sex, 5-year age groups, and 31 provinces from 1990 to 2016.

Results: At national level, age-standardized prevalence of TC > 200 mg/dL has decreased from 57·2%(53·3-61·1) to 22·4%(20·5-24·3) in women and 53·2%(49·1-57·3) to 18·0%(16·4-19·6) in men. TC distribution presented a condensation between 170-200 mg/dL. At subnational level, decreasing and converging patterns of raised TC prevalence were detected.

Conclusion: The decrease in raised TC is likely the result of statin widespread use, food industry improvements, and the expanded primary health care.

Supplementary information: The online version contains supplementary material available at 10.1007/s40200-022-01052-w.

Keywords: Cholesterol; Hypercholesterolemia; Iran; Longitudinal studies; Prevalence; Systematic review and meta-analysis.