Selective screening for dyslipidemia in a Canadian population.
The study assesses the clinical features of individuals that best enable an effective selective screening of the adult population for dyslipidemia. The results of the population-based 1990 Saskatchewan Heart Health Survey were examined. Dyslipidemia was defined as a total cholesterol (TC) to high-density lipoprotein cholesterol (HDL) ratio of > or = 5. In total, 805 men and 782 women, 18-74 years of age, had their plasma cholesterol measured. Using TC screening of the entire population as recommended by the Canadian Consensus Conference on Cholesterol would correctly identify 79% of those with dyslipidemia (sensitivity) and 67% of those with a normal profile (specificity). However, if one performs lipoprotein analysis on only those with a high waist-to-hip circumference ratio (WHR), 44% of the population would need to be screened to correctly identify 71% of those with dyslipidemia (sensitivity) and 66% of those with a normal profile (specificity). A high WHR is an especially strong predictor of dyslipidemia in young adults. In conclusion, a high WHR may provide an effective means of selective screening of the adult population for dyslipidemia.
Reeder
B A
BA
Saskatchewan Heart and Stroke Foundation Epidemiology Unit, Department of Community Health and Epidemiology, Saskatoon, Canada.
Liu
L
L
Horlick
L
L
D000293:Adolescent; D000328:Adult; D000368:Aged; D001824:Body Constitution; D002170:Canada / Q000453:epidemiology; D005260:Female; D006801:Humans; D006949:Hyperlipidemias / Q000097:blood* / Q000453:epidemiology / Q000517:prevention & control; D016015:Logistic Models; D008297:Male; D008403:Mass Screening / Q000379:methods*; D008875:Middle Aged; D018579:Patient Selection; D011159:Population Surveillance; D017410:Practice Guidelines as Topic; D011237:Predictive Value of Tests; D012307:Risk Factors; D012680:Sensitivity and Specificity