title: Gender differences in 7 years trends in cholesterol lipoproteins and lipids in India: Insights from a hospital database.
abstract: OBJECTIVE
  To determine gender differences and secular trends in total, low-density lipoprotein (LDL) and high DL (HDL) cholesterol and triglycerides using a large hospital database in India.
  
  
  METHODS
  All blood lipid tests evaluated from July 2007 to December 2014 were analyzed. Details of gender and age were available. Statin therapy was obtained at two separate periods. Trends were calculated using linear regression and Mantel-Haenszel X(2).
  
  
  RESULTS
  Data of 67395 subjects (men 49,904, women 17,491) aged 51 ± 12 years were analyzed. Mean levels (mg/dl) were total cholesterol 174.7 ± 45, LDL cholesterol 110.7 ± 38, non-HDL cholesterol 132.1 ± 44.8, HDL cholesterol 44.1 ± 10, triglycerides 140.8 ± 99, and total: HDL cholesterol 4.44 ± 1.5. Various dyslipidemias in men/women were total cholesterol ≥200 mg/dl 25.4/36.4%, LDL cholesterol ≥130 mg/dl 28.1/35.0% and ≥100 mg/dl 54.4/66.4%, non-HDL cholesterol ≥160 mg/dl 25.5/29.6%, HDL cholesterol <40/50 mg/dl 54.4/64.4%, and triglycerides ≥150 mg/dl 34.0/26.8%. Cholesterol lipoproteins declined over 7 years with greater decline in men versus women for cholesterol (Blinear regression = -0.82 vs. -0.33, LDL cholesterol (-1.01 vs. -0.65), non-HDL cholesterol (-0.88 vs. -0.52), and total: HDL cholesterol (-0.02 vs. -0.01). In men versus women there was greater decline in prevalence of hypercholesterolemia (X(2) trend 74.5 vs. 1.60), LDL cholesterol ≥130 mg/dl (X(2) trend 415.5 vs. 25.0) and ≥100 mg/dl (X(2) trend 501.5 vs. 237.4), non-HDL cholesterol (X(2) trend 77.4 vs. 6.85), total: HDL cholesterol (X(2) trend 212.7 vs. 10.5) and high triglycerides (X(2) trend 10.8 vs. 6.15) (P < 0.01). Use of statins was in 2.6% (36/1405) in 2008 and 9.0% (228/2527) in 2014 (P < 0.01). Statin use was significantly lower in women (5.8%) than men (10.3%).
  
  
  CONCLUSIONS
  In a large hospital - database we observed greater hypercholesterolemia and low HDL cholesterol in women. Mean levels and prevalence of high total, LDL, non-HDL and total: HDL cholesterol declined over 7 years. A lower decline was observed in women. This was associated with lower use of statins.
authors.affiliation: Department of Internal Medicine, Fortis Escorts Hospital, Jaipur, Rajasthan, India.
authors.forename: Rajeev
authors.initials: R
authors.lastname: Gupta
authors.affiliation: Department of Laboratory Medicine, Fortis Escorts Hospital, Jaipur, Rajasthan, India.
authors.forename: Madhawi
authors.initials: M
authors.lastname: Sharma
authors.affiliation: Department of Laboratory Medicine, Fortis Escorts Hospital, Jaipur, Rajasthan, India.
authors.forename: Neeraj Krishna
authors.initials: NK
authors.lastname: Goyal
authors.affiliation: Department of Laboratory Medicine, Fortis Escorts Hospital, Jaipur, Rajasthan, India.
authors.forename: Preeti
authors.initials: P
authors.lastname: Bansal
authors.affiliation: Department of Endocrinology, Fortis Escorts Hospital, Jaipur, Rajasthan, India.
authors.forename: Sailesh
authors.initials: S
authors.lastname: Lodha
authors.affiliation: Department of Research, Fortis Escorts Hospital, Jaipur, Rajasthan, India.
authors.forename: Krishna Kumar
authors.initials: KK
authors.lastname: Sharma
keywords: Cardiovascular disease; cholesterol; dyslipidemias