高脂浓度是心血管疾病可改变的危险因素。在过去的十年中，美国成年人的血脂浓度和血脂控制趋势发生了怎样的变化，我们所知甚少。研究的目的是确定从2007年到2018年，美国成年人的脂质浓度和脂质控制率是否发生变化，以及这些趋势是否因性别、种族和民族而不同。

在33040例患者中，在接受他汀治疗的成年人中，年龄调整血脂控制率从2007-2008年的墨西哥裔美国人在年龄调整血脂控制方面有显著改善(趋势P = .008)。在2015-2018年，年龄调整后的脂质控制率女性显著低于男性(OR, 0.54 [95% CI, 0.40 - 0.72])。此外，在其他种族和民族中没有观察到显著的差异。

在这项连续横断面研究中，美国成年人的脂质浓度从2007-2008年到2017-2018年有所改善。这些模式在所有种族和民族亚群中都被观察到，除了非西班牙裔的亚洲成年人。

Abstract

Importance: High lipid concentrations are a modifiable risk factor for cardiovascular disease. Little is known about how population-level lipid concentrations, as well as trends in lipid control, have changed over the past decade among US adults.

Objective: To determine whether lipid concentrations and rates of lipid control changed among US adults and whether these trends differed by sex and race and ethnicity, from 2007 to 2018.

Design, setting, and participants: Serial cross-sectional analysis of 33 040 US adults aged 20 years or older, weighted to be nationally representative, from the National Health and Nutrition Examination Surveys (2007-2008 to 2017-2018).

Main outcomes and measures: Lipid concentrations among US adults and rates of lipid control among adults receiving statin therapy. Lipid control was defined as a total cholesterol concentration of 200 mg/dL or less.

Results: The mean age of the study population was 47.4 years, and 51.4% were women; of the 33 040 participants, 12.0% were non-Hispanic Black; 10.3%, Mexican American; 6.4%, other Hispanic American; 62.7%, non-Hispanic White; and 8.5%, other race and ethnicities (including non-Hispanic Asian. Among all US adults, age-adjusted total cholesterol improved significantly in the overall population from 197 mg/dL in 2007-2008 to 189 mg/dL in 2017-2018 (difference, -8.6 mg/dL [95% CI, -12.2 to -4.9 mg/dL]; P for trend <.001), with similar patterns for men and women. Black, Mexican American, other Hispanic, and White adults experienced significant improvements in total cholesterol, but no significant change was observed for Asian adults. Among adults receiving statin therapy, age-adjusted lipid control rates did not significantly change from 78.5% in 2007-2008 to 79.5% in 2017-2018 (difference, 1.1% [95% CI, -3.7% to 5.8%]; P for trend = .27), and these patterns were similar for men and women. Across all racial and ethnic groups, only Mexican Americans experienced a significant improvement in age-adjusted lipid control (P for trend = .008). In 2015-2018, age-adjusted rates of lipid control were significantly lower for women than for men (OR, 0.54 [95% CI, 0.40 to 0.72]). In addition, when compared with White adults, rates of lipid control while taking statins were significantly lower among Black adults (OR, 0.66 [95% CI, 0.47 to 0.94]) and other Hispanic adults (OR, 0.59 [95% CI, 0.37 to 0.95]); no significant differences were observed for other racial and ethnic groups.

Conclusions and relevance: In this serial cross-sectional study, lipid concentrations improved in the US adult population from 2007-2008 through 2017-2018. These patterns were observed across all racial and ethnic subgroups, with the exception of non-Hispanic Asian adults.

文章连接：

https://jamanetwork.com/journals/jama/article-abstract/2795529

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