Lipid pattern in middle-aged inhabitants of the Lower Silesian region of Poland. The PURE Poland sub-study.

INTRODUCTION: A decreased serum high density lipoprotein-cholesterol (HDL-C) is a strong predictor of cardiovascular risk. However, total HDL is a very dynamic, changeable fraction, and does not perform the function of atherosclerosis markers. In the presented study, the pattern of serum lipids, including HDL-C subclasses (HDL2- and HDL3-cholesterol), in a middle- aged Polish Lower Silesia population was defined.

MATERIALS AND METHOD: A group of 746 males and 1,298 females, aged 35-70, were investigated. All subjects were participants in the PURE study. Mean serum lipid levels were determined for groups selected on the basis of gender, age, cigarette smoking, drinking alcohol and place of residence (urban/rural area). The data were analyzed using STATISTICA 6.0 PL.

RESULTS: In multiple linear regression models, age was the most important independent and consistent predictor of total cholesterol (TC) and LDL cholesterol (LDL-C). The prevalence of low HDL-C (threshold 40 mg/dL in males, 50 mg/dL in females) was 16.5% for males and 22.6% for females. This gender-conditioned difference in the prevalence of low HDL-C was greater in rural (20.0% vs. 30.9%, respectively, in males and females) in comparison to urban (14.4% vs. 17.1%) areas. The lipid pattern was significantly worse in rural than in urban females. Female rural inhabitants showed higher triglycerides (TG) and lower HDL cholesterol (total and contained in subclasses HDL2 and HDL3). Simultaneously, a higher BMI, higher percent of smokers and drinkers and lower age of smoking female rural inhabitants in comparison to urban females were estimated. In the total population, cigarette smoking or drinking alcohol were associated with significant increases in TC, LDL-C and TG, also with decreased HDL-C (smoking) or HDL2-C (drinking). Two-way analysis of variance showed the existence of interaction between these risk factors in their influence on HDL-C and HDL3-C.

CONCLUSION: In the middle-aged population of the Lower Silesian region in Poland the place of residence (urban/rural area) had a significant impact on the lipid pattern. This pattern is more atherogenic in rural women than in urban women.