CARDIOVASCULAR JOURNAL OF AFRICA • Volume 33, No 2, March/April 2022 54 AFRICA Statistical analysis All database management and statistical analyses were done using SAS software version 9.4 (SAS Institute, Cary, NC). We used mean and standard deviation to measure the central tendency and spread of all continuous characteristics, while categorical characteristics were expressed as proportions. Differences between means and proportions of binary independent groups were tested using the student’s t-test and chi-squared test, respectively. We used the Cochran–Armitage test to analyse the trend in ordinal multiple groups. Associations between lipid abnormalities and their determinants were assessed using logistic regressions. A p-value less than 0.05 was considered statistically significant in all two-tailed tests. Results The socio-demographic characteristics of the subjects according to place of residence are summarised in Table 1. A total of 3 211 subjects with an average age of 43.8 ± 16.3 years and BMI of 24.4 ± 5.2 kg/m2 were investigated for dyslipidaemia. Overall, 1 796 (55.9%) were women, 1 081 (34.2%) drank alcohol, 112 (3.40%) smoked cigarettes and 369 (11.5%) were obese. Nearly three out of 10 were hypertensive and two out of 50 were diabetic. The overall mean systolic and diastolic blood pressures were 125.0 ± 22.9 and 77.0 ± 13.0 mmHg, respectively. Cigarette smoking, alcohol consumption, physical inactivity, diabetes mellitus and hypertension were comparable (p > 0.05) between rural and urban dwellers. The mean levels of LDL-C (2.1 vs 1.8 mmol/l, p < 0.0001), TG (1.4 vs 1.2 mmol/l, p < 0.0001), TC (3.4 vs 3.1 mmol/l, p < 0.0001) and HDL-C (0.7 vs 0.8 mmol/l, p < 0.0001) were significantly higher in the rural compared to the urban dwellers. As shown in Table 2, the prevalence of l-HDL was 72.5% in the overall group, 72.3% in the diabetic group, 69.0% in the hypertensives and 73.2% in obese subjects. LDL-C was elevated in 13.6% of the overall group, 18.8% among the diabetics, 19.1% of the hypertensives and 20.3% of obese subjects. The prevalence of h-TG was 21.4, 39.3, 27.8 and 32.8% in overall, diabetic, hypertensive and obese subjects, respectively. High TC was prevalent in 7.5% of the overall group, 10.7% of diabetics, 12.6% of hypertensives and 11.9% of obese subjects. In comparison to urban residents, the prevalence of l-HDL (75.3 vs 69.2%), e-LDL (15.8 vs 10.9%) and h-TG (25.1 vs 17.0%) was significantly (p < 0.05) higher in subjects who resided in rural areas. With the exception of h-TG, all lipid abnormalities occurred significantly (p < 0.05) more often in women (l-HDL 74.6%, e-LDL 17.2%, h-CHL 9.3%) compared to men (l-HDL 69.9%, e-LDL 9.1%, h-CHL 5.2%). Fig. 2 shows the prevalence of dyslipidaemia in different age groups. The prevalence of all forms of dyslipidaemia, excluding l-HDL, steadily increased with age (p < 0.0001 for trend), with a peak occurring in subjects aged 41–50 or 51–60 years. The results in Table 3 show the odds of various factors associated with the different components of dyslipidaemia after adjusting for age, gender, cigarette smoking and alcohol intake. The adjusted odds ratio of e-LDL (AOR 1.42; 95% CI 1.13–1.80), h-TG (AOR 1.21; 95% CI 1.01–1.47), h-CHL (AOR 2.16; 95% CI 1.59–2.95) and l-HDL (AOR 0.78; 95% CI 0.65– 0.93) significantly increased with subjects being hypertensive. Additionally, the adjusted odds of h-TG increased with subjects being diabetic (AOR 2.04; 95% CI 1.36–3.03), obese (AOR 1.89; Table 1. Socio-demographic characteristics of participants by place of residence Characteristics Overall Rural Urban p-value Number of participants (%) 3211 1748 (54.4) 1463 (45.6) < 0.0001 Women, n (%) 1796 (55.9) 1085 (62.1) 711 (48.6) < 0.0001 Cigarette smoking, n (%) 112 (3.4) 49 (2.8) 63 (4.4) 0.0758 Alcohol intake, n (%) 1081 (34.2) 575 (33.1) 506 (35.6) 0.1414 Hypertension, n (%) 968 (30.2) 527 (30.2) 441 (30.1) 0.9974 Diabetes mellitus, n (%) 112 (3.5) 52 (3.0) 60 (4.1) 0.0832 Physical inactivity, n (%) 1170 (36.4) 641 (36.7) 529 (36.2) 0.7640 Obesity, n (%) 369 (11.5) 137 (7.8) 232 (15.9 < 0.0001 Age, years, mean ± SD 43.5 ± 16.4 45.8 ± 17.2 40.7 ± 14.9 < 0.0001 SBP, mmHg, mean ± SD 125.0 ± 22.9 124.3 ± 24.4 125.8 ± 21.0 0.0775 DBP, mmHg, mean ± SD 77.7 ± 13.0 77.2 ± 12.9 78.3 ± 13.2 0.0193 RBG, mmol/l, mean ± SD 6.2 ± 1.9 6.2 ± 1.8 6.3 ± 2.1 0.1852 BMI, kg/m2, mean ± SD 24.1 ± 4.9 23.3 ± 4.4 25.0 ± 5.4 < 0.0001 HDL-C, mmol/l, mean ± SD 0.7 ± 0.4 0.7 ± 0.4 0.8 ± 0.4 < 0.0001 LDL-C, mmol/l, mean ± SD 2.0 ± 1.2 2.1 ± 1.1 1.8 ± 1.1 < 0.0001 TG, mmol/l, mean ± SD 1.3 ± 0.6 1.4 ± 0.7 1.2 ± 0.6 < 0.0001 TC, mmol/l, mean ± SD 3.3 ± 1.3 3.4 ± 1.3 3.1 ± 1.3 < 0.0001 SBP, systolic blood pressure, and DBP, diastolic blood pressure were derived from the average of five consecutive auscultatory readings. Hypertension was systolic blood pressure ≥ 140 mmHg and/or diastolic blood pressure ≥ 90 mmHg. BMI, body mass index; HDL-C, high-density lipoprotein cholesterol; LDL-C, low-density lipoprotein cholesterol; TG, triglycerides; TC, total cholesterol; RBG, random blood glucose. Table 2. Prevalence of dyslipidaemia by selected variables Variables No in group Low HDL-C Elevated LDL-C Elevated TG Elevated TC Overall, n (%) 3211 2328 (72.5) 436 (13.6) 688 (21.4) 241 (7.5) Place of residence, n (%) Rural 1748 1316 (75.3) 276 (15.8) 439 (25.1) 145 (8.3) Urban 1463 1012 (69.2) 160 (10.9) 249 (17.0) 96 (6.6) p-value 0.0001 < 0.0001 < 0.0001 0.0634 Gender, n (%) Men 1415 989 (69.9) 128 (9.1) 308 (21.8) 74 (5.2) Women 1796 1339 (74.6) 308 (17.2) 380 (21.2) 167 (9.3) p-value 0.0033 < 0.0001 0.6764 < 0.0001 Cigarette smoking, n (%) No 3069 2241 (73.0) 422 (13.8) 648 (21.1) 232 (7.6) Yes 112 71 (63.4) 7 (6.3) 31 (27.7) 4 (3.6) p-value 0.0247 0.0225 0.0959 0.1137 Alcohol consumption, n (%) No 2081 1547 (74.3) 272 (13.1) 419 (20.1) 143 (6.9) Yes 1081 749 (69.3) 146 (13.5) 264 (24.4) 86 (8.0) p-value 0.0025 0.7317 0.0055 0.2647 BMI, n (%) No 2842 2058 (72.4) 361 (12.7) 567 (20.0) 197 (6.9) Yes 369 270 (73.2) 75 (20.3) 121 (32.8) 44 (11.9) p-value 0.7593 < 0.0001 < 0.0001 0.0006 Hypertension, n (%) No 2243 1660 (74.1) 251 (11.2) 419 (18.7) 119 (5.3) Yes 968 668 (69.0) 185 (19.1) 269 (27.8) 122 (12.6) p-value 0.0036 < 0.0036 < 0.0001 < 0.0001 Diabetes mellitus, n (%) No 3099 2247 (72.5) 415 (13.4) 644 (20.8) 299 (7.4) Yes 112 81 (72.3) 21 (18.8) 44 (39.3) 12 (10.7) p-value 0.9655 0.1039 < 0.0001 0.1895 HDL-C, high-density lipoprotein cholesterol; LDL-C, low-density lipoprotein cholesterol; TG, triglycerides; TC, total cholesterol, BMI, body mass index.
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