Low HDL-C Prevalence and Associated Factors in Korean Adults

Purpose: This study estimated the prevalence of low high-density lipoprotein cholesterol (HDL-C) and its associated factors among Korean adults using the 2022-2023 KNHANES data.Methods: A cross-sectional analysis of 7,706 adults ( 20 years) from KNHANES 2022-2023 was performed, applying complex sample weights, strata, and clusters to reflect the survey design.The sociodemographic and health-behavioral characteristics were compared according to the HDL-C status (HDL-C < 40mg/dL in men; < 50mg/dL in women) using complex sample tests.Multivariable logistic regression analyses were conducted to examine the independent associations, presenting odds ratios (ORs) and 95% confidence intervals (CIs). Results:The overall prevalence of low HDL-C was 24.0% (men, 22.9%; women, 25.1%).The significant associated factors included lower education (elementary or below: OR, 1.36 [1.09-1.71];middle school: OR, 1.29 [1.00-1.66]),rural residence (OR, 1.25 [1.09-1.44]),second income quartile (OR, 1.23 [1.03-1.47]),current smoking (OR, 1.71 [1.38-2.12]),absence of strength exercise (OR, 1.28 [1.05-1.58]),diabetes (OR, 1.64 [1.43-1.89]),and abdominal obesity (OR, 2.27 [2.00-2.58]);moderate alcohol consumption was protective (OR, 0.53 [0.46-0.61]). Conclusion:Approximately one-quarter of Korean adults exhibited low HDL-C.Targeted screening and tailored interventions among socioeconomically vulnerable groups, smokers, physically inactive individuals, and those with metabolic risk factors are warranted to improve the HDL-C levels and reduce cardiovascular risk.