BACKGROUND: Despite high cardiovascular mortality in Central Asian republics of the former Soviet Union, there is limited information about major risk factors, including blood lipids. We investigated the prevalence of impaired concentrations of blood lipids, the awareness, treatment and control of hypercholesterolemia, and factors associated with these indicators in urban and rural populations in Kazakhstan. METHODS: We conducted a cross-sectional study of random urban and rural population samples (the state capital Astana and Akmol village). Men and women aged 50-74 years were examined; a total of 954 adults participated (response rate 59%). Serum concentrations of total, LDL and HDL cholesterol and triglycerides and a range of other cardiovascular risk factors were measured. RESULTS: The overall prevalence of hypercholesterolemia (total cholesterol ≥6.2 mmol/l) was 37%; among subjects with hypercholesterolemia, 57% were aware of their condition, 41% took medication and 23% had total cholesterol <6.2 mmol/l (4.5% <5 mmol/l). The prevalence, awareness, treatment, and control of hypercholesterolemia were all higher in the urban than the rural area. Similarly, the proportions of subjects with impaired concentrations of specific lipids fractions were also considerably higher in the urban population. Most associations with other covariates were in the expected direction. CONCLUSIONS: This study found relatively high prevalence of dyslipidemia in the Kazakh population, and the blood lipid profile was less favourable in the urban area. These pronounced urban-rural differences may be related to urbanization, the associated nutrition transition and to access to health care.

Centre for Experimental Medicine Institute of Clinical and Experimental Medicine Videnska 1958 9 14021 Prague 4 Czech Republic

Department of Epidemiology and Public Health University College London 1 19 Torrington Place London WC1E 6BT UK

Laboratory of Epidemiology and Public Health Center for Life Sciences PI National Laboratory Astana Nazarbayev University Kabanbay Batyr Ave 53 Astana Kazakhstan 010000

Zobrazit více v PubMed

WHO: Global status report on noncommunicable diseases 2014. In. Geneva: World Health Organization; 2014.

Fletcher B, Berra K, Ades P, Braun LT, Burke LE, Durstine JL, Fair JM, Fletcher GF, Goff D, Hayman LL, et al. Managing abnormal blood lipids: a collaborative approach. Circulation. 2005;112(20):3184–3209. doi: 10.1161/CIRCULATIONAHA.105.169180. PubMed DOI

Barter P. HDL-C: role as a risk modifier. Atheroscler Suppl. 2011;12(3):267–270. doi: 10.1016/S1567-5688(11)70885-6. PubMed DOI

Gandotra P, Miller M. The role of triglycerides in cardiovascular risk. Curr Cardiol Rep. 2008;10(6):505–511. doi: 10.1007/s11886-008-0079-0. PubMed DOI

WHO . Global Health Observatory data repository. 2014. PubMed

Yim A, Humphries D, Abuova G. Food, alcohol and cigarette availability and consumption in Almaty, Kazakstan: results and appraisal of a rapid assessment. Public Health Nutr. 2003;6(8):791–800. doi: 10.1079/PHN2003503. PubMed DOI

Goryakin Y, Rocco L, Suhrcke M, Roberts B, McKee M. Fruit and vegetable consumption in the former soviet union: the role of individual- and community-level factors. Public Health Nutr. 2015;18(15):2825–2835. doi: 10.1017/S1368980015000105. PubMed DOI PMC

Supiyev A, Kossumov A, Utepova L, Nurgozhin T, Zhumadilov Z, Bobak M. Prevalence, awareness, treatment and control of arterial hypertension in Astana, Kazakhstan. A cross-sectional study. Public Health. 2015;129(7):948–953. doi: 10.1016/j.puhe.2015.02.020. PubMed DOI

Supiyev A, Kossumov A, Kassenova A, Nurgozhin T, Zhumadilov Z, Peasey A, Bobak M. Diabetes prevalence, awareness and treatment and their correlates in older persons in urban and rural population in the Astana region, Kazakhstan. Diabetes Res Clin Pract. 2016;112:6–12. doi: 10.1016/j.diabres.2015.11.011. PubMed DOI

National Cholesterol Education Program (NCEP) Expert panel on detection Ea, and treatment of high blood cholesterol in adults (adult treatment panel III): third report of the National Cholesterol Education Program (NCEP) expert panel on detection, evaluation, and treatment of high blood cholesterol in adults (adult treatment panel III) final report. Circulation. 2002;106(25):3143–3421. PubMed

Amiri M, Majid HA, Hairi F, Thangiah N, Bulgiba A, Su TT. Prevalence and determinants of cardiovascular disease risk factors among the residents of urban community housing projects in Malaysia. BMC Public Health. 2014;14(Suppl 3):S3. doi: 10.1186/1471-2458-14-S3-S3. PubMed DOI PMC

The World Health Organization MONICA project (monitoring trends and determinants in cardiovascular disease): a major international collaboration. WHO MONICA project principal investigators. J Clin Epidemiol. 1988;41(2):105–114. doi: 10.1016/0895-4356(88)90084-4. PubMed DOI

WHO . Waist circumference and waist–hip ratio: report of a WHO expert consultation. Geneva: World Health Organization; 2008.

Johnson TP, Wislar JS. Response rates and nonresponse errors in surveys. JAMA. 2012;307(17):1805–1806. doi: 10.1001/jama.2012.3532. PubMed DOI

Suominen S, Koskenvuo K, Sillanmäki L, Vahtera J, Korkeila K, Kivimäki M, Mattila KJ, Virtanen P, Sumanen M, Rautava P, et al. Non-response in a nationwide follow-up postal survey in Finland: a register-based mortality analysis of respondents and non-respondents of the health and social support (HeSSup) study. BMJ Open. 2012;2(2):e000657. doi: 10.1136/bmjopen-2011-000657. PubMed DOI PMC

Gordon T, Castelli WP, Hjortland MC, Kannel WB, Dawber TR. Diabetes, blood lipids, and the role of obesity in coronary heart disease risk for women. The Framingham study. Ann Intern Med. 1977;87(4):393–397. doi: 10.7326/0003-4819-87-4-393. PubMed DOI

Choudhury KN, Mainuddin AK, Wahiduzzaman M, Islam SM. Serum lipid profile and its association with hypertension in Bangladesh. Vasc Health Risk Manag. 2014;10:327–332. PubMed PMC

Facchini F, Fiori G, Bedogni G, Galletti L, Belcastro MG, Ismagulov O, Ismagulova A, Sharmanov T, Tsoy I, Rizzoli S, et al. Prevalence of overweight and cardiovascular risk factors in rural and urban children from Central Asia: the Kazakhstan health and nutrition examination survey. Am J Hum Biol. 2007;19(6):809–820. doi: 10.1002/ajhb.20646. PubMed DOI

Turgunova L, Laryushina E, Amirkhanova D, Alina A, Bayesheva T. Prevalence of modifiable risk factors of chronic non infection diseases among urban and rural residents of karaganda region. Georgian Med News. 2016;252:32–36. PubMed

Adambekov S, Kaiyrlykyzy A, Igissinov N, Linkov F. Health challenges in Kazakhstan and Central Asia. J Epidemiol Community Health. 2016;70(1):104–108. doi: 10.1136/jech-2015-206251. PubMed DOI

Angkurawaranon C, Jiraporncharoen W, Chenthanakij B, Doyle P, Nitsch D. Urbanization and non-communicable disease in Southeast Asia: a review of current evidence. Public Health. 2014;128(10):886–895. doi: 10.1016/j.puhe.2014.08.003. PubMed DOI

Joshi SR, Anjana RM, Deepa M, Pradeepa R, Bhansali A, Dhandania VK, Joshi PP, Unnikrishnan R, Nirmal E, Subashini R, et al. Prevalence of dyslipidemia in urban and rural India: the ICMR-INDIAB study. PLoS One. 2014;9(5):e96808. doi: 10.1371/journal.pone.0096808. PubMed DOI PMC

Pan L, Yang Z, Wu Y, Yin RX, Liao Y, Wang J, Gao B, Zhang L. Group CNSoCKDW: the prevalence, awareness, treatment and control of dyslipidemia among adults in China. Atherosclerosis. 2016;248:2–9. doi: 10.1016/j.atherosclerosis.2016.02.006. PubMed DOI

Cai L, Zhang L, Liu A, Li S, Wang P. Prevalence, awareness, treatment, and control of dyslipidemia among adults in Beijing, China. J Atheroscler Thromb. 2012;19(2):159–168. doi: 10.5551/jat.10116. PubMed DOI

Bayram F, Kocer D, Gundogan K, Kaya A, Demir O, Coskun R, Sabuncu T, Karaman A, Cesur M, Rizzo M, et al. Prevalence of dyslipidemia and associated risk factors in Turkish adults. J Clin Lipidol. 2014;8(2):206–216. doi: 10.1016/j.jacl.2013.12.011. PubMed DOI

Omboni S, Carabelli G, Ghirardi E, Carugo S. Awareness, treatment, and control of major cardiovascular risk factors in a small-scale Italian community: results of a screening campaign. Vasc Health Risk Manag. 2013;9:177–185. doi: 10.2147/VHRM.S40925. PubMed DOI PMC

Farzadfar F, Finucane MM, Danaei G, Pelizzari PM, Cowan MJ, Paciorek CJ, Singh GM, Lin JK, Stevens GA, Riley LM, et al. National, regional, and global trends in serum total cholesterol since 1980: systematic analysis of health examination surveys and epidemiological studies with 321 country-years and 3·0 million participants. Lancet. 2011;377(9765):578–586. doi: 10.1016/S0140-6736(10)62038-7. PubMed DOI

Bays HE, Toth PP, Kris-Etherton PM, Abate N, Aronne LJ, Brown WV, Gonzalez-Campoy JM, Jones SR, Kumar R, La Forge R, et al. Obesity, adiposity, and dyslipidemia: a consensus statement from the National Lipid Association. J Clin Lipidol. 2013;7(4):304–383. doi: 10.1016/j.jacl.2013.04.001. PubMed DOI

Beauchamp A, Tonkin A, Peeters A, Wolfe R, Turrell G, Harriss L, Giles GG, English DR, Jenkins AJ. Associations among smoking status, lifestyle and lipoprotein subclasses. J Clin Lipidol. 2010;4(6):522–530. doi: 10.1016/j.jacl.2010.09.003. PubMed DOI

Hubacek JA, Stanek V, Gebauerova M, Adamkova V, Lesauskaite V, Zaliaduonyte-Peksiene D, Tamosiunas A, Supiyev A, Kossumov A, Zhumadilova A, et al. Traditional risk factors of acute coronary syndrome in four different male populations - total cholesterol value does not seem to be relevant risk factor. Physiol Res. 2017;66(Supplementum 1):S121–S128. PubMed

Davletov K, McKee M, Berkinbayev S, Battakova Z, Zhussupov B, Amirov B, Junusbekova G, Rechel B. Ethnic differences in all-cause mortality rates in Kazakhstan. Public Health. 2016;133:57–62. doi: 10.1016/j.puhe.2015.11.026. PubMed DOI

Prevalence, awareness, treatment and control of hypertension, diabetes and hypercholesterolemia, and associated risk factors in the Czech Republic, Russia, Poland and Lithuania: a cross-sectional study