title: Prevalence of familial hypercholesterolemia: a meta-analysis of six large, observational, population-based studies in Poland.
abstract: BACKGROUND
  Familial hypercholesterolemia (FH) is a severely underdiagnosed and undertreated genetic disorder. Little is known about regional variation in the prevalence of FH, and information for Central and Eastern Europe (CEE) is scarce. This paper assesses the prevalence of FH and related cardiovascular disease (CVD) risk factors in Poland.
  
  
  METHODS
  We performed a meta-analysis of six population-based studies in Poland. The FH was assessed using the Dutch Lipids Clinics Network (DLCN) criteria. The categories "definite" (> 8 points) and "probable" (6-8 points) were combined into "potential FH". Combined estimates of proportions across studies were pooled by meta-analysis with a random effects model.
  
  
  RESULTS
  A total of 37,889 persons aged 20-79 years were included in the analysis. The distribution of DLCN scores was skewed, and there were only 7 cases of definite FH. Prevalence of potential FH was 404/100,000 people (95% CI = 277-531/100,000). Familial hypercholesterolemia was more prevalent in women than in men, and the prevalence was the highest in the age group 45-54 years in men and 55-64 years in women. After adjustment for age and sex, compared to participants with normal cholesterol, persons with potential FH had twice the prevalence of hypertension (p < 0.01); smoking was more prevalent by about 80% (p < 0.01) and hypertriglyceridemia was nine times more frequent (p < 0.001). There was no difference in the prevalence of low high-density lipoprotein (HDL)-cholesterol or diabetes.
  
  
  CONCLUSIONS
  We believe that our study might facilitate the planning of a strategy to manage the disease at a population level, i.e. to develop a national strategy for the detection, diagnosis, and treatment of FH.
authors.affiliation: Department of Epidemiology and Population Studies, Institute of Public Health, Faculty of Health Sciences, Jagiellonian University Medical College, Krakow, Poland.
authors.forename: Andrzej
authors.initials: A
authors.lastname: Pajak
authors.affiliation: Department of Epidemiology and Population Studies, Institute of Public Health, Faculty of Health Sciences, Jagiellonian University Medical College, Krakow, Poland.
authors.forename: Krystyna
authors.initials: K
authors.lastname: Szafraniec
authors.affiliation: Department of Epidemiology and Population Studies, Institute of Public Health, Faculty of Health Sciences, Jagiellonian University Medical College, Krakow, Poland.
authors.forename: Maciej
authors.initials: M
authors.lastname: Polak
authors.affiliation: Department of Epidemiology, Cardiovascular Disease Prevention and Health Promotion, Institute of Cardiology, Warsaw, Poland; Department of Preventive Medicine, Medical University of Lodz, Lodz, Poland.
authors.forename: Wojciech
authors.initials: W
authors.lastname: Drygas
authors.affiliation: Department of Epidemiology, Cardiovascular Disease Prevention and Health Promotion, Institute of Cardiology, Warsaw, Poland.
authors.forename: Walerian
authors.initials: W
authors.lastname: Piotrowski
authors.affiliation: Department of Prevention and Medical Education, Medical University of Gdansk, Gdansk, Poland.
authors.forename: Tomasz
authors.initials: T
authors.lastname: Zdrojewski
authors.affiliation: Department of Intensive Electrotherapy and Hypertension, Jagiellonian University Medical College, Krakow, Poland.
authors.forename: Piotr
authors.initials: P
authors.lastname: Jankowski
keywords: Dutch Lipids Clinics Network criteria; epidemiology; familial hypercholesterolemia; prevalence; risk factors