Evidence for low high-density lipoprotein cholesterol levels in Australian indigenous peoples: a systematic review

BMC Public Health

Karen Z Walker¹  Kerin O’Dea²  Jasmine G Lyons² 

[1] Department of Nutrition and Dietetics, Monash University, 264 Ferntree Gully Road Notting Hill, Victoria 3168 Melbourne, Australia;School of Population Health, Division of Health Sciences, University of South Australia, North Terrace, Adelaide, South Australia 5000, Australia

关键词: Non-communicable disease;    Cardiometabolic;    Cardiovascular disease risk factors;    Cardiovascular disease;    High-density lipoprotein cholesterol;    Dyslipidaemia;    Lipids;    Torres Strait Islanders;    Australian Aborigines;    Indigenous;   

Others  :  1129922
DOI  :  10.1186/1471-2458-14-545

 received in 2014-03-04, accepted in 2014-05-23,  发布年份 2014

【 摘 要 】

Background

Low plasma high-density lipoprotein cholesterol (HDL-C) levels are a strong, independent, but poorly understood risk factor for cardiovascular disease (CVD). Although this atherogenic lipid abnormality has been widely reported in Australia’s Indigenous peoples, Aboriginal and Torres Strait Islanders, the evidence has not come under systematic review. This review therefore examines published data for Indigenous Australians reporting 1) mean HDL-C levels for both sexes and 2) factors associated with low HDL-C.

Methods

PubMed, Medline and Informit ATSI Health databases were systematically searched between 1950 and 2012 for studies on Indigenous Australians reporting mean HDL-C levels in both sexes. Retrieved studies were evaluated by standard criteria. Low HDL-C was defined as: <1.0 mmol/L. Analyses of primary data associating measures of HDL-C with other CVD risk factors were also performed.

Results

Fifteen of 93 retrieved studies were identified for inclusion. These provided 58 mean HDL-C levels; 29 for each sex, most obtained in rural/regional (20%) or remote settings (60%) and including 51–1641 participants. For Australian Aborigines, mean HDL-C values ranged between 0.81-1.50 mmol/L in females and 0.76-1.60 mmol/L in males. Two of 15 studies reported HDL-C levels for Torres Strait Islander populations, mean HDL-C: 1.00 or 1.11 mmol/L for females and 1.01 or 1.13 mmol/L for males. Low HDL-C was observed only in rural/regional and remote settings - not in national or urban studies (n = 3) in either gender. Diabetes prevalence, mean/median waist-to-hip ratio and circulating C-reactive protein levels were negatively associated with HDL-C levels (all P < 0.05). Thirty-four per cent of studies reported lower mean HDL-C levels in females than in males.

Conclusions

Very low mean HDL-C levels are common in Australian Indigenous populations living in rural and remote communities. Inverse associations between HDL-C and central obesity, diabetes prevalence and inflammatory markers suggest a particularly adverse CVD risk factor profile. An absence of sex dichotomy in HDL-C levels warrants further investigation.

【 授权许可】

   
2014 Lyons et al.; licensee BioMed Central Ltd.

【 图 表 】

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