Advertisement

Irish Journal of Medical Science (1971 -)

, Volume 188, Issue 1, pp 241–247 | Cite as

A snapshot of lipid levels in the Republic of Ireland in 2017

  • Ruth Agar
  • Catherine Markham
  • Meabh Prendergast
  • Rebecca Canning
  • Edana Maher
  • Caroline Finn
  • Nuala Sammon
  • Sarah Fall
  • Noeleen Fallon
  • Evonne Hanrahan
  • Lisa King
  • Vincent MaherEmail author
Original Article

Abstract

Background

Abnormalities in blood lipid levels are causally linked with cardiovascular disease and pancreatitis. Data is limited regarding lipid abnormalities in Ireland.

Aims

As part of a cholesterol awareness campaign, we performed a pilot study of current lipid levels to preliminarily assess the extent and pattern of lipid abnormalities in Ireland.

Methods

Non-fasting, full lipid profiles and glucose measurements were performed in 259 people (32 on lipid-lowering medication and 225 untreated) using a validated Cholestech LDX machine. Untreated participants included 95 men and 130 women, aged 51 ± 16 years.

Results

The mean ± SD, total, low-density lipoprotein (LDL), high-density lipoprotein cholesterol (HDL) and median(IQR) non-HDL cholesterol and triglyceride levels in untreated individuals were 5.0 ± 1.1, 2.8 ± 1.0, 1.5 ± 0.5 and 3.4 (2.8–4.3), 1.6 (1.0–2.3) mmol/l respectively. Glucose was 5.3 (4.8–5.8) mmol/l. Glucose > 7.8 mmol/l occurred in 10 individuals (4%). Using defined criteria for non-fasting lipid levels, 60% of participants had some form of lipid abnormality with a frequency of 47% having a total cholesterol > 5, 35% with LDL > 3.0, 26% with HDL < 1.0/1.2, 33% with triglycerides > 2.0 and 32% with non-HDL cholesterol > 3.9 mmol/l. Three individuals had untreated LDL > 5 mmol/l (i.e. a ratio of 1:75 of those tested) and eight people had HDLc < 0.7 (1:28) and four had triglyceride above 7.3 mmol/l (1:56).

Conclusions

This pilot study reveals significant lipid abnormalities which require further larger more detailed lipid studies to assess the true burden of lipid abnormalities in Ireland. Cascade screening and genetic testing of relatives of those with severe lipid abnormalities should be considered.

Keywords

Cholesterol Ireland Lipid genetic disorders Lipids Non-fasting Screening 

Notes

Acknowledgements

We are grateful to the Communications department, CEO and staff of Tallaght Hospital for their assistance with the cholesterol campaign and lipid testing approval. We acknowledge Alere/Abbot Laboratories for the provision of test cassettes and Cholestech LDX machines used to complete the lipid testing on site. We also appreciate the support from the various venues used for cholesterol testing. Special thanks to the Meath Foundation and Sanofi Ireland for their ongoing support for the Advanced Lipid Management And Research (ALMAR) Centre at Tallaght hospital and the Irish Lipid Network. The public awareness campaign would not have been possible without generous coverage from numerous national and local newspapers and radio stations as well as RTE news.

References

  1. 1.
    Ference BA, Ginsberg HN, Graham I, Ray KK, Packard CJ, Bruckert E, Hegele RA, Krauss RM, Raal FJ, Schunkert H, Watts GF, Borén J, Fazio S, Horton JD, Masana L, Nicholls SJ, Nordestgaard BG, van de Sluis B, Taskinen MR, Tokgözoğlu L, Landmesser U, Laufs U, Wiklund O, Stock JK, Chapman MJ, Catapano AL (2017) Low-density lipoproteins cause atherosclerotic cardiovascular disease. Evidence from genetic, epidemiologic, and clinical studies. A consensus statement from the European Atherosclerosis Society Consensus Panel. Eur Heart J 38:2459–2472.  https://doi.org/10.1093/eurheartj/ehx144 CrossRefGoogle Scholar
  2. 2.
    Berglund L, Brunzell JD, Goldberg AC, Goldberg IJ, Sacks F, Murad MH, Stalenhoef AF, Endocrine society (2012) Evaluation and treatment of hypertriglyceridemia: an Endocrine Society clinical practice guideline. J Clin Endocrinol Metab 97:2969–2989CrossRefGoogle Scholar
  3. 3.
    Boullart AC, de Graaf J, Stalenhoef AF (2012) Serum triglycerides and risk of cardiovascular disease. Biochim Biophys Acta 1821:867–875CrossRefGoogle Scholar
  4. 4.
    Chapman MJ, Ginsberg HN, Amarenco P, Andreotti F, Borén J, Catapano AL, Descamps OS, Fisher E, Kovanen PT, Kuivenhoven JA, Lesnik P, Masana L, Nordestgaard BG, Ray KK, Reiner Z, Taskinen MR, Tokgözoglu L, Tybjærg-Hansen A, Watts GF, for the European Atherosclerosis Society Consensus Panel (2011) Triglyceride-rich lipoproteins and high-density lipoprotein cholesterol in patients at high risk of cardiovascular disease: evidence and guidance for management. Eur Heart J 32:1345–1361CrossRefGoogle Scholar
  5. 5.
    Freiberg JJ, Tybjaerg-Hansen A, Jensen JS, Nordestgaard BG (2008) Nonfasting triglycerides and risk of ischemic stroke in the general population. JAMA 300:2142–2152CrossRefGoogle Scholar
  6. 6.
    Varbo A, Benn M, Tybjærg-Hansen A, Jørgensen AB, Frikke-Schmidt R, Nordestgaard BG (2013) Remnant cholesterol as a causal risk factor for ischemic heart disease. J Am Coll Cardiol 61(4):427–436.  https://doi.org/10.1016/j.jacc.2012.08.1026 CrossRefGoogle Scholar
  7. 7.
    Hokanson JE, Austin MA (1996) Plasma triglyceride level is a risk factor for cardiovascular disease independent of high-density lipoprotein cholesterol level: a meta-analysis of population-based prospective studies. J Cardiovasc Risk 3:213–219CrossRefGoogle Scholar
  8. 8.
    Toskes PP (1990) Hyperlipidaemic pancreatitis. Gastroenterol Clin N Am 19(4):783–791Google Scholar
  9. 9.
    Sniderman AD, Williams K, Contois JH et al., A meta-analysis of low-density lipoprotein cholesterol, non-high-density lipoprotein cholesterol, and apolipoprotein B as markers of cardiovascular risk. Circ Cardiovasc Qual Outcomes 2011;4:337–345.Google Scholar
  10. 10.
    Voight BF, Peloso GM, Orho-Melander M, Frikke-Schmidt R, Barbalic M, Jensen MK, Hindy G, Hólm H, Ding EL, Johnson T, Schunkert H, Samani NJ, Clarke R, Hopewell JC, Thompson JF, Li M, Thorleifsson G, Newton-Cheh C, Musunuru K, Pirruccello JP, Saleheen D, Chen L, Stewart AFR, Schillert A, Thorsteinsdottir U, Thorgeirsson G, Anand S, Engert JC, Morgan T, Spertus J, Stoll M, Berger K, Martinelli N, Girelli D, McKeown PP, Patterson CC, Epstein SE, Devaney J, Burnett MS, Mooser V, Ripatti S, Surakka I, Nieminen MS, Sinisalo J, Lokki ML, Perola M, Havulinna A, de Faire U, Gigante B, Ingelsson E, Zeller T, Wild P, de Bakker PIW, Klungel OH, Maitland-van der Zee AH, Peters BJM, de Boer A, Grobbee DE, Kamphuisen PW, Deneer VHM, Elbers CC, Onland-Moret NC, Hofker MH, Wijmenga C, Verschuren WMM, Boer JMA, van der Schouw YT, Rasheed A, Frossard P, Demissie S, Willer C, Do R, Ordovas JM, Abecasis GR, Boehnke M, Mohlke KL, Daly MJ, Guiducci C, Burtt NP, Surti A, Gonzalez E, Purcell S, Gabriel S, Marrugat J, Peden J, Erdmann J, Diemert P, Willenborg C, König IR, Fischer M, Hengstenberg C, Ziegler A, Buysschaert I, Lambrechts D, van de Werf F, Fox KA, el Mokhtari NE, Rubin D, Schrezenmeir J, Schreiber S, Schäfer A, Danesh J, Blankenberg S, Roberts R, McPherson R, Watkins H, Hall AS, Overvad K, Rimm E, Boerwinkle E, Tybjaerg-Hansen A, Cupples LA, Reilly MP, Melander O, Mannucci PM, Ardissino D, Siscovick D, Elosua R, Stefansson K, O'Donnell CJ, Salomaa V, Rader DJ, Peltonen L, Schwartz SM, Altshuler D, Kathiresan S (2012 Aug 11) Plasma HDL cholesterol and risk of myocardial infarction: a Mendelian randomisation study. Lancet 380(9841):572–580CrossRefGoogle Scholar
  11. 11.
    Khera AV, Cuchel M, de la Llera-Moya M et al (2011) Cholesterol efflux capacity, high-density lipoprotein function, and atherosclerosis. N Engl J Med 364:127–135CrossRefGoogle Scholar
  12. 12.
    Rohatgi A, Khera A, Berry JD et al., HDL cholesterol efflux capacity and incident cardiovascular events. N Engl J Med 2014;371:2383–2393.Google Scholar
  13. 13.
    Nordestgaard B, Chapman M, J, Humphries S, for the European Atherosclerosis Society Consensus Panel et al (2013) Familial hypercholesterolaemia is underdiagnosed and undertreated in the general population:guidance for clinicians to prevent coronary heart disease Consensus Statement of the European Atherosclerosis Society. EHJ 34:3478–3490.  https://doi.org/10.1093/eurheartj/eht 273
  14. 14.
    Lipids, lipoproteins, and apolipoproteins as risk markers of myocardial infarction in 52 countries (the INTERHEART study): a case-control study. Lancet. 2008 ;372(9634):224–33.Google Scholar
  15. 15.
    Kabir Z, Perry I, Critchley J, O’Flaherty M, Capewell S, Bennett K (2013) Modelling coronary heart disease mortality declines in the Republic of Ireland 1985–2006. Int J Cardiol 2013 Oct 3;168(3):2462–2467.Google Scholar
  16. 16.
    Central Statistics Office (2013) Vital statistics and fourth quarter and yearly summary 2012. Central Statistics Office, Stationery Office, DublinGoogle Scholar
  17. 17.
    Shelley E, Daly L, Collins C, Christie M, Conroy R, Gibney M, Hickey N, Kelleher C, Kilcoyne D, Lee P (1995) Cardiovascular risk factor changes in the Kilkenny Health Project: a community health promotion programme. Eur Heart J 16(6):752–760CrossRefGoogle Scholar
  18. 18.
    Murphy C, Shelley E, O'Halloran AM, Fahey T, Kenny RA (2017) Failure to control hypercholesterolaemia in the Irish adult population: cross-sectional analysis of the baseline wave of The Irish Longitudinal Study on Ageing (TILDA). Ir J Med Sci 186:1009–1017.  https://doi.org/10.1007/s11845-017-1590-3. CrossRefGoogle Scholar
  19. 19.
    Farzadfar F, Finucane MM, Danaei G, Pelizzari PM, Cowan MJ, Paciorek CJ, Singh GM, Lin JK, Stevens GA, Riley LM, Ezzati M (2011) National, regional, and global trends in serum total cholesterol since 1980: systematic analysis of health examination surveys and epidemiological studies with 321 country-years and 3.0 million participants. Lancet 377(9765):578–586CrossRefGoogle Scholar
  20. 20.
    M. Carey, C Markham P Gaffney G Boran V Maher Validation of a point of care lipid analyser using a hospital based reference laboratory Dec 2006 Irish Journal of Medical ScienceGoogle Scholar
  21. 21.
    Friedewald WT, Levy RI, Fredrickson DS (1972) Estimation of the concentration of low-density lipoprotein cholesterol in plasma, without use of the preparative ultracentrifuge. Clin Chem 18:499–502Google Scholar
  22. 22.
    Nordestgaard BG, Langsted A, Mora S, Kolovou G, Baum H, Bruckert E, Watts GF, Sypniewska G, Wiklund O, Boren J, Chapman MJ, Cobbaert C, Descamps OS, von Eckardstein A, Kamstrup PR, Pulkki K, Kronenberg F, Remaley AT, Rifai N, Ros E, Langlois M, for the European Atherosclerosis Society (EAS) and the European Federation of Clinical Chemistry and Laboratory Medicine (EFLM) Joint Consensus Initiative (2016) European Atherosclerosis Society (EAS) and the European Federation of Clinical Chemistry and Laboratory Medicine (EFLM) Joint Consensus Initiative. Fasting Is Not Routinely Required for Determination of a Lipid Profile: Clinical and Laboratory Implications Including Flagging at Desirable Concentration Cutpoints-A Joint Consensus Statement from the European Atherosclerosis Society and European Federation of Clinical Chemistry and Laboratory Medicine. Clin Chem 62(7):930–946.  https://doi.org/10.1373/clinchem.2016.258897 CrossRefGoogle Scholar
  23. 23.
    Irish College of General Practitioners—A Practical Guide to Integrated Type 2 Care 2016Google Scholar
  24. 24.
    UK Heart Survey NHS The information centre for health and social care (2011) Health Survey for England 2011 Health, social care and lifestyles, Summary of key findings. Department of Health, LondonGoogle Scholar
  25. 25.
    Morgan K, McGee H, Watson D et al., (2007) SLAN 2007: Survey of lifestyle, attitudes & nutrition in Ireland. Main report. Department of Health and Children, DublinGoogle Scholar
  26. 26.
    Carroll MD, Kit BK, Lacher DA, Shero ST, Mussolino ME (2012) Trends in lipids and lipoproteins in US adults, 1988–2010. JAMA 308(15):1545–1554CrossRefGoogle Scholar
  27. 27.
    Leahy S, O’Halloran A, O’Leary N, Healy M, McCormack M, Kenny R, O’Connell J (2015) Prevalence and correlates of diagnosed and undiagnosed type 2 diabetes mellitus and pre-diabetes in older adults: findings from the Irish Longitudinal Study on Ageing (TILDA). Diabetes Res Clin Pract 110:241–249CrossRefGoogle Scholar
  28. 28.
    Packard CJ (2006) Small dense low-density lipoprotein and its role as an independent predictor of cardiovascular disease. Curr Opin Lipidol 17:412–417CrossRefGoogle Scholar
  29. 29.
    Murphy C, Bennett K, Fahey T, Shelley E, Graham I, Kenny RA (2015) Statin use in adults at high risk of cardiovascular disease mortality: cross-sectional analysis of baseline data from The Irish Longitudinal Study on Ageing (TILDA). BMJ Open 5:e008017.  https://doi.org/10.1136/bmjopen-2015-008017 CrossRefGoogle Scholar
  30. 30.
    Kotseva K, De Bacquer D, De Backer G, On Behalf of the Euroaspire Investigators Lifestyle and risk factor management in people at high risk of cardiovascular disease et al (2016) A report from the European Society of Cardiology European Action on Secondary and Primary Prevention by Intervention to Reduce Events (EUROASPIRE) IV cross-sectional survey in 14 European regions. Eur J Prev Cardiol 23(18):2007–2018.  https://doi.org/10.1177/2047487316667784 CrossRefGoogle Scholar
  31. 31.
    Dunne M, MacAnaney O, Markham C, Maher V (April 2013) Lipid targets in clinical practice: successes, failures and lessons to be learned. Ir J Med Sci 182(4):673–678.  https://doi.org/10.1007/s11845-013-0954-6. CrossRefGoogle Scholar
  32. 32.
    Maher V, Gallagher J, Thompson G, Myant N (December 1995) Does the presence of the 3500 mutant apolipoprotein B-100 in low density lipoprotein particles affect their atherogenicity? Atherosclerosis 118(1):105–110CrossRefGoogle Scholar
  33. 33.
    Khera AV, Won HH, Peloso GM, Lawson KS, Bartz TM, Deng X, van Leeuwen EM, Natarajan P, Emdin CA, Bick AG, Morrison AC, Brody JA, Gupta N, Nomura A, Kessler T, Duga S, Bis JC, van Duijn CM, Cupples LA, Psaty B, Rader DJ, Danesh J, Schunkert H, McPherson R, Farrall M, Watkins H, Lander E, Wilson JG, Correa A, Boerwinkle E, Merlini PA, Ardissino D, Saleheen D, Gabriel S, Kathiresan S (2016 Jun 7) Diagnostic Yield and Clinical Utility of Sequencing Familial Hypercholesterolemia Genes in Patients with Severe Hypercholesterolemia. J Am Coll Cardiol 67(22):2578–2589CrossRefGoogle Scholar

Copyright information

© Royal Academy of Medicine in Ireland 2018

Authors and Affiliations

  • Ruth Agar
    • 1
    • 2
  • Catherine Markham
    • 1
    • 2
  • Meabh Prendergast
    • 1
    • 2
  • Rebecca Canning
    • 1
    • 2
  • Edana Maher
    • 1
    • 2
  • Caroline Finn
    • 1
    • 2
  • Nuala Sammon
    • 1
  • Sarah Fall
    • 1
    • 2
  • Noeleen Fallon
    • 1
    • 2
  • Evonne Hanrahan
    • 1
  • Lisa King
    • 1
  • Vincent Maher
    • 1
    • 2
    Email author
  1. 1.Advanced Lipid Management and Research CentreTallaght HospitalDublinIreland
  2. 2.Department of Cardiology, Tallaght HospitalDublinIreland

Personalised recommendations