Dyslipidaemia burden and population-specific lipid thresholds in rural Nigerian adults: Implications for cardiovascular risk screening

Background and AimThere is a rising prevalence of cardiovascular disease (CVD) and CVD-related deaths in Nigeria, and a pressing need for targeted prevention strategies.However, robust evidence on cholesterol distribution, and population-specific lipid thresholds to guide risk assessment in Nigerian populations is lacking.This study aimed to describe sex-and age-specific distributions of total cholesterol, LDL-cholesterol (LDL-C), non-HDL cholesterol, and triglycerides in rural Nigerian adults, and to determine percentile-based lipid thresholds for this population. Methods:A cross-sectional study of 1,309 adults (577 men, 732 women) was conducted in a tertiary hospital in Southern Nigeria.Blood test results collected over an 8-month period (April-November 2022) were analysed.Cholesterol distributions by sex and age-group were described, and 95th percentile lipid-thresholds were determined. Results:Overall, 46.8% of participants had raised total cholesterol (mean 198.93mg/dl (SD 57.81)), 14.6% had raised LDL-C (mean 120.83mg/dl (SD 51.62)), and 27.9% had raised triglycerides (triglycerides 128.83mg/dl (SD 75.26).Women had higher mean values than men for total cholesterol (203.3mg/dlvs 193.4mg/dl),LDL-C (125.1mg/dlvs 115.5mg/dl), and non-HDL cholesterol (148.4mg/dlvs 141.1mg/dl).The 95 th percentile values for total cholesterol and LDL-C in the population were 294mg/dl (7.6mmol/L) and 205.7mg/dl (5.3mmol/L) respectively. Conclusions:Nearly half of rural Nigerian adults have dyslipidaemia, with women at disproportionately higher risk.The derived 95 th percentile lipid thresholds may represent population-specific cutoffs for increased risk of atherosclerotic CVD within this population and similar settings in Nigeria.Evidence from this study will aid targeted interventions to reduce the hypercholesterolaemia burden and consequent atherosclerotic CVD risk.