Factors associated with low HDL cholesterol in Brazilian adults according to the National Health Survey: a cross-sectional study

Factors associated with low HDL cholesterol in Brazilian adults according to the National Health Survey: a cross-sectional study | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Factors associated with low HDL cholesterol in Brazilian adults according to the National Health Survey: a cross-sectional study Ana Carolina Micheletti Gomide Nogueira de Sá, Tércia Moreira Ribeiro Silva, and 5 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-7293046/v1 This work is licensed under a CC BY 4.0 License Status: Under Review Version 1 posted 8 You are reading this latest preprint version Abstract Background Dyslipidemia can be defined as abnormal concentrations of circulating lipids in the bloodstream, such as total cholesterol, triglycerides (TGs), low-density lipoproteins (LDLs), or high-density lipoproteins (HDLs). HDL is an Apo A lipoprotein complex with an anti-atherogenic role and possesses antiproliferative, antithrombotic, and anti-inflammatory properties, and its low concentration in the blood is associated with increased cardiovascular risk. Given the importance of HDL concentration, this study aimed to analyze the factors associated with low HDL cholesterol in Brazilian adults. Methods A cross-sectional study that used the database of laboratory tests from 8,520 individuals collected by the National Health Survey between 2014 and 2015. The prevalences of HDL-Cholesterol < 40 and ≥ 40 mg/dL were estimated, with the outcome variable being low HDL-Cholesterol (≤ 40 mg/dL) and the explanatory variables including sociodemographic factors (sex, age group, education level, race/skin color, regions of Brazil), anthropometric factors (BMI), lifestyle (abusive alcohol consumption, smoking, physical activity), chronic diseases (diabetes, kidney failure, hypertension, anemia), and self-reported health. To verify the associations, Poisson regression with robust variance was used, estimating crude and adjusted (PRa) prevalence ratios and 95% confidence intervals (95% CI). Results The prevalence of low HDL cholesterol was 34.81%. In the final multivariate model, the following factors were associated with the outcome: male sex (PRa = 2.00; 95% CI 1.84–2.16), intermediate education level—complete elementary or incomplete high school (PRa = 1.23; 95% CI 1.10–1.37), overweight (PRa = 1.46; 95% CI 1.33–1.61), obesity (PRa = 1.72; 95% CI 1.54–1.91), diabetes (PRa = 1.18; 95% CI 1.06–1.32), chronic kidney disease (PRa = 1.22; 95% CI 1.06–1.41), and hypertension (PRa = 1.18; 95% CI 1.08–1.29). Conclusion Low HDL cholesterol was associated with male sex, intermediate education level, overweight and obesity, diabetes, chronic kidney disease, and hypertension. Cholesterol HDL Dyslipidemias Health Surveys Laboratory Test Brazil BACKGROUND Dyslipidemia can be defined as abnormal concentrations of circulating lipids in the bloodstream, such as total cholesterol, triglycerides (TGs), low-density lipoproteins (LDLs), or high-density lipoproteins (HDLs) ( 1 ). A reduction in HDL concentrations and an increase in LDL and TG levels are identified as independent risk factors for the development of atherosclerotic diseases ( 2 ). Furthermore, elevated serum cholesterol levels are associated with an increased risk of heart disease and cerebrovascular accidents ( 3 ). In Brazil, cardiovascular diseases have significant epidemiological relevance, as they are responsible for approximately one-third of all deaths in the country and generate high healthcare-related costs ( 2 ). In this context, controlling dyslipidemia is essential for improving this situation, as it is associated with reduced mortality and cardiovascular events ( 3 ). Among lipoproteins, HDL is an Apo A lipoprotein complex with an anti-atherogenic role, possesses antiproliferative, antithrombotic, and anti-inflammatory properties ( 4 , 5 ) and provides protection against the oxidation of LDL cholesterol in the arterial wall, a key event in atherogenesis ( 5 ). In addition, it is responsible for mediating reverse cholesterol transport (RCT), which involves removing cholesterol from peripheral tissues and transporting it to the liver, where it is eliminated through bile or feces ( 5 ). The literature reports that the HDL cholesterol concentration is inversely related to the incidence of coronary atherosclerotic disease ( 4 ), and a decrease in HDL cholesterol, combined with high levels of triglycerides (TGs), may increase the risk of coronary artery disease ( 4 ). Thus, blood HDL cholesterol levels have been used as a laboratory indicator of cardiovascular risk, and higher concentrations in the blood are associated with greater atheroprotection due to actions such as more efficient RCTs ( 5 ). Serum HDL levels greater than 40 mg/dL are considered the recommended levels ( 6 ). Laboratory data from the 2014–2015 National Health Survey ( in Portuguese Pesquisa Nacional de Saúde - PNS ) showed that approximately 32% of the adult population in Brazil had elevated total cholesterol (≥ 200 mg/dL) and 18.4% had HDL-C levels below the recommended threshold (< 40 mg/dL). This highlights the relevance of HDL-C as a cardiovascular risk marker ( 3 ). From this perspective, a low HDL cholesterol concentration in the blood is associated with increased cardiovascular risk ( 7 ), as patients with low HDL cholesterol levels have a risk of coronary artery disease comparable to that of patients with high LDL cholesterol levels ( 8 ). This may be explained by the potential loss of cardioprotection provided by HDL through reverse cholesterol transport (RCT), the inhibition of LDL oxidation in the arteries, and cholesterol efflux from macrophages, which reduces the formation of foam cells ( 8 ). This could be due to the loss of the anti-atherogenic benefits of this lipoprotein. Globally, according to data from the Global Burden of Disease (GBD) , dyslipidemia is a critical risk factor for cardiovascular disease (CVD), significantly contributing to morbidity and mortality ( 9 ). In 2019, approximately 4.4 million deaths were attributed to elevated cholesterol, accounting for approximately 7.8% of total deaths worldwide ( 10 ). Dyslipidemia is a global health challenge, especially in countries undergoing economic transition, due to the combination of dietary factors and inadequate clinical management of the disease ( 9 ). Given the continuous growth of obesity, diabetes mellitus, and metabolic syndrome, the prevalence of low HDL will continue to rise, which justifies the need for studies addressing evaluations of this lipoprotein. There is also evidence that low HDL is present in approximately 63% of patients with coronary artery disease (CAD) ( 11 ). In addition, the risk of CAD increases sharply as HDL levels progressively decrease below 40 mg/dL ( 12 , 13 , 14 , 15 , 16 ). According to the literature, some factors are associated with low HDL cholesterol, such as a greater likelihood of being male, being over 60 years of age, having an increased BMI, and having increased waist circumference. On the other hand, not consuming alcohol is associated with a lower chance of having low HDL ( 4 ). The inverse relationship between CAD and low HDL cholesterol has consistently been shown to be an independent predictor of cardiovascular risk ( 8 ). Thus, considering the importance of evaluating the factors associated with low HDL cholesterol in Brazilian adults due to the significance of this marker for increased cardiovascular risk, this study advances by investigating the factors associated with low HDL cholesterol through laboratory tests. Therefore, the objective of this study was to analyze the factors associated with low HDL cholesterol in the Brazilian adult population. METHODS Study design This was a cross-sectional study that used the laboratory test database from the PNS between the years 2014 and 2015. Context The PNS is a national, household-based survey coordinated by the Brazilian Institute of Geography and Statistics (IBGE) in partnership with the Ministry of Health (MS). The 2013 PNS used a probabilistic sample in three stages, collecting interview records from 64,348 households and interviewing 60,202 adults (17,18). For the selected adult residents, measurements of weight, height, waist circumference, and blood pressure were taken, and laboratory tests were planned with the collection of biological material from a subsample of 25% of the census sectors. The achieved sample size was 8,952 adults (17,18). Owing to losses and aiming to reduce representation bias, the study adopted poststratification weights on the basis of sex, age, education, and region. Peripheral blood collection was carried out at any time of day (3), and the study followed a protocol that does not require fasting for cholesterol measurement (6). The HDL-cholesterol samples were collected in tubes with gel. The samples were left to stand for 30 minutes for clot retraction, followed by centrifugation and transportation of the samples under refrigeration at 2 to 8°C, with temperature control throughout the process. This parameter was measured via an automated enzymatic/colorimetric method (3). Further methodological details of the PNS are available in other publications (17,18). Data Source The microdata used are freely accessible and available on the PNS website: https://www.pns.icict.fiocruz.br/bases-de-dados/. Participants The 2013 PNS included 8,952 adults aged 18 years or older. A total of 432 samples were excluded due to insufficient material, hemolysis, and sample loss, with blood samples from 8,520 adults included in this analysis. Variables Outcome variables: The outcome variable was whether or not the individual had low HDL-Cholesterol, defined by the cutoff point of HDL-Cholesterol ≤ 40 mg/dL (6), values above 40 mg/dL were considered ideal, while values less than or equal to 40 mg/dL were classified as low. Explanatory variables: The explanatory variables were as follows: 1. Sociodemographic characteristics: Sex (male and female); Age group in years (18 to 29; 30 to 44; 45 to 59; and 60 or older); Education level (illiterate and incomplete elementary school, complete elementary and incomplete high school, complete high school or higher); Race/skin color (white and others, which included yellow and Indigenous; Black and Brown); Regions of Brazil (North, Northeast, Southeast, South, and Central-West). 2. Anthropometric: body Mass Index (BMI), categorized as: normal/underweight (<25 kg/m²), overweight (between 25 and 29 kg/m²), and obesity (≥30 kg/m²). BMI was calculated based on measured weight and height. 3. Abusive alcohol consumption: yes or no. Self-reported measure. Consumption was considered abusive when five or more drinks were consumed on a single occasion (19); Smoking was considered yes or no. Individuals who reported using tobacco products were considered smokers. Sufficient leisure-time physical activity: poor/insufficient or sufficient. Individuals were considered to have sufficient leisure-time physical activity if they reported engaging in at least 150 minutes per week of light or moderate intensity physical activity or at least 75 minutes per week of vigorous intensity activity, regardless of the number of days practiced per week (20). 4. Noncommunicable chronic diseases (NCDs): diabetes: yes or no. A glycated hemoglobin (HbA1c) value of ≥6.5% was used as the criterion (21) Measured through blood testing in the PNS and self-reported diagnosis of the disease. Chronic kidney disease: yes or no. A glomerular filtration rate (GFR) less than 60 mL/min/1.73 m², calculated via the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equation, was used as the criterion. Race-based correction was not applied, as recommended by most methods (22);Arterial hypertension: yes or no. Blood pressure measurements were used, with hypertension defined as systolic pressure ≥140 mmHg and diastolic pressure ≥90 mmHg (23). In addition, the self-reported diagnosis of the disease. Anemia: yes or no. This indicator was calculated from the laboratory tests of the PNS. Anemia was considered in women with hemoglobin levels below 12 mg/dL and in men with hemoglobin levels below 13 mg/dL(24,25). 5. Self-rated health: very good/good; fair; very poor/poor. Self-reported measures. The questions from the PNS questionnaire used to construct indicators that relied on self-reported measures are available in Supplementary Material 1. Statistical analyses In the descriptive analyses, the prevalences of HDL-Cholesterol ≤ 40 mg/dL (low) and < 40 mg/dL (ideal) were estimated and presented as proportions (%) with 95% confidence intervals (CI95%). Differences between the strata were estimated using Pearson's χ² test, with a significance level of 5%. To assess the associations between the explanatory variables and the outcome, the prevalence ratio (PR) was used as a measure of association and was calculated via a Poisson regression model with robust variance. The theoretical models of Bergmann et al. (26) and Sá et al. (1) and the study of Ge et al. (4) Bivariate analyses were performed, and crude prevalence ratios (PRc) and 95% confidence intervals (CI95%) were estimated. Multivariate analysis was conducted, including variables with a p value <0.20 in the bivariate analyses. Adjusted prevalence ratios (PRa) and CI95% were estimated. The backward and forward methods were used for variable selection. In the final model, variables with a p value ≤0.05 were considered associated factors. Confounding variables were tested based on the literature. The analyses were performed via Data Analysis and Statistical software (Stata), version 14, which uses the survey module for complex samples and incorporates poststratification weights. Ethical aspects The PNS was approved by the National Research Ethics Committee of the National Health Council, under Opinion No. 328,159. Adult participation was voluntary, and the confidentiality of the information was guaranteed (17). RESULTS The analyses of this study were conducted via blood samples from 8,520 adults aged 18 years or older. The prevalence of low HDL cholesterol was 34.81% (CI95% 33.46--36.18), which was higher among males (46.11%; CI95% 43.90--48.33), those with incomplete elementary school or incomplete high school (42.18%; CI95% 38.53--45.92), those with black skin color (36.97%; CI95% 35.08--38.89), smokers (39.82%; CI95% 36.09--43.67), those with obesity (42.99%; CI95% 39.99--46.04), those with diabetes (45.03%; CI95% 40.85--49.28), those with chronic kidney disease (41.74%; CI95% 36.71--46.95), those with hypertension (40.66%; CI95% 37.96--43.41), and those who self-rated their health as very poor or poor (38.76%; CI95% 34.17--43.56). Adults living in the southern (28.75%; CI95% 25.90--31.78) and southeastern (33.53%; CI95% 30.98--36.18) regions had the lowest prevalence rates of low HDL cholesterol (Table 1). Table 1 According to the bivariate analyses, a relatively high crude prevalence ratio of low HDL cholesterol was associated with being male (PRc = 1.86;CI 95% 1.72--2.01), being black (PRc = 1.10; CI95% 1.01--1.19), smoking (PRc = 1.17; CI95% 1.06--1.30), having completed elementary school or incomplete high school (PRc = 1.17; CI95% 1.05--1.29), being overweight (PRc = 1.47; CI95% 1.34--1.61), being obese (PRc = 1.60; CI95% 1.44--1.77), having diabetes (PRc = 1.33; CI95% 1.20--1.48), having chronic kidney disease (PRc = 1.21; CI95% 1.07--1.38), having arterial hypertension (PRc = 1.24; CI95% 1.15--1.40), self-rating health as fair (PRc = 1.12; CI95% 1.03--1.22) or being poor/very poor (PRc = 1.16; CI95% 1.02-1.33). Lower crude prevalence ratios of low HDL cholesterol were associated with having completed high school or higher education (PRc = 0.86; CI95% 0.79--0.94) and residing in Southeast (PRc = 0.84; CI95% 0.76--0.93) and South (PRc = 0.72; CI95% 0.64--0.81) regions (Table 2). Table 2 In the final multivariable model, male sex (PRa = 2.00; 95%CI: 1.84–2.16), having intermediate education, such as primary or incomplete secondary school (PRa = 1.23; 95%CI: 1.10–1.37), overweight (PRa = 1.46; 95%CI: 1.33–1.61), obesity (PRa = 1.72; 95%CI: 1.54–1.91), diabetes (PRa = 1.18; 95%CI: 1.06–1.32), chronic kidney disease (PRa = 1.22; 95%CI: 1.06–1.41), and hypertension (PRa = 1.18; 95%CI: 1.08–1.29), were associated with a higher prevalence of low HDL-C. Being over 60 years old (PRa = 0.84; 95%CI: 0.72–0.97), being black/skin color (PRa = 0.85; 95%CI: 0.72–0.99), having higher education, such as those who have completed secondary school or above (PRa = 0.91; 95%CI: 0.83–1.00), residing in Southeast (PRa = 0.79; 95%CI: 0.72–0.88), South (PRa = 0.65; 95%CI: 0.57–0.73), or Central-West regions (PRa = 0.87; 95%CI: 0.79–0.97), and engaging in heavy alcohol consumption (PRa = 0.72; 95%CI: 0.63–0.82) were protective factors against low HDL-cholesterol (Table 3). Table 3 DISCUSSION Low HDL-C (< 40 mg/dL) is highly prevalent in Brazil, affecting 1 in every 3 Brazilian adults. The factors positively associated with low HDL-C among Brazilian adults were being male, being a smoker, having lower educational attainment (completed primary or incomplete secondary education), being overweight, being obese, having diabetes, having chronic kidney disease, and having hypertension. On the other hand, protective factors against low HDL-C included living in Northeast, Southeast, Central-West, and South regions; being over 60 years old; being black; having higher educational attainment (completing secondary education or higher); and engaging in heavy alcohol consumption. In this study, the prevalence of low HDL-C was similar to that reported in a study conducted in South Korea, where women had lower rates of low HDL-C than men did ( 27 ). In the aforementioned study, 39% of Korean men had HDL-C levels between 30–40 mg/dL, whereas 38.3% of women had HDL-C levels between 40–50 mg/dL ( 27 ). Another study conducted in China reported similar findings, with a higher prevalence of low HDL-C among men (67.6%) than among women (55.4%) ( 4 ). The higher prevalence of low HDL-C among men than among women is supported in the literature by significant differences in lipid metabolism between the two sexes. Some of these differences may be influenced by sexual dimorphism in metabolism, and having a male or female genotype may also determine intermediate metabolism. Thus, women's advantage over men in terms of the lipid profile may be directly related to the female genotypic advantage, which favors the kinetics of lipid molecules, resulting in a more balanced lipid profile in women than in men ( 28 ). Another possible explanation is the lower access to and use of health services by men, as previously identified in a study using self-reported data from the 2019 National Health Survey (PNS) ( 29 ). In this study, differences in the prevalence of low HDL-C were observed according to educational level, with individuals with lower education (completed primary/incomplete secondary) presenting a risk factor for low HDL-C, whereas a protective effect was observed for Brazilian adults with higher education (completed secondary or higher). Other evidence from the 2019 National Health Survey (PNS) also revealed that more educated Brazilian adults had a lower prevalence of high cholesterol than did those with lower education levels ( 2 ). This finding is possibly because people with higher education levels may have greater access to health services, which is related to better disease understanding and risk awareness ( 2 , 30 , 31 ). A Danish study showed that people with higher education levels may have earlier access to statin treatment in primary healthcare ( 32 ). In this context, education level may influence the pursuit of healthcare due to a better understanding of the importance of prevention and control of cardiovascular risk factors, which can contribute to better management of cholesterol and its fractions. Black and brown skin color had a protective effect on the adjusted analyses. This finding is consistent with results from the ELSA-Brasil study and other studies conducted in the United States, which indicated a lower prevalence of dyslipidemia among individuals of black race/skin color. Notably, a possible reason for this finding is that dietary patterns and other environmental factors vary widely by ethnicity; however, further research is needed to explore this topic more thoroughly in Brazil ( 33 ), with an approach to race/skin color and ethnicity. Body mass index (BMI) is a risk factor for low HDL-C levels. The association between high BMI and dyslipidemia has been well established and supported by several studies. According to the literature, the main dyslipidemia associated with obesity is characterized by mild to moderate elevations in triglycerides and decreased HDL-c ( 34 ), and the regional distribution of body fat, particularly excessive abdominal fat deposition, has been associated with low HDL concentrations ( 35 ). Notably, individuals residing in the South and Southeast regions had lower prevalences of low HDL cholesterol. Despite the protective effects observed in other regions, higher prevalences are noted in the Northeast Region, which highlights the need to improve access to healthy food, lifestyles, and healthcare services across regions. Although data from the National Health Survey (PNS) show improvements and progress in healthcare access and use, regional disparities still persist in the country. Primary, secondary, and tertiary care are more available in the South and Southeast regions, while gaps in healthcare services remain in the Northeast ( 31 ). These findings likely reflect greater access to diagnosis and treatment in the South and Southeast regions, with studies indicating higher proportions of medical consultations in these areas, which have better living conditions and higher human development index (HDI) scores than other regions do ( 31 ). Smoking was inversely correlated with blood HDL-C levels, indicating that smoking is a risk factor. This finding is consistent with previous studies ( 36 ) and the Brazilian Guidelines on Dyslipidemias and Atherosclerosis Prevention ( 6 ). The habit of smoking results in endothelial dysfunction, promoting the development of atherosclerosis, which is associated with increased total cholesterol levels and decreased HDL-c ( 37 , 38 ). With respect to alcohol consumption, similar to a study conducted in China ( 4 ), we identified a significant inverse association between low HDL-cholesterol concentrations and alcohol consumption, which is supported by studies that reported that alcohol intake can increase HDL cholesterol levels and that frequent alcohol use is associated with higher HDL cholesterol levels ( 39 , 40 , 41 ). Another possible hypothesis is that the negative associations between heavy alcohol use and low HDL-C may be related to lifestyle changes and treatment and could represent a potential reverse causality. The noncommunicable chronic diseases (NCDs) analyzed in this study (diabetes, hypertension, and chronic kidney disease) were identified as risk factors for low HDL levels and are frequently associated with dyslipidemia ( 42 ). In diabetes mellitus, there is a common pattern of lipid abnormalities known as diabetic dyslipidemia, which includes hypertriglyceridemia, low HDL, and small dense LDL ( 43 ). Insulin resistance is the major risk factor for the development of diabetic dyslipidemia, as it reduces lipogenic activity in adipose cells, resulting in a decreased capacity of these cells to store fatty acids. This leads to an increase in free fatty acids in the circulation, contributing to the development of dyslipidemias such as low HDL-c ( 43 ). The presence of reduced HDL-c in diabetic patients indicates a high-risk population for cardiovascular events ( 44 ). In the present study, chronic kidney disease (CKD) was correlated with decreased HDL levels, as has also been reported in other studies ( 45 , 46 , 47 ). CKD causes alterations in lipoprotein metabolism, leading to changes in blood lipid levels. As kidney function worsens, HDL levels decrease, whereas LDL and triglyceride levels tend to increase ( 2 ). As stated in the Brazilian Guideline on Dyslipidemias and Atherosclerosis Prevention ( 6 ) and other studies ( 48 , 49 ), esta investigação identificou associação positiva entre a hipertensão e o diagnóstico de baixo HDL-c. Some studies ( 50 , 51 ) have shown that endothelial dysfunction resulting from high blood pressure negatively affects HDL metabolism, impairing reverse cholesterol transport and promoting greater development of atherosclerosis ( 48 ). Among the limitations of this study, it is important to highlight the inability to establish a causal relationship, since the outcome and its causes were analyzed at a single point in time, and the associations may result from changes in lifestyle and treatment. Furthermore, there is the possibility of reverse causality between the studied noncommunicable chronic diseases (NCDs) and low HDL-C, warranting cautious interpretation of the results. However, owing to the representative sample of the Brazilian adult population, the generalization of the results is relatively reliable for national estimates and closely reflects the reality of the country. CONCLUSION Low HDL cholesterol affects 1 in 3 Brazilian adults and is associated with sociodemographic factors (male sex, education, and region of the country), unhealthy lifestyles (smoking), the presence of overweight and obesity, and noncommunicable diseases (NCDs), such as diabetes, chronic kidney disease, and hypertension. These results reinforce the importance of controlling and preventing dyslipidemia and may provide support for public health policies, programmes, and goals aimed at reducing dyslipidemia due to low HDL cholesterol levels, especially among the most vulnerable Brazilian adults. Declarations Ethics approval and consent to participate The PNS was approved by the National Research Ethics Committee of the National Health Council, under opinion No. 328,159. Consent for publication Not applicable. Availability of data and materials The datasets generated and/or analyzed during the current study are available on the PNS website,https://biblioteca.ibge.gov.br/index.php/biblioteca-catalogo?view=detalhes&id=291110 (17). Competing interests The authors declare that they have no competing interests. Funding Not applicable. Authors' contributions Sá ACMGN participated in the study design, planning, statistical analyses, data interpretation, and manuscript writing; developed the first version of the manuscript; and approved the version to be published. Silva TMR, Prates EJS, Silva RMM, Damaceno GS, Peixoto MRC and Malta DC participated in writing the manuscript. Acknowledgments We would like to thank the Office of the Dean of Research at the Federal University of Minas Gerais (PRPq/UFMG) for their support; the National Council for Scientific and Technological Development (CNPq) for the scientific initiation scholarship received by GSD; and CNPq for the Research Productivity grant awarded to DCM. Authors' information (optional) 1Department of Maternal and Child Nursing and Public Health, School of Nursing, Federal University of Minas Gerais (UFMG), Belo Horizonte, Brazil 2Postgraduate Program in Nursing, School of Nursing, Federal University of Minas Gerais, Belo Horizonte, Brazil 3School of Nursing, Federal University of Minas Gerais, Belo Horizonte, Brazil References Sá ACMGN, Machado ÍE, Bernal RTI, Malta DC. Factors associated with high LDL-Cholesterol in the Brazilian adult population: National Health Survey. Cien Saude Colet. 2021 Feb;26(2):541-553. doi: 10.1590/1413-81232021262.37102020. 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Diabetes Care. 2018 Jan;41(Suppl 1):S13-S27. doi: 10.2337/dc18-S002. Stevens PE, Levin A; Kidney Disease: Improving Global Outcomes Chronic Kidney Disease Guideline Development Work Group Members. Evaluation and management of chronic kidney disease: synopsis of the kidney disease: improving global outcomes 2012 clinical practice guideline. Ann Intern Med. 2013 Jun 4;158(11):825-30. doi: 10.7326/0003-4819-158-11-201306040-00007. Barroso WKS, Rodrigues CIS, Bortolotto LA, Mota-Gomes MA, Brandão AA, Feitosa ADM, et al. Brazilian Guidelines of Hypertension - 2020. Arq Bras Cardiol. 2021 Mar;116(3):516-658. doi: 10.36660/abc.20201238. World Health Organization. Hemoglobin concentrations for the diagnosis of anemia and assessment of severity. Vitamin and Mineral Nutrition Information System. Genebra: World Health Organization; 2011. https://www.who.int/vmnis/indicators/haemoglobin.pdf. Accessed 19 Jun 2025. Machado ÍE, Malta DC, Bacal NS, Rosenfeld LGM. Prevalence of anemia in Brazilian adults and elderly. Rev Bras Epidemiol. 2019 Oct 7;22Suppl 02(Suppl 02):E190008.SUPL.2. doi: 10.1590/1980-549720190008.supl.2. Bergmann ML, Bergmann GG, Halpern R, Rech RR, Constanzi CB, Alli LR. Associated factors to total cholesterol: school based study in southern Brazil. Arq Bras Cardiol. 2011 Jul;97(1):17-25. doi: 10.1590/s0066-782x2011005000065. Epub 2011 May 27. Kim HJ, Park HA, Cho YG, Kang JH, Kim KW, Kang JH, et al. Gender Difference in the Level of HDL Cholesterol in Korean Adults. Korean J Fam Med. 2011 Mar;32(3):173-81. doi: 10.4082/kjfm.2011.32.3.173. Mittendorfer B. Sexual dimorphism in human lipid metabolism. J Nutr. 2005 Apr;135(4):681-6. doi: 10.1093/jn/135.4.681. Palmeira NC, Moro JP, Getulino F de A, Vieira YP, Soares Junior A de O, Saes M de O. Analysis of access to health services in Brazil according to sociodemographic profile: National Health Survey, 2019. Epidemiologia e Serviços de Saúde. 2022 Dec 19;31:e2022966. doi: 10.1590/S2237-96222022000300013 Psaltopoulou T, Hatzis G, Papageorgiou N, Androulakis E, Briasoulis A, Tousoulis D. Socioeconomic status and risk factors for cardiovascular disease: Impact of dietary mediators. Hellenic J Cardiol. 2017 Jan-Feb;58(1):32-42. doi: 10.1016/j.hjc.2017.01.022. Stopa SR, Malta DC, Monteiro CN, Szwarcwald CL, Goldbaum M, Cesar CLG. Use of and access to health services in Brazil, 2013 National Health Survey. Revista de Saúde Pública. 2017;51(suppl 1). doi: 10.1590/S1518-8787.2017051000074 Flege MM, Kriegbaum M, Jørgensen HL, Lind BS, Bathum L, Andersen CL, et al. Associations between education level, blood-lipid measurements and statin treatment in a Danish primary health care population from 2000 to 2018. Scand J Prim Health Care. 2023 Jun;41(2):170-178. doi: 10.1080/02813432.2023.2198584. Santos RD, Bensenor IM, Pereira AC, Lotufo PA. 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Atherosclerosis. 1978 May;30(1):17-25. doi: 10.1016/0021-9150(78)90149-1. Auerbach O, Hammond EC, Garfinkel L. Smoking in relation to atherosclerosis of the coronary arteries. N Engl J Med. 1965 Oct 7;273(15):775-9. doi: 10.1056/NEJM196510072731501. Sackett DL, Gibson RW, Bross ID, Pickren JW. Relation between aortic atherosclerosis and the use of cigarettes and alcohol. An autopsy study. N Engl J Med. 1968 Dec 26;279(26):1413-20. doi: 10.1056/NEJM196812262792602. Yoon YS, Oh SW, Baik HW, Park HS, Kim WY. Alcohol consumption and the metabolic syndrome in Korean adults: the 1998 Korean National Health and Nutrition Examination Survey. Am J Clin Nutr. 2004 Jul;80(1):217-24. doi: 10.1093/ajcn/80.1.217 Choi SJ, Park SH, Park HY. Increased Prevalence of low High-density Lipoprotein Cholesterol (HDL-C) Levels in Korean Adults: Analysis of the Three Korean National Health and Nutrition Examination Surveys (KNHANES 1998-2005). Osong Public Health Res Perspect. 2011 Sep;2(2):94-103. doi: 10.1016/j.phrp.2011.07.006. Peasey A, Bobak M, Malyutina S, Pajak A, Kubinova R, Pikhart H, Kurilovitch S, Poledne R, Marmot M. Do lipids contribute to the lack of cardio-protective effect of binge drinking: alcohol consumption and lipids in three eastern European countries. Alcohol Alcohol. 2005 Sep-Oct;40(5):431-5. doi: 10.1093/alcalc/agh161. Shibashi T, Kaneko H, Matsuoka S, et al. HDL cholesterol and clinical outcomes in diabetes mellitus. Eur J Prev Cardiol. 2023;30(8):646-653. doi:10.1093/eurjpc/zwad029 Wu L, Parhofer KG. Diabetic dyslipidemia. Metabolism. 2014 Dec;63(12):1469-79. doi: 10.1016/j.metabol.2014.08.010. Epub 2014 Aug 29. Pirillo A, Casula M, Olmastroni E, Norata GD, Catapano AL. Global epidemiology of dyslipidemias. Nat Rev Cardiol. 2021 Oct;18(10):689-700. doi: 10.1038/s41569-021-00541-4. Bowe B, Xie Y, Xian H, Balasubramanian S, Al-Aly Z. Low levels of high-density lipoprotein cholesterol increase the risk of incident kidney disease and its progression. Kidney Int. 2016 Apr;89(4):886-96. doi: 10.1016/j.kint.2015.12.034. Cases A, Coll E. Dyslipidemia and the progression of renal disease in chronic renal failure patients. Kidney Int Suppl. 2005 Dec;(99):S87-93. doi: 10.1111/j.1523-1755.2005.09916.x. Melsom T, Norvik JV, Enoksen IT, Stefansson V, Rismo R, Jenssen T, Solbu MD, Eriksen BO. Association of High-Density Lipoprotein Cholesterol With GFR Decline in a General Nondiabetic Population. Kidney Int Rep. 2021 May 19;6(8):2084-2094. doi: 10.1016/j.ekir.2021.05.007 Fonseca FAH, Kuymijian W, Izar MCO, Ihara SSM. Hipertensão e dislipidemias. Rev Bras Hipertens. 2002; 9: 268-272 Halperin RO, Sesso HD, Ma J, Buring JE, Stampfer MJ, Gaziano JM. Dyslipidemia and the risk of incident hypertension in men. Hypertension. 2006 Jan;47(1):45-50. doi: 10.1161/01.HYP.0000196306.42418.0e Dąbrowska E, Narkiewicz K. Hypertension and Dyslipidemia: the Two Partners in Endothelium-Related Crime. Curr Atheroscler Rep. 2023 Sep;25(9):605-612. doi: 10.1007/s11883-023-01132-z. Casino PR, Kilcoyne CM, Quyyumi AA, Hoeg JM, Panza JA. The role of nitric oxide in endothelium-dependent vasodilation of hypercholesterolemic patients. Circulation. 1993 Dec;88(6):2541-7. doi: 10.1161/01.cir.88.6.2541 Tables Table 1 - Prevalence of HDL-C in Brazilian adults by sociodemographic and health factors: PNS 2014-2015 HDL cholesterol > 40 (ideal) ≤ 40 (low) Variáveis n* % IC 95% % IC 95% p* Total 8520 65.19 63.82-66.54 34.81 33.46-36.18 Sexo 8520 Male 53.89 51.67-56.10 46.11 43.90-48.33 0.0000 Female 75.24 73.67-76.74 24.76 23.26-26.33 Age group 8520 18 a 29 66.72 63.11-70.14 33.28 29.86-36.89 0.1491 30 a 44 66.60 64.13-68.97 33.40 31.03-35.87 45 a 59 62.84 60.27-65.34 37.16 34.66-39.73 60 years or more 64.61 62.00-67.14 35.39 32.86-38.00 Education 8520 Illiterate/Incomplete Elementary 63.79 61.80-65.74 36.21 34.26-38.20 0.0000 Complete Elementary/Incomplete High School 57.82 54.08-61.47 42.18 38.53-45.92 Complete High School and higher 68.88 66.76-70.93 31.12 29.07-33.24 Race/skin color 8520 White and others 66.39 64.29-68.43 33.61 31.57-35.71 0.0255 Brown 68.52 63.75-72.92 31.48 27.08-36.25 Black 63.03 61.11-64.92 36.97 35.08-38.89 Region 8520 North 60.12 57.86-62.34 39.88 37.66-42.14 0.0000 Northeast 61.63 59.77-63.46 38.37 36.54-40.23 Southeast 66.47 63.82-69.02 33.53 30.98-36.18 South 71.25 68.22-74.10 28.75 25.90-31.78 Central-West 62.69 59.31-65.95 37.31 34.05-40.69 Body Mass Index 8427 Underweight/Normal 73.06 71.02-75.01 26.94 24.99-28.98 0.0000 Overweight 60.39 58.09-62.64 39.61 37.36-41.91 Obesity 57.01 53.96-60.01 42.99 39.99-46.04 Abusive alcohol consumption 8520 No 64.64 63.17-66.09 35.36 33.91-36.83 0.585 Yes 68.54 64.76-72.1 31.46 27.90-35.24 Smoking 8513 No 66.02 64.55-67.46 33.98 32.54-35.45 0.0040 Yes 60.18 56.33-63.91 39.82 36.09-43.67 Physical activity 8510 Poor/Insufficient 64.77 63.24-66.27 35.23 33.73-36.76 0.3054 Sufficient 66.57 63.44-69.55 33.43 30.45-36.56 Diabetes 8292 No 66.18 64.71-67.61 33.82 32.39-35.29 0.0000 Yes 54.97 50.72.59.15 45.03 40.85-49.28 Chronic kidney disease 8520 No 65.60 64.18-66.99 34.40 33.01-35.82 0.0053 Yes 58.26 53.05-63.29 41.74 36.71-46.95 Arterial hypertension 8146 No 67.33 65.71-68.91 32.67 31.09-34.29 0.0000 Yes 59.34 56.59-62.04 40.66 37.96-43.41 Anemia 7904 No 64.93 63.43-66.41 35.07 33.59-36.57 0.2809 Yes 67.40 63.10-71.43 32.60 28.57-36.90 Self-rated health 8513 Very good/Good 66.64 64.88-68.36 33.36 31.64-35.12 0.0055 Fair 62.63 60.20-65.00 37.37 35.00-39.80 Very poor/Poor 61.24 56.44-65.83 38.76 34.17-43.56 *The total sample size is 8.952 participants; however. missing data are not shown. %: Prevalence. 95% CI: 95% confidence interval. HDL-Cholesterol: ideal (> 40 mg/dL) and low (≤ 40 mg/dL). Pearson’s χ² test. Table 2 – Crude prevalence ratios for low HDL cholesterol in Brazilian adults by health and sociodemographic factors: PNS from 2014-2015 Variable RPb IC95% p* Sex Female 1 Male 1.86 1.72-2.01 0.000 Age group 18 a 29 1 30 a 44 1.00 0.88-1.14 0.956 45 a 59 1.12 0.99-1.27 0.086 60 years or more 1.06 0.94-1.21 0.348 Education level Illiterate / Incomplete elementary education 1 Completed elementary / Incomplete high school 1.17 1.05-1.29 0.004 Completed high school or higher 0.86 0.79-0.94 0.001 Race/skin color White and others 1 Brown 0.94 0.80- 1.10 0.419 Black 1.10 1.01-1.19 0.02 Region North 1 Northeast 0.96 0.89- 1.04 0.306 Southeast 0.84 0.76-0.93 0.000 South 0.72 0.64-0.81 0.000 Central-West 0.94 0.84-1.04 0.215 Body Mass Index Underweight/Normal 1 Overweight 1.47 1.34-1.61 0.000 Obesity 1.60 1.44-1.77 0.000 Abusive alcohol consumption No 1 Yes 0.89 0.79-1.01 0.064 Smoking No 1 Yes 1.17 1.06-1.30 0.003 Physical activity Poor/Insufficient 1 Sufficient 0.95 0.86-1.05 0.310 Diabetes No 1 Yes 1.33 1.20-1.48 0.000 Chronic kidney disease No 1 Yes 1.21 1.07-1.38 0.003 Arterial hypertension No 1 Yes 1.24 1.15-1.40 0.000 Anemia No 1 Yes 0.93 0.81-1.06 0.288 Self-rated health Very good/Good 1 Fair 1.12 1.03-1.22 0.007 Very poor/Poor 1.16 1.02-1.33 0.026 PRb: Crude Prevalence Ratio; 95%CI: 95% Confidence Interval. HDL-Cholesterol: low (≤ 40 mg/dL). Table 3 – Adjusted prevalence ratios for low HDL in Brazilian adults: final Poisson model. PNS 2014–2015 Variable RPa IC95% p Sex Female 1 Male 2.00 1.84-2.16 0.000 Age group 18 a 29 1 30 a 44 0.95 0.84-1.09 0.470 45 a 59 0.94 0.82-1.08 0.372 60 years or more 0.84 0.72-0.97 0.020 Education level Illiterate / Incomplete elementary education 1 Completed elementary / Incomplete high school 1.23 1.10-1.37 0.000 Completed high school or higher 0.91 0.83-1.00 0.041 Race/skin color White and others 1 Brown 0.99 0.91-1.08 0.815 Black 0.85 0.72-0.99 0.035 Region North 1 Northeast 0.94 0.87-1.01 0.114 Southeast 0.79 0.72-0.88 0.000 South 0.65 0.57-0.73 0.000 Central-West 0.87 0.79-0.97 0.013 Body Mass Index Underweight/Normal 1 Overweight 1.46 1.33-1.61 0.000 Obesity 1.72 1.54-1.91 0.000 Abusive alcohol consumption No 1 Yes 0.72 0.63-0.82 0.000 Smoking No 1 Yes 1.19 1.08-1.32 0.002 Physical activity Poor/Insufficient 1 Sufficient 1.18 1.06-1.32 0.003 Diabetes No 1 Yes 1.22 1.06-1.41 0.004 Chronic kidney disease No 1 Yes 1.18 1.08-1.29 0.000 PRa: Prevalence ratio adjusted for all explanatory variables with a p value < 0.20 in the bivariate analysis. 95%CI: 95% confidence interval. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-7293046","acceptedTermsAndConditions":true,"allowDirectSubmit":false,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":512601387,"identity":"a8845dfc-a41f-4ea3-933b-cb055276859b","order_by":0,"name":"Ana Carolina Micheletti Gomide Nogueira de Sá","email":"data:image/png;base64,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","orcid":"","institution":"Federal University of Minas Gerais (UFMG)","correspondingAuthor":true,"prefix":"","firstName":"Ana","middleName":"Carolina Micheletti Gomide Nogueira","lastName":"de Sá","suffix":""},{"id":512601389,"identity":"b3e33038-baaa-49d1-8987-b4c06c2e331f","order_by":1,"name":"Tércia Moreira Ribeiro Silva","email":"","orcid":"","institution":"Federal University of Minas Gerais (UFMG)","correspondingAuthor":false,"prefix":"","firstName":"Tércia","middleName":"Moreira Ribeiro","lastName":"Silva","suffix":""},{"id":512601390,"identity":"b83157ed-5b34-4fc0-b040-f9d698f1bb9b","order_by":2,"name":"Elton Junio Sady Prates","email":"","orcid":"","institution":"Federal University of Minas Gerais (UFMG)","correspondingAuthor":false,"prefix":"","firstName":"Elton","middleName":"Junio Sady","lastName":"Prates","suffix":""},{"id":512601391,"identity":"487ff16a-5918-4dbb-a7a2-3104b43194f1","order_by":3,"name":"Raissa Mourão Marques Silva","email":"","orcid":"","institution":"Federal University of Minas Gerais (UFMG)","correspondingAuthor":false,"prefix":"","firstName":"Raissa","middleName":"Mourão Marques","lastName":"Silva","suffix":""},{"id":512601393,"identity":"2cad5108-96dc-4a4f-a749-d3cdccb6de15","order_by":4,"name":"Gabriel Soares Damaceno","email":"","orcid":"","institution":"Federal University of Minas Gerais (UFMG)","correspondingAuthor":false,"prefix":"","firstName":"Gabriel","middleName":"Soares","lastName":"Damaceno","suffix":""},{"id":512601395,"identity":"5b6b577a-e234-4046-8b38-0caf0a611115","order_by":5,"name":"Marcella Ribeiro Cunha Peixoto","email":"","orcid":"","institution":"Federal University of Minas Gerais (UFMG)","correspondingAuthor":false,"prefix":"","firstName":"Marcella","middleName":"Ribeiro Cunha","lastName":"Peixoto","suffix":""},{"id":512601400,"identity":"72c3e462-846f-49fa-8792-6aefd0a3159d","order_by":6,"name":"Deborah Carvalho Malta","email":"","orcid":"","institution":"Federal University of Minas Gerais (UFMG)","correspondingAuthor":false,"prefix":"","firstName":"Deborah","middleName":"Carvalho","lastName":"Malta","suffix":""}],"badges":[],"createdAt":"2025-08-04 16:08:24","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-7293046/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-7293046/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":91057757,"identity":"7623c624-308a-4503-8f5c-3916fa4650a5","added_by":"auto","created_at":"2025-09-11 08:17:17","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":1363062,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-7293046/v1/02e8f8d2-1ba3-4bbd-b4c5-af0109a22f7c.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"Factors associated with low HDL cholesterol in Brazilian adults according to the National Health Survey: a cross-sectional study","fulltext":[{"header":"BACKGROUND","content":"\u003cp\u003eDyslipidemia can be defined as abnormal concentrations of circulating lipids in the bloodstream, such as total cholesterol, triglycerides (TGs), low-density lipoproteins (LDLs), or high-density lipoproteins (HDLs) (\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e). A reduction in HDL concentrations and an increase in LDL and TG levels are identified as independent risk factors for the development of atherosclerotic diseases (\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e). Furthermore, elevated serum cholesterol levels are associated with an increased risk of heart disease and cerebrovascular accidents (\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e). In Brazil, cardiovascular diseases have significant epidemiological relevance, as they are responsible for approximately one-third of all deaths in the country and generate high healthcare-related costs (\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e). In this context, controlling dyslipidemia is essential for improving this situation, as it is associated with reduced mortality and cardiovascular events (\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e).\u003c/p\u003e\u003cp\u003eAmong lipoproteins, HDL is an Apo A lipoprotein complex with an anti-atherogenic role, possesses antiproliferative, antithrombotic, and anti-inflammatory properties (\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e, \u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e) and provides protection against the oxidation of LDL cholesterol in the arterial wall, a key event in atherogenesis (\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e). In addition, it is responsible for mediating reverse cholesterol transport (RCT), which involves removing cholesterol from peripheral tissues and transporting it to the liver, where it is eliminated through bile or feces (\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e). The literature reports that the HDL cholesterol concentration is inversely related to the incidence of coronary atherosclerotic disease (\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e), and a decrease in HDL cholesterol, combined with high levels of triglycerides (TGs), may increase the risk of coronary artery disease (\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e). Thus, blood HDL cholesterol levels have been used as a laboratory indicator of cardiovascular risk, and higher concentrations in the blood are associated with greater atheroprotection due to actions such as more efficient RCTs (\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e). Serum HDL levels greater than 40 mg/dL are considered the recommended levels (\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e). Laboratory data from the 2014\u0026ndash;2015 National Health Survey (\u003cem\u003ein Portuguese Pesquisa Nacional de Sa\u0026uacute;de - PNS\u003c/em\u003e) showed that approximately 32% of the adult population in Brazil had elevated total cholesterol (\u0026ge;\u0026thinsp;200 mg/dL) and 18.4% had HDL-C levels below the recommended threshold (\u0026lt;\u0026thinsp;40 mg/dL). This highlights the relevance of HDL-C as a cardiovascular risk marker (\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e).\u003c/p\u003e\u003cp\u003eFrom this perspective, a low HDL cholesterol concentration in the blood is associated with increased cardiovascular risk (\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e), as patients with low HDL cholesterol levels have a risk of coronary artery disease comparable to that of patients with high LDL cholesterol levels (\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e). This may be explained by the potential loss of cardioprotection provided by HDL through reverse cholesterol transport (RCT), the inhibition of LDL oxidation in the arteries, and cholesterol efflux from macrophages, which reduces the formation of foam cells (\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e). This could be due to the loss of the anti-atherogenic benefits of this lipoprotein.\u003c/p\u003e\u003cp\u003eGlobally, according to data from the Global Burden of Disease \u003cem\u003e(GBD)\u003c/em\u003e, dyslipidemia is a critical risk factor for cardiovascular disease (CVD), significantly contributing to morbidity and mortality (\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e). In 2019, approximately 4.4\u0026nbsp;million deaths were attributed to elevated cholesterol, accounting for approximately 7.8% of total deaths worldwide (\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e). Dyslipidemia is a global health challenge, especially in countries undergoing economic transition, due to the combination of dietary factors and inadequate clinical management of the disease (\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e).\u003c/p\u003e\u003cp\u003eGiven the continuous growth of obesity, diabetes mellitus, and metabolic syndrome, the prevalence of low HDL will continue to rise, which justifies the need for studies addressing evaluations of this lipoprotein. There is also evidence that low HDL is present in approximately 63% of patients with coronary artery disease (CAD) (\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e). In addition, the risk of CAD increases sharply as HDL levels progressively decrease below 40 mg/dL (\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e, \u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e, \u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e, \u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e, \u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e). According to the literature, some factors are associated with low HDL cholesterol, such as a greater likelihood of being male, being over 60 years of age, having an increased BMI, and having increased waist circumference. On the other hand, not consuming alcohol is associated with a lower chance of having low HDL (\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e).\u003c/p\u003e\u003cp\u003eThe inverse relationship between CAD and low HDL cholesterol has consistently been shown to be an independent predictor of cardiovascular risk (\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e). Thus, considering the importance of evaluating the factors associated with low HDL cholesterol in Brazilian adults due to the significance of this marker for increased cardiovascular risk, this study advances by investigating the factors associated with low HDL cholesterol through laboratory tests.\u003c/p\u003e\u003cp\u003eTherefore, the objective of this study was to analyze the factors associated with low HDL cholesterol in the Brazilian adult population.\u003c/p\u003e"},{"header":"METHODS","content":"\u003cp\u003e\u003cstrong\u003eStudy design\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis was a cross-sectional study that used the laboratory test database from the PNS between the years 2014 and 2015.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eContext\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe PNS is a national, household-based survey coordinated by the Brazilian Institute of Geography and Statistics (IBGE) in partnership with the Ministry of Health (MS). The 2013 PNS used a probabilistic sample in three stages, collecting interview records from 64,348 households and interviewing 60,202 adults (17,18). For the selected adult residents, measurements of weight, height, waist circumference, and blood pressure were taken, and laboratory tests were planned with the collection of biological material from a subsample of 25% of the census sectors. The achieved sample size was 8,952 adults (17,18).\u003c/p\u003e\n\u003cp\u003eOwing to losses and aiming to reduce representation bias, the study adopted poststratification weights on the basis of sex, age, education, and region. Peripheral blood collection was carried out at any time of day (3), and the study followed a protocol that does not require fasting for cholesterol measurement (6). The HDL-cholesterol samples were collected in tubes with gel. The samples were left to stand for 30 minutes for clot retraction, followed by centrifugation and transportation of the samples under refrigeration at 2 to 8\u0026deg;C, with temperature control throughout the process. This parameter was measured via an automated enzymatic/colorimetric method (3). Further methodological details of the PNS are available in other publications (17,18).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eData Source\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe microdata used are freely accessible and available on the PNS website:\u003ca href=\"https://www.pns.icict.fiocruz.br/bases-de-dados/\"\u003e\u0026nbsp;\u003c/a\u003ehttps://www.pns.icict.fiocruz.br/bases-de-dados/.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eParticipants\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;The 2013 PNS included 8,952 adults aged 18 years or older. A total of 432 samples were excluded due to insufficient material, hemolysis, and sample loss, with blood samples from 8,520 adults included in this analysis.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eVariables\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eOutcome variables:\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eThe outcome variable was whether or not the individual had low HDL-Cholesterol, defined by the cutoff point of HDL-Cholesterol \u0026le; 40 mg/dL (6), values above 40 mg/dL were considered ideal, while values less than or equal to 40 mg/dL were classified as low.\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eExplanatory variables:\u003c/em\u003e\u003cbr\u003e\u0026nbsp;The explanatory variables were as follows:\u003cbr\u003e\u0026nbsp;1. Sociodemographic characteristics: Sex (male and female); Age group in years (18 to 29; 30 to 44; 45 to 59; and 60 or older); Education level (illiterate and incomplete elementary school, complete elementary and incomplete high school, complete high school or higher); Race/skin color (white and others, which included yellow and Indigenous; Black and Brown); Regions of Brazil (North, Northeast, Southeast, South, and Central-West).\u003c/p\u003e\n\u003cp\u003e2. Anthropometric: body Mass Index (BMI), categorized as: normal/underweight (\u0026lt;25 kg/m\u0026sup2;), overweight (between 25 and 29 kg/m\u0026sup2;), and obesity (\u0026ge;30 kg/m\u0026sup2;). BMI was calculated based on measured weight and height.\u003c/p\u003e\n\u003cp\u003e3. Abusive alcohol consumption: yes or no. Self-reported measure. Consumption was considered abusive when five or more drinks were consumed on a single occasion\u0026nbsp;(19); Smoking was considered yes or no. Individuals who reported using tobacco products were considered smokers. Sufficient leisure-time physical activity: poor/insufficient or sufficient. Individuals were considered to have sufficient leisure-time physical activity if they reported engaging in at least 150 minutes per week of light or moderate intensity physical activity or at least 75 minutes per week of vigorous intensity activity, regardless of the number of days practiced per week (20).\u003c/p\u003e\n\u003cp\u003e4. Noncommunicable chronic diseases (NCDs): diabetes: yes or no. A glycated hemoglobin (HbA1c) value of \u0026ge;6.5% was used as the criterion (21) Measured through blood testing in the PNS and self-reported diagnosis of the disease. Chronic kidney disease: yes or no. A glomerular filtration rate (GFR) less than 60 mL/min/1.73 m\u0026sup2;, calculated via the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equation, was used as the criterion.\u0026nbsp;Race-based correction was not applied, as recommended by most methods (22);Arterial hypertension: yes or no. Blood pressure measurements were used, with hypertension defined as systolic pressure \u0026ge;140 mmHg and diastolic pressure \u0026ge;90 mmHg (23). In addition, the self-reported diagnosis of the disease. Anemia: yes or no. This indicator was calculated from the laboratory tests of the PNS. Anemia was considered in women with hemoglobin levels below 12 mg/dL and in men with hemoglobin levels below 13 mg/dL(24,25).\u003c/p\u003e\n\u003cp\u003e5. Self-rated health: very good/good; fair; very poor/poor. Self-reported measures.\u003c/p\u003e\n\u003cp\u003eThe questions from the PNS questionnaire used to construct indicators that relied on self-reported measures are available in Supplementary Material 1.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eStatistical analyses\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eIn the descriptive analyses, the prevalences of HDL-Cholesterol \u0026le; 40 mg/dL (low) and \u0026lt; 40 mg/dL (ideal) were estimated and presented as proportions (%) with 95% confidence intervals (CI95%). Differences between the strata were estimated using Pearson\u0026apos;s \u0026chi;\u0026sup2; test, with a significance level of 5%.\u003c/p\u003e\n\u003cp\u003eTo assess the associations between the explanatory variables and the outcome, the prevalence ratio (PR) was used as a measure of association and was calculated via a Poisson regression model with robust variance. The theoretical models of Bergmann et al. (26) and S\u0026aacute; et al. (1) and the study of Ge et al. (4)\u003c/p\u003e\n\u003cp\u003eBivariate analyses were performed, and crude prevalence ratios (PRc) and 95% confidence intervals (CI95%) were estimated. Multivariate analysis was conducted, including variables with a p value \u0026lt;0.20 in the bivariate analyses. Adjusted prevalence ratios (PRa) and CI95% were estimated. The backward and forward methods were used for variable selection. In the final model, variables with a p value \u0026le;0.05 were considered associated factors. Confounding variables were tested based on the literature.\u003c/p\u003e\n\u003cp\u003eThe analyses were performed via Data Analysis and Statistical software (Stata), version 14, which uses the survey module for complex samples and incorporates poststratification weights.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eEthical aspects\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe PNS was approved by the National Research Ethics Committee of the National Health Council, under Opinion No. 328,159. Adult participation was voluntary, and the confidentiality of the information was guaranteed (17).\u003c/p\u003e"},{"header":"RESULTS","content":"\u003cp\u003eThe analyses of this study were conducted via blood samples from 8,520 adults aged 18 years or older.\u003c/p\u003e\n\u003cp\u003eThe prevalence of low HDL cholesterol was 34.81% (CI95% 33.46--36.18), which was higher among males (46.11%; CI95% 43.90--48.33), those with incomplete elementary school or incomplete high school (42.18%; CI95% 38.53--45.92), those with black skin color (36.97%; CI95% 35.08--38.89), smokers (39.82%; CI95% 36.09--43.67), those with obesity (42.99%; CI95% 39.99--46.04), those with diabetes (45.03%; CI95% 40.85--49.28), those with chronic kidney disease (41.74%; CI95% 36.71--46.95), those with hypertension (40.66%; CI95% 37.96--43.41), and those who self-rated their health as very poor or poor (38.76%; CI95% 34.17--43.56). Adults living in the southern (28.75%; CI95% 25.90--31.78) and southeastern (33.53%; CI95% 30.98--36.18) regions had the lowest prevalence rates of low HDL cholesterol (Table 1).\u003c/p\u003e\n\u003cp\u003eTable 1 \u003c/p\u003e\n\u003cp\u003eAccording to the bivariate analyses, a relatively high crude prevalence ratio of low HDL cholesterol was associated with being male (PRc = 1.86;CI 95% 1.72--2.01), being black (PRc = 1.10; CI95% 1.01--1.19), smoking (PRc = 1.17; CI95% 1.06--1.30), having completed elementary school or incomplete high school (PRc = 1.17; CI95% 1.05--1.29), being overweight (PRc = 1.47; CI95% 1.34--1.61), being obese (PRc = 1.60; CI95% 1.44--1.77), having diabetes (PRc = 1.33; CI95% 1.20--1.48), having chronic kidney disease (PRc = 1.21; CI95% 1.07--1.38), having arterial hypertension (PRc = 1.24; CI95% 1.15--1.40), self-rating health as fair (PRc = 1.12; CI95% 1.03--1.22) or being poor/very poor (PRc = 1.16; CI95% 1.02-1.33). Lower crude prevalence ratios of low HDL cholesterol were associated with having completed high school or higher education (PRc = 0.86; CI95% 0.79--0.94) and residing in Southeast (PRc = 0.84; CI95% 0.76--0.93) and South (PRc = 0.72; CI95% 0.64--0.81) regions (Table 2).\u003c/p\u003e\n\u003cp\u003eTable 2\u003c/p\u003e\n\u003cp\u003eIn the final multivariable model, male sex (PRa = 2.00; 95%CI: 1.84\u0026ndash;2.16), having intermediate education, such as primary or incomplete secondary school (PRa = 1.23; 95%CI: 1.10\u0026ndash;1.37), overweight (PRa = 1.46; 95%CI: 1.33\u0026ndash;1.61), obesity (PRa = 1.72; 95%CI: 1.54\u0026ndash;1.91), diabetes (PRa = 1.18; 95%CI: 1.06\u0026ndash;1.32), chronic kidney disease (PRa = 1.22; 95%CI: 1.06\u0026ndash;1.41), and hypertension (PRa = 1.18; 95%CI: 1.08\u0026ndash;1.29), were associated with a higher prevalence of low HDL-C. Being over 60 years old (PRa = 0.84; 95%CI: 0.72\u0026ndash;0.97), being black/skin color (PRa = 0.85; 95%CI: 0.72\u0026ndash;0.99), having higher education, such as those who have completed secondary school or above (PRa = 0.91; 95%CI: 0.83\u0026ndash;1.00), residing in Southeast (PRa = 0.79; 95%CI: 0.72\u0026ndash;0.88), South (PRa = 0.65; 95%CI: 0.57\u0026ndash;0.73), or Central-West regions (PRa = 0.87; 95%CI: 0.79\u0026ndash;0.97), and engaging in heavy alcohol consumption (PRa = 0.72; 95%CI: 0.63\u0026ndash;0.82) were protective factors against low HDL-cholesterol (Table 3).\u003c/p\u003e\n\u003cp\u003eTable 3\u003c/p\u003e"},{"header":"DISCUSSION","content":"\u003cp\u003eLow HDL-C (\u0026lt;\u0026thinsp;40 mg/dL) is highly prevalent in Brazil, affecting 1 in every 3 Brazilian adults. The factors positively associated with low HDL-C among Brazilian adults were being male, being a smoker, having lower educational attainment (completed primary or incomplete secondary education), being overweight, being obese, having diabetes, having chronic kidney disease, and having hypertension. On the other hand, protective factors against low HDL-C included living in Northeast, Southeast, Central-West, and South regions; being over 60 years old; being black; having higher educational attainment (completing secondary education or higher); and engaging in heavy alcohol consumption.\u003c/p\u003e\u003cp\u003eIn this study, the prevalence of low HDL-C was similar to that reported in a study conducted in South Korea, where women had lower rates of low HDL-C than men did (\u003cspan citationid=\"CR27\" class=\"CitationRef\"\u003e27\u003c/span\u003e). In the aforementioned study, 39% of Korean men had HDL-C levels between 30\u0026ndash;40 mg/dL, whereas 38.3% of women had HDL-C levels between 40\u0026ndash;50 mg/dL (\u003cspan citationid=\"CR27\" class=\"CitationRef\"\u003e27\u003c/span\u003e). Another study conducted in China reported similar findings, with a higher prevalence of low HDL-C among men (67.6%) than among women (55.4%) (\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e).\u003c/p\u003e\u003cp\u003eThe higher prevalence of low HDL-C among men than among women is supported in the literature by significant differences in lipid metabolism between the two sexes. Some of these differences may be influenced by sexual dimorphism in metabolism, and having a male or female genotype may also determine intermediate metabolism. Thus, women's advantage over men in terms of the lipid profile may be directly related to the female genotypic advantage, which favors the kinetics of lipid molecules, resulting in a more balanced lipid profile in women than in men (\u003cspan citationid=\"CR28\" class=\"CitationRef\"\u003e28\u003c/span\u003e). Another possible explanation is the lower access to and use of health services by men, as previously identified in a study using self-reported data from the 2019 National Health Survey (PNS) (\u003cspan citationid=\"CR29\" class=\"CitationRef\"\u003e29\u003c/span\u003e).\u003c/p\u003e\u003cp\u003eIn this study, differences in the prevalence of low HDL-C were observed according to educational level, with individuals with lower education (completed primary/incomplete secondary) presenting a risk factor for low HDL-C, whereas a protective effect was observed for Brazilian adults with higher education (completed secondary or higher). Other evidence from the 2019 National Health Survey (PNS) also revealed that more educated Brazilian adults had a lower prevalence of high cholesterol than did those with lower education levels (\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e). This finding is possibly because people with higher education levels may have greater access to health services, which is related to better disease understanding and risk awareness (\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e, \u003cspan citationid=\"CR30\" class=\"CitationRef\"\u003e30\u003c/span\u003e, \u003cspan citationid=\"CR31\" class=\"CitationRef\"\u003e31\u003c/span\u003e). A Danish study showed that people with higher education levels may have earlier access to statin treatment in primary healthcare (\u003cspan citationid=\"CR32\" class=\"CitationRef\"\u003e32\u003c/span\u003e). In this context, education level may influence the pursuit of healthcare due to a better understanding of the importance of prevention and control of cardiovascular risk factors, which can contribute to better management of cholesterol and its fractions.\u003c/p\u003e\u003cp\u003eBlack and brown skin color had a protective effect on the adjusted analyses. This finding is consistent with results from the ELSA-Brasil study and other studies conducted in the United States, which indicated a lower prevalence of dyslipidemia among individuals of black race/skin color. Notably, a possible reason for this finding is that dietary patterns and other environmental factors vary widely by ethnicity; however, further research is needed to explore this topic more thoroughly in Brazil (\u003cspan citationid=\"CR33\" class=\"CitationRef\"\u003e33\u003c/span\u003e), with an approach to race/skin color and ethnicity.\u003c/p\u003e\u003cp\u003eBody mass index (BMI) is a risk factor for low HDL-C levels. The association between high BMI and dyslipidemia has been well established and supported by several studies. According to the literature, the main dyslipidemia associated with obesity is characterized by mild to moderate elevations in triglycerides and decreased HDL-c (\u003cspan citationid=\"CR34\" class=\"CitationRef\"\u003e34\u003c/span\u003e), and the regional distribution of body fat, particularly excessive abdominal fat deposition, has been associated with low HDL concentrations (\u003cspan citationid=\"CR35\" class=\"CitationRef\"\u003e35\u003c/span\u003e).\u003c/p\u003e\u003cp\u003eNotably, individuals residing in the South and Southeast regions had lower prevalences of low HDL cholesterol. Despite the protective effects observed in other regions, higher prevalences are noted in the Northeast Region, which highlights the need to improve access to healthy food, lifestyles, and healthcare services across regions. Although data from the National Health Survey (PNS) show improvements and progress in healthcare access and use, regional disparities still persist in the country. Primary, secondary, and tertiary care are more available in the South and Southeast regions, while gaps in healthcare services remain in the Northeast (\u003cspan citationid=\"CR31\" class=\"CitationRef\"\u003e31\u003c/span\u003e). These findings likely reflect greater access to diagnosis and treatment in the South and Southeast regions, with studies indicating higher proportions of medical consultations in these areas, which have better living conditions and higher human development index (HDI) scores than other regions do (\u003cspan citationid=\"CR31\" class=\"CitationRef\"\u003e31\u003c/span\u003e).\u003c/p\u003e\u003cp\u003eSmoking was inversely correlated with blood HDL-C levels, indicating that smoking is a risk factor. This finding is consistent with previous studies (\u003cspan citationid=\"CR36\" class=\"CitationRef\"\u003e36\u003c/span\u003e) and the Brazilian Guidelines on Dyslipidemias and Atherosclerosis Prevention (\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e). The habit of smoking results in endothelial dysfunction, promoting the development of atherosclerosis, which is associated with increased total cholesterol levels and decreased HDL-c (\u003cspan citationid=\"CR37\" class=\"CitationRef\"\u003e37\u003c/span\u003e, \u003cspan citationid=\"CR38\" class=\"CitationRef\"\u003e38\u003c/span\u003e).\u003c/p\u003e\u003cp\u003eWith respect to alcohol consumption, similar to a study conducted in China (\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e), we identified a significant inverse association between low HDL-cholesterol concentrations and alcohol consumption, which is supported by studies that reported that alcohol intake can increase HDL cholesterol levels and that frequent alcohol use is associated with higher HDL cholesterol levels (\u003cspan citationid=\"CR39\" class=\"CitationRef\"\u003e39\u003c/span\u003e, \u003cspan citationid=\"CR40\" class=\"CitationRef\"\u003e40\u003c/span\u003e, \u003cspan citationid=\"CR41\" class=\"CitationRef\"\u003e41\u003c/span\u003e). Another possible hypothesis is that the negative associations between heavy alcohol use and low HDL-C may be related to lifestyle changes and treatment and could represent a potential reverse causality.\u003c/p\u003e\u003cp\u003eThe noncommunicable chronic diseases (NCDs) analyzed in this study (diabetes, hypertension, and chronic kidney disease) were identified as risk factors for low HDL levels and are frequently associated with dyslipidemia (\u003cspan citationid=\"CR42\" class=\"CitationRef\"\u003e42\u003c/span\u003e). In diabetes mellitus, there is a common pattern of lipid abnormalities known as diabetic dyslipidemia, which includes hypertriglyceridemia, low HDL, and small dense LDL (\u003cspan citationid=\"CR43\" class=\"CitationRef\"\u003e43\u003c/span\u003e). Insulin resistance is the major risk factor for the development of diabetic dyslipidemia, as it reduces lipogenic activity in adipose cells, resulting in a decreased capacity of these cells to store fatty acids. This leads to an increase in free fatty acids in the circulation, contributing to the development of dyslipidemias such as low HDL-c (\u003cspan citationid=\"CR43\" class=\"CitationRef\"\u003e43\u003c/span\u003e). The presence of reduced HDL-c in diabetic patients indicates a high-risk population for cardiovascular events (\u003cspan citationid=\"CR44\" class=\"CitationRef\"\u003e44\u003c/span\u003e).\u003c/p\u003e\u003cp\u003eIn the present study, chronic kidney disease (CKD) was correlated with decreased HDL levels, as has also been reported in other studies (\u003cspan citationid=\"CR45\" class=\"CitationRef\"\u003e45\u003c/span\u003e, \u003cspan citationid=\"CR46\" class=\"CitationRef\"\u003e46\u003c/span\u003e, \u003cspan citationid=\"CR47\" class=\"CitationRef\"\u003e47\u003c/span\u003e). CKD causes alterations in lipoprotein metabolism, leading to changes in blood lipid levels. As kidney function worsens, HDL levels decrease, whereas LDL and triglyceride levels tend to increase (\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e).\u003c/p\u003e\u003cp\u003eAs stated in the Brazilian Guideline on Dyslipidemias and Atherosclerosis Prevention (\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e) and other studies (\u003cspan citationid=\"CR48\" class=\"CitationRef\"\u003e48\u003c/span\u003e, \u003cspan citationid=\"CR49\" class=\"CitationRef\"\u003e49\u003c/span\u003e), esta investiga\u0026ccedil;\u0026atilde;o identificou associa\u0026ccedil;\u0026atilde;o positiva entre a hipertens\u0026atilde;o e o diagn\u0026oacute;stico de baixo HDL-c. Some studies (\u003cspan citationid=\"CR50\" class=\"CitationRef\"\u003e50\u003c/span\u003e, \u003cspan citationid=\"CR51\" class=\"CitationRef\"\u003e51\u003c/span\u003e) have shown that endothelial dysfunction resulting from high blood pressure negatively affects HDL metabolism, impairing reverse cholesterol transport and promoting greater development of atherosclerosis (\u003cspan citationid=\"CR48\" class=\"CitationRef\"\u003e48\u003c/span\u003e).\u003c/p\u003e\u003cp\u003eAmong the limitations of this study, it is important to highlight the inability to establish a causal relationship, since the outcome and its causes were analyzed at a single point in time, and the associations may result from changes in lifestyle and treatment. Furthermore, there is the possibility of reverse causality between the studied noncommunicable chronic diseases (NCDs) and low HDL-C, warranting cautious interpretation of the results. However, owing to the representative sample of the Brazilian adult population, the generalization of the results is relatively reliable for national estimates and closely reflects the reality of the country.\u003c/p\u003e"},{"header":"CONCLUSION","content":"\u003cp\u003eLow HDL cholesterol affects 1 in 3 Brazilian adults and is associated with sociodemographic factors (male sex, education, and region of the country), unhealthy lifestyles (smoking), the presence of overweight and obesity, and noncommunicable diseases (NCDs), such as diabetes, chronic kidney disease, and hypertension. These results reinforce the importance of controlling and preventing dyslipidemia and may provide support for public health policies, programmes, and goals aimed at reducing dyslipidemia due to low HDL cholesterol levels, especially among the most vulnerable Brazilian adults.\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eEthics approval and consent to participate\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe PNS was approved by the National Research Ethics Committee of the National Health Council, under opinion No. 328,159.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConsent for publication\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNot applicable.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAvailability of data and materials\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe datasets generated and/or analyzed during the current study are available on the PNS website,https://biblioteca.ibge.gov.br/index.php/biblioteca-catalogo?view=detalhes\u0026amp;id=291110 (17).\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCompeting interests\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors declare that they have no competing interests.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFunding\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNot applicable.\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthors\u0026apos; contributions\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eS\u0026aacute; ACMGN participated in the study design, planning, statistical analyses, data interpretation, and manuscript writing; developed the first version of the manuscript; and approved the version to be published. Silva TMR, Prates EJS, Silva RMM, Damaceno GS, Peixoto MRC and Malta DC participated in writing the manuscript.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAcknowledgments\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eWe would like to thank the Office of the Dean of Research at the Federal University of Minas Gerais (PRPq/UFMG) for their support; the National Council for Scientific and Technological Development (CNPq) for the scientific initiation scholarship received by GSD; and CNPq for the Research Productivity grant awarded to DCM.\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthors\u0026apos; information (optional)\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e1Department of Maternal and Child Nursing and Public Health, School of Nursing, Federal University of Minas Gerais (UFMG), Belo Horizonte, Brazil\u003c/p\u003e\n\u003cp\u003e2Postgraduate Program in Nursing, School of Nursing, Federal University of Minas Gerais, Belo Horizonte, Brazil\u003c/p\u003e\n\u003cp\u003e3School of Nursing, Federal University of Minas Gerais, Belo Horizonte, Brazil\u003c/p\u003e"},{"header":"References","content":"\u003col start=\"1\" type=\"1\"\u003e\n\u003cli\u003eS\u0026aacute; ACMGN, Machado \u0026Iacute;E, Bernal RTI, Malta DC. Factors associated with high LDL-Cholesterol in the Brazilian adult population: National Health Survey. Cien Saude Colet. 2021 Feb;26(2):541-553. doi: 10.1590/1413-81232021262.37102020. \u003c/li\u003e\n\u003cli\u003eNogueira de S\u0026aacute; ACMG, Gomes CS, Moreira AD, Velasquez-Melendez G, Malta DC. Prevalence and factors associated with self-reported diagnosis of high cholesterol in the Brazilian adult population: National Health Survey 2019. Epidemiol Serv Saude. 2022 Jun 29;31(spe1):e2021380. doi: 10.1590/SS2237-9622202200002.especial.\u003c/li\u003e\n\u003cli\u003eMalta DC, Szwarcwald CL, Machado \u0026Iacute;E, Pereira CA, Figueiredo AW, S\u0026aacute; ACMGN, Velasquez-Melendez G, Santos FMD, Souza Junior PB, Stopa SR, Rosenfeld LG. Prevalence of altered total cholesterol and fractions in the Brazilian adult population: National Health Survey. 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J Nutr. 2005 Apr;135(4):681-6. doi: 10.1093/jn/135.4.681.\u003c/li\u003e\n\u003cli\u003ePalmeira NC, Moro JP, Getulino F de A, Vieira YP, Soares Junior A de O, Saes M de O. Analysis of access to health services in Brazil according to sociodemographic profile: National Health Survey, 2019. Epidemiologia e Servi\u0026ccedil;os de Sa\u0026uacute;de. 2022 Dec 19;31:e2022966. doi: 10.1590/S2237-96222022000300013\u003c/li\u003e\n\u003cli\u003ePsaltopoulou T, Hatzis G, Papageorgiou N, Androulakis E, Briasoulis A, Tousoulis D. Socioeconomic status and risk factors for cardiovascular disease: Impact of dietary mediators. Hellenic J Cardiol. 2017 Jan-Feb;58(1):32-42. doi: 10.1016/j.hjc.2017.01.022.\u003c/li\u003e\n\u003cli\u003eStopa SR, Malta DC, Monteiro CN, Szwarcwald CL, Goldbaum M, Cesar CLG. Use of and access to health services in Brazil, 2013 National Health Survey. 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Circulation. 1993 Dec;88(6):2541-7. doi: 10.1161/01.cir.88.6.2541\u003c/li\u003e\n\u003c/ol\u003e"},{"header":"Tables","content":"\u003cp\u003eTable 1 - Prevalence of HDL-C in Brazilian adults by sociodemographic and health factors: PNS 2014-2015\u0026nbsp;\u003c/p\u003e\n\u003ctable border=\"0\" cellspacing=\"0\" cellpadding=\"0\" width=\"564\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 152px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eHDL cholesterol\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 51px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"bottom\" style=\"width: 152px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u0026gt; 40 (ideal)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"bottom\" style=\"width: 147px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026le;\u003c/strong\u003e\u003cstrong\u003e40 (low)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 63px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 152px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eVari\u0026aacute;veis\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 51px;\"\u003e\n \u003cp\u003e\u003cstrong\u003en*\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 64px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e%\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 88px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eIC 95%\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 64px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e%\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 83px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eIC 95%\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 63px;\"\u003e\n \u003cp\u003e\u003cstrong\u003ep*\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 152px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eTotal\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 51px;\"\u003e\n \u003cp\u003e8520\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 64px;\"\u003e\n \u003cp\u003e65.19\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 88px;\"\u003e\n \u003cp\u003e63.82-66.54\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 64px;\"\u003e\n \u003cp\u003e34.81\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 83px;\"\u003e\n \u003cp\u003e33.46-36.18\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 63px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 152px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eSexo\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 51px;\"\u003e\n \u003cp\u003e8520\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 64px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 88px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 64px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 83px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 63px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 152px;\"\u003e\n \u003cp\u003eMale\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 51px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 64px;\"\u003e\n \u003cp\u003e53.89\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 88px;\"\u003e\n \u003cp\u003e51.67-56.10\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 64px;\"\u003e\n \u003cp\u003e46.11\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 83px;\"\u003e\n \u003cp\u003e43.90-48.33\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" style=\"width: 63px;\"\u003e\n \u003cp\u003e0.0000\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 152px;\"\u003e\n \u003cp\u003eFemale\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 51px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 64px;\"\u003e\n \u003cp\u003e75.24\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 88px;\"\u003e\n \u003cp\u003e73.67-76.74\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 64px;\"\u003e\n \u003cp\u003e24.76\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 83px;\"\u003e\n \u003cp\u003e23.26-26.33\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 152px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eAge group\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 51px;\"\u003e\n \u003cp\u003e8520\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 64px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 88px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 64px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 83px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 63px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 152px;\"\u003e\n \u003cp\u003e18 a 29\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 51px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 64px;\"\u003e\n \u003cp\u003e66.72\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 88px;\"\u003e\n \u003cp\u003e63.11-70.14\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 64px;\"\u003e\n \u003cp\u003e33.28\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 83px;\"\u003e\n \u003cp\u003e29.86-36.89\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"4\" style=\"width: 63px;\"\u003e\n \u003cp\u003e0.1491\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 152px;\"\u003e\n \u003cp\u003e30 a 44\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 51px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 64px;\"\u003e\n \u003cp\u003e66.60\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 88px;\"\u003e\n \u003cp\u003e64.13-68.97\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 64px;\"\u003e\n \u003cp\u003e33.40\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 83px;\"\u003e\n \u003cp\u003e31.03-35.87\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 152px;\"\u003e\n \u003cp\u003e45 a 59\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 51px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 64px;\"\u003e\n \u003cp\u003e62.84\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 88px;\"\u003e\n \u003cp\u003e60.27-65.34\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 64px;\"\u003e\n \u003cp\u003e37.16\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 83px;\"\u003e\n \u003cp\u003e34.66-39.73\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 152px;\"\u003e\n \u003cp\u003e60 years or more\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 51px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 64px;\"\u003e\n \u003cp\u003e64.61\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 88px;\"\u003e\n \u003cp\u003e62.00-67.14\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 64px;\"\u003e\n \u003cp\u003e35.39\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 83px;\"\u003e\n \u003cp\u003e32.86-38.00\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 152px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003eEducation\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 51px;\"\u003e\n \u003cp\u003e8520\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 64px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 88px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 64px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 83px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 63px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 152px;\"\u003e\n \u003cp\u003eIlliterate/Incomplete Elementary\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 51px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 64px;\"\u003e\n \u003cp\u003e63.79\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 88px;\"\u003e\n \u003cp\u003e61.80-65.74\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 64px;\"\u003e\n \u003cp\u003e36.21\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 83px;\"\u003e\n \u003cp\u003e34.26-38.20\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"3\" style=\"width: 63px;\"\u003e\n \u003cp\u003e0.0000\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 152px;\"\u003e\n \u003cp\u003eComplete\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003eElementary/Incomplete High School\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 51px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 64px;\"\u003e\n \u003cp\u003e57.82\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 88px;\"\u003e\n \u003cp\u003e54.08-61.47\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 64px;\"\u003e\n \u003cp\u003e42.18\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 83px;\"\u003e\n \u003cp\u003e38.53-45.92\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 152px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003eComplete High\u003c/p\u003e\n \u003cp\u003eSchool and higher\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 51px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 64px;\"\u003e\n \u003cp\u003e68.88\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 88px;\"\u003e\n \u003cp\u003e66.76-70.93\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 64px;\"\u003e\n \u003cp\u003e31.12\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 83px;\"\u003e\n \u003cp\u003e29.07-33.24\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 152px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eRace/skin color\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 51px;\"\u003e\n \u003cp\u003e8520\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 64px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 88px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 64px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 83px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 63px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 152px;\"\u003e\n \u003cp\u003eWhite and others\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 51px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 64px;\"\u003e\n \u003cp\u003e66.39\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 88px;\"\u003e\n \u003cp\u003e64.29-68.43\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 64px;\"\u003e\n \u003cp\u003e33.61\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 83px;\"\u003e\n \u003cp\u003e31.57-35.71\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"3\" style=\"width: 63px;\"\u003e\n \u003cp\u003e0.0255\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 152px;\"\u003e\n \u003cp\u003eBrown\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 51px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 64px;\"\u003e\n \u003cp\u003e68.52\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 88px;\"\u003e\n \u003cp\u003e63.75-72.92\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 64px;\"\u003e\n \u003cp\u003e31.48\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 83px;\"\u003e\n \u003cp\u003e27.08-36.25\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 152px;\"\u003e\n \u003cp\u003eBlack\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 51px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 64px;\"\u003e\n \u003cp\u003e63.03\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 88px;\"\u003e\n \u003cp\u003e61.11-64.92\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 64px;\"\u003e\n \u003cp\u003e36.97\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 83px;\"\u003e\n \u003cp\u003e35.08-38.89\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 152px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eRegion\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 51px;\"\u003e\n \u003cp\u003e8520\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 64px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 88px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 64px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 83px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 63px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 152px;\"\u003e\n \u003cp\u003eNorth\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 51px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 64px;\"\u003e\n \u003cp\u003e60.12\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 88px;\"\u003e\n \u003cp\u003e57.86-62.34\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 64px;\"\u003e\n \u003cp\u003e39.88\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 83px;\"\u003e\n \u003cp\u003e37.66-42.14\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"5\" style=\"width: 63px;\"\u003e\n \u003cp\u003e0.0000\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 152px;\"\u003e\n \u003cp\u003eNortheast\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 51px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 64px;\"\u003e\n \u003cp\u003e61.63\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 88px;\"\u003e\n \u003cp\u003e59.77-63.46\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 64px;\"\u003e\n \u003cp\u003e38.37\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 83px;\"\u003e\n \u003cp\u003e36.54-40.23\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 152px;\"\u003e\n \u003cp\u003eSoutheast\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 51px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 64px;\"\u003e\n \u003cp\u003e66.47\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 88px;\"\u003e\n \u003cp\u003e63.82-69.02\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 64px;\"\u003e\n \u003cp\u003e33.53\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 83px;\"\u003e\n \u003cp\u003e30.98-36.18\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 152px;\"\u003e\n \u003cp\u003eSouth\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 51px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 64px;\"\u003e\n \u003cp\u003e71.25\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 88px;\"\u003e\n \u003cp\u003e68.22-74.10\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 64px;\"\u003e\n \u003cp\u003e28.75\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 83px;\"\u003e\n \u003cp\u003e25.90-31.78\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 152px;\"\u003e\n \u003cp\u003eCentral-West\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 51px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 64px;\"\u003e\n \u003cp\u003e62.69\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 88px;\"\u003e\n \u003cp\u003e59.31-65.95\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 64px;\"\u003e\n \u003cp\u003e37.31\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 83px;\"\u003e\n \u003cp\u003e34.05-40.69\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 152px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eBody Mass Index\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 51px;\"\u003e\n \u003cp\u003e8427\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 64px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 88px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 64px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 83px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 63px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 152px;\"\u003e\n \u003cp\u003eUnderweight/Normal\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 51px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 64px;\"\u003e\n \u003cp\u003e73.06\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 88px;\"\u003e\n \u003cp\u003e71.02-75.01\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 64px;\"\u003e\n \u003cp\u003e26.94\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 83px;\"\u003e\n \u003cp\u003e24.99-28.98\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"3\" style=\"width: 63px;\"\u003e\n \u003cp\u003e0.0000\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 152px;\"\u003e\n \u003cp\u003eOverweight\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 51px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 64px;\"\u003e\n \u003cp\u003e60.39\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 88px;\"\u003e\n \u003cp\u003e58.09-62.64\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 64px;\"\u003e\n \u003cp\u003e39.61\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 83px;\"\u003e\n \u003cp\u003e37.36-41.91\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 152px;\"\u003e\n \u003cp\u003eObesity\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 51px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 64px;\"\u003e\n \u003cp\u003e57.01\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 88px;\"\u003e\n \u003cp\u003e53.96-60.01\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 64px;\"\u003e\n \u003cp\u003e42.99\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 83px;\"\u003e\n \u003cp\u003e39.99-46.04\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 152px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eAbusive alcohol consumption\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 51px;\"\u003e\n \u003cp\u003e8520\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 64px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 88px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 64px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 83px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 63px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 152px;\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 51px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 64px;\"\u003e\n \u003cp\u003e64.64\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 88px;\"\u003e\n \u003cp\u003e63.17-66.09\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 64px;\"\u003e\n \u003cp\u003e35.36\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 83px;\"\u003e\n \u003cp\u003e33.91-36.83\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" style=\"width: 63px;\"\u003e\n \u003cp\u003e0.585\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 152px;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 51px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 64px;\"\u003e\n \u003cp\u003e68.54\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 88px;\"\u003e\n \u003cp\u003e64.76-72.1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 64px;\"\u003e\n \u003cp\u003e31.46\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 83px;\"\u003e\n \u003cp\u003e27.90-35.24\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 152px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eSmoking\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 51px;\"\u003e\n \u003cp\u003e8513\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 64px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 88px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 64px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 83px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 63px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 152px;\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 51px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 64px;\"\u003e\n \u003cp\u003e66.02\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 88px;\"\u003e\n \u003cp\u003e64.55-67.46\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 64px;\"\u003e\n \u003cp\u003e33.98\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 83px;\"\u003e\n \u003cp\u003e32.54-35.45\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" style=\"width: 63px;\"\u003e\n \u003cp\u003e0.0040\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 152px;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 51px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 64px;\"\u003e\n \u003cp\u003e60.18\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 88px;\"\u003e\n \u003cp\u003e56.33-63.91\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 64px;\"\u003e\n \u003cp\u003e39.82\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 83px;\"\u003e\n \u003cp\u003e36.09-43.67\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 152px;\"\u003e\n \u003cp\u003e\u003cstrong\u003ePhysical activity\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 51px;\"\u003e\n \u003cp\u003e8510\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 64px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 88px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 64px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 83px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 63px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 152px;\"\u003e\n \u003cp\u003ePoor/Insufficient\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 51px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 64px;\"\u003e\n \u003cp\u003e64.77\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 88px;\"\u003e\n \u003cp\u003e63.24-66.27\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 64px;\"\u003e\n \u003cp\u003e35.23\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 83px;\"\u003e\n \u003cp\u003e33.73-36.76\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" style=\"width: 63px;\"\u003e\n \u003cp\u003e0.3054\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 152px;\"\u003e\n \u003cp\u003eSufficient\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 51px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 64px;\"\u003e\n \u003cp\u003e66.57\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 88px;\"\u003e\n \u003cp\u003e63.44-69.55\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 64px;\"\u003e\n \u003cp\u003e33.43\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 83px;\"\u003e\n \u003cp\u003e30.45-36.56\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 152px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eDiabetes\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 51px;\"\u003e\n \u003cp\u003e8292\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 64px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 88px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 64px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 83px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 63px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 152px;\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 51px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 64px;\"\u003e\n \u003cp\u003e66.18\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 88px;\"\u003e\n \u003cp\u003e64.71-67.61\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 64px;\"\u003e\n \u003cp\u003e33.82\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 83px;\"\u003e\n \u003cp\u003e32.39-35.29\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" style=\"width: 63px;\"\u003e\n \u003cp\u003e0.0000\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 152px;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 51px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 64px;\"\u003e\n \u003cp\u003e54.97\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 88px;\"\u003e\n \u003cp\u003e50.72.59.15\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 64px;\"\u003e\n \u003cp\u003e45.03\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 83px;\"\u003e\n \u003cp\u003e40.85-49.28\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 152px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eChronic kidney disease\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 51px;\"\u003e\n \u003cp\u003e8520\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 64px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 88px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 64px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 83px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 63px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 152px;\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 51px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 64px;\"\u003e\n \u003cp\u003e65.60\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 88px;\"\u003e\n \u003cp\u003e64.18-66.99\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 64px;\"\u003e\n \u003cp\u003e34.40\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 83px;\"\u003e\n \u003cp\u003e33.01-35.82\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" style=\"width: 63px;\"\u003e\n \u003cp\u003e0.0053\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 152px;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 51px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 64px;\"\u003e\n \u003cp\u003e58.26\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 88px;\"\u003e\n \u003cp\u003e53.05-63.29\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 64px;\"\u003e\n \u003cp\u003e41.74\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 83px;\"\u003e\n \u003cp\u003e36.71-46.95\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 152px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eArterial hypertension\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 51px;\"\u003e\n \u003cp\u003e8146\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 64px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 88px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 64px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 83px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 63px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 152px;\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 51px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 64px;\"\u003e\n \u003cp\u003e67.33\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 88px;\"\u003e\n \u003cp\u003e65.71-68.91\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 64px;\"\u003e\n \u003cp\u003e32.67\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 83px;\"\u003e\n \u003cp\u003e31.09-34.29\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" style=\"width: 63px;\"\u003e\n \u003cp\u003e0.0000\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 152px;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 51px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 64px;\"\u003e\n \u003cp\u003e59.34\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 88px;\"\u003e\n \u003cp\u003e56.59-62.04\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 64px;\"\u003e\n \u003cp\u003e40.66\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 83px;\"\u003e\n \u003cp\u003e37.96-43.41\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 152px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eAnemia\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 51px;\"\u003e\n \u003cp\u003e7904\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 64px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 88px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 64px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 83px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 63px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 152px;\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 51px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 64px;\"\u003e\n \u003cp\u003e64.93\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 88px;\"\u003e\n \u003cp\u003e63.43-66.41\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 64px;\"\u003e\n \u003cp\u003e35.07\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 83px;\"\u003e\n \u003cp\u003e33.59-36.57\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 63px;\"\u003e\n \u003cp\u003e0.2809\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 152px;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 51px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 64px;\"\u003e\n \u003cp\u003e67.40\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 88px;\"\u003e\n \u003cp\u003e63.10-71.43\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 64px;\"\u003e\n \u003cp\u003e32.60\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 83px;\"\u003e\n \u003cp\u003e28.57-36.90\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 63px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 152px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eSelf-rated health\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 51px;\"\u003e\n \u003cp\u003e8513\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 64px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 88px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 64px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 83px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 63px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 152px;\"\u003e\n \u003cp\u003eVery good/Good\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 51px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 64px;\"\u003e\n \u003cp\u003e66.64\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 88px;\"\u003e\n \u003cp\u003e64.88-68.36\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 64px;\"\u003e\n \u003cp\u003e33.36\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 83px;\"\u003e\n \u003cp\u003e31.64-35.12\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"3\" style=\"width: 63px;\"\u003e\n \u003cp\u003e0.0055\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 152px;\"\u003e\n \u003cp\u003eFair\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 51px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 64px;\"\u003e\n \u003cp\u003e62.63\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 88px;\"\u003e\n \u003cp\u003e60.20-65.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 64px;\"\u003e\n \u003cp\u003e37.37\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 83px;\"\u003e\n \u003cp\u003e35.00-39.80\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 152px;\"\u003e\n \u003cp\u003eVery poor/Poor\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 51px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 64px;\"\u003e\n \u003cp\u003e61.24\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 88px;\"\u003e\n \u003cp\u003e56.44-65.83\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 64px;\"\u003e\n \u003cp\u003e38.76\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 83px;\"\u003e\n \u003cp\u003e34.17-43.56\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u003cstrong\u003e*The total sample size is 8.952 participants; however. missing data are not shown. %: Prevalence. 95% CI: 95% confidence interval. HDL-Cholesterol: ideal (\u0026gt; 40 mg/dL) and low (\u0026le; 40 mg/dL). Pearson\u0026rsquo;s \u0026chi;\u0026sup2; test.\u003c/strong\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eTable 2 \u0026ndash; Crude prevalence ratios for low HDL cholesterol in Brazilian adults by health and sociodemographic factors: PNS from 2014-2015\u003c/p\u003e\n\u003ctable border=\"0\" cellspacing=\"0\" cellpadding=\"0\" width=\"541\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 218px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eVariable\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 95px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eRPb\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 127px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eIC95%\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 101px;\"\u003e\n \u003cp\u003e\u003cstrong\u003ep*\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 218px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eSex\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 95px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 127px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 101px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 218px;\"\u003e\n \u003cp\u003eFemale\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 95px;\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 127px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 101px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 218px;\"\u003e\n \u003cp\u003eMale\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 95px;\"\u003e\n \u003cp\u003e1.86\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 127px;\"\u003e\n \u003cp\u003e1.72-2.01\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 101px;\"\u003e\n \u003cp\u003e0.000\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 218px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eAge group\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 95px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 127px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 101px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 218px;\"\u003e\n \u003cp\u003e18 a 29\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 95px;\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 127px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 101px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 218px;\"\u003e\n \u003cp\u003e30 a 44\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 95px;\"\u003e\n \u003cp\u003e1.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 127px;\"\u003e\n \u003cp\u003e0.88-1.14\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 101px;\"\u003e\n \u003cp\u003e0.956\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 218px;\"\u003e\n \u003cp\u003e45 a 59\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 95px;\"\u003e\n \u003cp\u003e1.12\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 127px;\"\u003e\n \u003cp\u003e0.99-1.27\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 101px;\"\u003e\n \u003cp\u003e0.086\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 218px;\"\u003e\n \u003cp\u003e60 years or more\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 95px;\"\u003e\n \u003cp\u003e1.06\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 127px;\"\u003e\n \u003cp\u003e0.94-1.21\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 101px;\"\u003e\n \u003cp\u003e0.348\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 218px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eEducation level\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 95px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 127px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 101px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 218px;\"\u003e\n \u003cp\u003eIlliterate / Incomplete elementary education\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 95px;\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 127px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 101px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 218px;\"\u003e\n \u003cp\u003eCompleted elementary / Incomplete high school\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 95px;\"\u003e\n \u003cp\u003e1.17\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 127px;\"\u003e\n \u003cp\u003e1.05-1.29\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 101px;\"\u003e\n \u003cp\u003e0.004\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 218px;\"\u003e\n \u003cp\u003eCompleted high school or higher\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 95px;\"\u003e\n \u003cp\u003e0.86\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 127px;\"\u003e\n \u003cp\u003e0.79-0.94\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 101px;\"\u003e\n \u003cp\u003e0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 218px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eRace/skin color\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 95px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 127px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 101px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 218px;\"\u003e\n \u003cp\u003eWhite and others\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 95px;\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 127px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 101px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 218px;\"\u003e\n \u003cp\u003eBrown\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 95px;\"\u003e\n \u003cp\u003e0.94\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 127px;\"\u003e\n \u003cp\u003e0.80- 1.10\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 101px;\"\u003e\n \u003cp\u003e0.419\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 218px;\"\u003e\n \u003cp\u003eBlack\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 95px;\"\u003e\n \u003cp\u003e1.10\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 127px;\"\u003e\n \u003cp\u003e1.01-1.19\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 101px;\"\u003e\n \u003cp\u003e0.02\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 218px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eRegion\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 95px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 127px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 101px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 218px;\"\u003e\n \u003cp\u003eNorth\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 95px;\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 127px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 101px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 218px;\"\u003e\n \u003cp\u003eNortheast\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 95px;\"\u003e\n \u003cp\u003e0.96\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 127px;\"\u003e\n \u003cp\u003e0.89- 1.04\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 101px;\"\u003e\n \u003cp\u003e0.306\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 218px;\"\u003e\n \u003cp\u003eSoutheast\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 95px;\"\u003e\n \u003cp\u003e0.84\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 127px;\"\u003e\n \u003cp\u003e0.76-0.93\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 101px;\"\u003e\n \u003cp\u003e0.000\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 218px;\"\u003e\n \u003cp\u003eSouth\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 95px;\"\u003e\n \u003cp\u003e0.72\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 127px;\"\u003e\n \u003cp\u003e0.64-0.81\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 101px;\"\u003e\n \u003cp\u003e0.000\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 218px;\"\u003e\n \u003cp\u003eCentral-West\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 95px;\"\u003e\n \u003cp\u003e0.94\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 127px;\"\u003e\n \u003cp\u003e0.84-1.04\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 101px;\"\u003e\n \u003cp\u003e0.215\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 218px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eBody Mass Index\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 95px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 127px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 101px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 218px;\"\u003e\n \u003cp\u003eUnderweight/Normal\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 95px;\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 127px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 101px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 218px;\"\u003e\n \u003cp\u003eOverweight\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 95px;\"\u003e\n \u003cp\u003e1.47\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 127px;\"\u003e\n \u003cp\u003e\u0026nbsp;1.34-1.61\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 101px;\"\u003e\n \u003cp\u003e0.000\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 218px;\"\u003e\n \u003cp\u003eObesity\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 95px;\"\u003e\n \u003cp\u003e1.60\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 127px;\"\u003e\n \u003cp\u003e1.44-1.77\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 101px;\"\u003e\n \u003cp\u003e0.000\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 218px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eAbusive alcohol consumption\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 95px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 127px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 101px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 218px;\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 95px;\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 127px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 101px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 218px;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 95px;\"\u003e\n \u003cp\u003e0.89\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 127px;\"\u003e\n \u003cp\u003e0.79-1.01\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 101px;\"\u003e\n \u003cp\u003e0.064\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 218px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eSmoking\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 95px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 127px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 101px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 218px;\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 95px;\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 127px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 101px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 218px;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 95px;\"\u003e\n \u003cp\u003e1.17\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 127px;\"\u003e\n \u003cp\u003e\u0026nbsp;1.06-1.30\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 101px;\"\u003e\n \u003cp\u003e0.003\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 218px;\"\u003e\n \u003cp\u003e\u003cstrong\u003ePhysical activity\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 95px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 127px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 101px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 218px;\"\u003e\n \u003cp\u003ePoor/Insufficient\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 95px;\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 127px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 101px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 218px;\"\u003e\n \u003cp\u003eSufficient\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 95px;\"\u003e\n \u003cp\u003e0.95\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 127px;\"\u003e\n \u003cp\u003e0.86-1.05\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 101px;\"\u003e\n \u003cp\u003e0.310\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 218px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eDiabetes\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 95px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 127px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 101px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 218px;\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 95px;\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 127px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 101px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 218px;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 95px;\"\u003e\n \u003cp\u003e1.33\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 127px;\"\u003e\n \u003cp\u003e1.20-1.48\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 101px;\"\u003e\n \u003cp\u003e0.000\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 218px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eChronic kidney disease\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 95px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 127px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 101px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 218px;\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 95px;\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 127px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 101px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 218px;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 95px;\"\u003e\n \u003cp\u003e1.21\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 127px;\"\u003e\n \u003cp\u003e1.07-1.38\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 101px;\"\u003e\n \u003cp\u003e0.003\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 218px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eArterial hypertension\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 95px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 127px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 101px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 218px;\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 95px;\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 127px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 101px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 218px;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 95px;\"\u003e\n \u003cp\u003e1.24\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 127px;\"\u003e\n \u003cp\u003e1.15-1.40\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 101px;\"\u003e\n \u003cp\u003e0.000\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 218px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eAnemia\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 95px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 127px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 101px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 218px;\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 95px;\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 127px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 101px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 218px;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 95px;\"\u003e\n \u003cp\u003e0.93\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 127px;\"\u003e\n \u003cp\u003e0.81-1.06\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 101px;\"\u003e\n \u003cp\u003e0.288\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 218px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eSelf-rated health\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 95px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 127px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 101px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 218px;\"\u003e\n \u003cp\u003eVery good/Good\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 95px;\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 127px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 101px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 218px;\"\u003e\n \u003cp\u003eFair\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 95px;\"\u003e\n \u003cp\u003e1.12\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 127px;\"\u003e\n \u003cp\u003e1.03-1.22\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 101px;\"\u003e\n \u003cp\u003e0.007\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 218px;\"\u003e\n \u003cp\u003eVery poor/Poor\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 95px;\"\u003e\n \u003cp\u003e1.16\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 127px;\"\u003e\n \u003cp\u003e1.02-1.33\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 101px;\"\u003e\n \u003cp\u003e0.026\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003ePRb: Crude Prevalence Ratio; 95%CI: 95% Confidence Interval. HDL-Cholesterol: low (\u0026le; 40 mg/dL).\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eTable 3 \u0026ndash; Adjusted prevalence ratios for low HDL in Brazilian adults: final Poisson model. PNS 2014\u0026ndash;2015\u003c/p\u003e\n\u003ctable border=\"0\" cellspacing=\"0\" cellpadding=\"0\" width=\"537\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 268px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eVariable\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 95px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eRPa\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 100px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eIC95%\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 75px;\"\u003e\n \u003cp\u003e\u003cstrong\u003ep\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 268px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eSex\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 95px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 100px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 75px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 268px;\"\u003e\n \u003cp\u003eFemale\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 95px;\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 100px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 75px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 268px;\"\u003e\n \u003cp\u003eMale\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 95px;\"\u003e\n \u003cp\u003e2.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 100px;\"\u003e\n \u003cp\u003e1.84-2.16\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 75px;\"\u003e\n \u003cp\u003e0.000\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 268px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eAge group\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 95px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 100px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 75px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 268px;\"\u003e\n \u003cp\u003e18 a 29\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 95px;\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 100px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 75px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 268px;\"\u003e\n \u003cp\u003e30 a 44\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 95px;\"\u003e\n \u003cp\u003e0.95\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 100px;\"\u003e\n \u003cp\u003e0.84-1.09\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 75px;\"\u003e\n \u003cp\u003e0.470\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 268px;\"\u003e\n \u003cp\u003e45 a 59\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 95px;\"\u003e\n \u003cp\u003e0.94\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 100px;\"\u003e\n \u003cp\u003e0.82-1.08\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 75px;\"\u003e\n \u003cp\u003e0.372\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 268px;\"\u003e\n \u003cp\u003e60 years or more\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 95px;\"\u003e\n \u003cp\u003e0.84\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 100px;\"\u003e\n \u003cp\u003e0.72-0.97\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 75px;\"\u003e\n \u003cp\u003e0.020\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 268px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eEducation level\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 95px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 100px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 75px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 268px;\"\u003e\n \u003cp\u003eIlliterate / Incomplete elementary education\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 95px;\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 100px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 75px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 268px;\"\u003e\n \u003cp\u003eCompleted elementary / Incomplete high school\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 95px;\"\u003e\n \u003cp\u003e1.23\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 100px;\"\u003e\n \u003cp\u003e1.10-1.37\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 75px;\"\u003e\n \u003cp\u003e0.000\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 268px;\"\u003e\n \u003cp\u003eCompleted high school or higher\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 95px;\"\u003e\n \u003cp\u003e0.91\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 100px;\"\u003e\n \u003cp\u003e0.83-1.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 75px;\"\u003e\n \u003cp\u003e0.041\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 268px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eRace/skin color\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 95px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 100px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 75px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 268px;\"\u003e\n \u003cp\u003eWhite and others\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 95px;\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 100px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 75px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 268px;\"\u003e\n \u003cp\u003eBrown\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 95px;\"\u003e\n \u003cp\u003e0.99\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 100px;\"\u003e\n \u003cp\u003e0.91-1.08\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 75px;\"\u003e\n \u003cp\u003e0.815\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 268px;\"\u003e\n \u003cp\u003eBlack\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 95px;\"\u003e\n \u003cp\u003e0.85\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 100px;\"\u003e\n \u003cp\u003e0.72-0.99\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 75px;\"\u003e\n \u003cp\u003e0.035\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 268px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eRegion\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 95px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 100px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 75px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 268px;\"\u003e\n \u003cp\u003eNorth\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 95px;\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 100px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 75px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 268px;\"\u003e\n \u003cp\u003eNortheast\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 95px;\"\u003e\n \u003cp\u003e0.94\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 100px;\"\u003e\n \u003cp\u003e0.87-1.01\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 75px;\"\u003e\n \u003cp\u003e0.114\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 268px;\"\u003e\n \u003cp\u003eSoutheast\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 95px;\"\u003e\n \u003cp\u003e0.79\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 100px;\"\u003e\n \u003cp\u003e0.72-0.88\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 75px;\"\u003e\n \u003cp\u003e0.000\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 268px;\"\u003e\n \u003cp\u003eSouth\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 95px;\"\u003e\n \u003cp\u003e0.65\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 100px;\"\u003e\n \u003cp\u003e0.57-0.73\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 75px;\"\u003e\n \u003cp\u003e0.000\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 268px;\"\u003e\n \u003cp\u003eCentral-West\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 95px;\"\u003e\n \u003cp\u003e0.87\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 100px;\"\u003e\n \u003cp\u003e0.79-0.97\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 75px;\"\u003e\n \u003cp\u003e0.013\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 268px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eBody Mass Index\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 95px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 100px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 75px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 268px;\"\u003e\n \u003cp\u003eUnderweight/Normal\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 95px;\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 100px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 75px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 268px;\"\u003e\n \u003cp\u003eOverweight\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 95px;\"\u003e\n \u003cp\u003e1.46\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 100px;\"\u003e\n \u003cp\u003e1.33-1.61\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 75px;\"\u003e\n \u003cp\u003e0.000\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 268px;\"\u003e\n \u003cp\u003eObesity\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 95px;\"\u003e\n \u003cp\u003e1.72\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 100px;\"\u003e\n \u003cp\u003e1.54-1.91\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 75px;\"\u003e\n \u003cp\u003e0.000\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 268px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eAbusive alcohol consumption\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 95px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 100px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 75px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 268px;\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 95px;\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 100px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 75px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 268px;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 95px;\"\u003e\n \u003cp\u003e0.72\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 100px;\"\u003e\n \u003cp\u003e0.63-0.82\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 75px;\"\u003e\n \u003cp\u003e0.000\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 268px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eSmoking\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 95px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 100px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 75px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 268px;\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 95px;\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 100px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 75px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 268px;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 95px;\"\u003e\n \u003cp\u003e1.19\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 100px;\"\u003e\n \u003cp\u003e1.08-1.32\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 75px;\"\u003e\n \u003cp\u003e0.002\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 268px;\"\u003e\n \u003cp\u003e\u003cstrong\u003ePhysical activity\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 95px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 100px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 75px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 268px;\"\u003e\n \u003cp\u003ePoor/Insufficient\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 95px;\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 100px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 75px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 268px;\"\u003e\n \u003cp\u003eSufficient\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 95px;\"\u003e\n \u003cp\u003e1.18\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 100px;\"\u003e\n \u003cp\u003e1.06-1.32\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 75px;\"\u003e\n \u003cp\u003e0.003\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 268px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eDiabetes\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 95px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 100px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 75px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 268px;\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 95px;\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 100px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 75px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 268px;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 95px;\"\u003e\n \u003cp\u003e1.22\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 100px;\"\u003e\n \u003cp\u003e1.06-1.41\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 75px;\"\u003e\n \u003cp\u003e0.004\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 268px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eChronic kidney disease\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 95px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 100px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 75px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 268px;\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 95px;\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 100px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 75px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 268px;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 95px;\"\u003e\n \u003cp\u003e1.18\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 100px;\"\u003e\n \u003cp\u003e1.08-1.29\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 75px;\"\u003e\n \u003cp\u003e0.000\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003ePRa: Prevalence ratio adjusted for all explanatory variables with a p value \u0026lt; 0.20 in the bivariate analysis. 95%CI: 95% confidence interval.\u0026nbsp;\u003c/p\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"bmc-cardiovascular-disorders","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"bcar","sideBox":"Learn more about [BMC Cardiovascular Disorders](http://bmccardiovascdisord.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/bcar/default.aspx","title":"BMC Cardiovascular Disorders","twitterHandle":"BMC_series","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true},"keywords":"Cholesterol, HDL, Dyslipidemias, Health Surveys, Laboratory Test, Brazil","lastPublishedDoi":"10.21203/rs.3.rs-7293046/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-7293046/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003ch2\u003eBackground\u003c/h2\u003e\u003cp\u003eDyslipidemia can be defined as abnormal concentrations of circulating lipids in the bloodstream, such as total cholesterol, triglycerides (TGs), low-density lipoproteins (LDLs), or high-density lipoproteins (HDLs). HDL is an Apo A lipoprotein complex with an anti-atherogenic role and possesses antiproliferative, antithrombotic, and anti-inflammatory properties, and its low concentration in the blood is associated with increased cardiovascular risk. Given the importance of HDL concentration, this study aimed to analyze the factors associated with low HDL cholesterol in Brazilian adults.\u003c/p\u003e\u003ch2\u003eMethods\u003c/h2\u003e\u003cp\u003eA cross-sectional study that used the database of laboratory tests from 8,520 individuals collected by the National Health Survey between 2014 and 2015. The prevalences of HDL-Cholesterol\u0026thinsp;\u0026lt;\u0026thinsp;40 and \u0026ge;\u0026thinsp;40 mg/dL were estimated, with the outcome variable being low HDL-Cholesterol (\u0026le;\u0026thinsp;40 mg/dL) and the explanatory variables including sociodemographic factors (sex, age group, education level, race/skin color, regions of Brazil), anthropometric factors (BMI), lifestyle (abusive alcohol consumption, smoking, physical activity), chronic diseases (diabetes, kidney failure, hypertension, anemia), and self-reported health. To verify the associations, Poisson regression with robust variance was used, estimating crude and adjusted (PRa) prevalence ratios and 95% confidence intervals (95% CI).\u003c/p\u003e\u003ch2\u003eResults\u003c/h2\u003e\u003cp\u003eThe prevalence of low HDL cholesterol was 34.81%. In the final multivariate model, the following factors were associated with the outcome: male sex (PRa\u0026thinsp;=\u0026thinsp;2.00; 95% CI 1.84\u0026ndash;2.16), intermediate education level\u0026mdash;complete elementary or incomplete high school (PRa\u0026thinsp;=\u0026thinsp;1.23; 95% CI 1.10\u0026ndash;1.37), overweight (PRa\u0026thinsp;=\u0026thinsp;1.46; 95% CI 1.33\u0026ndash;1.61), obesity (PRa\u0026thinsp;=\u0026thinsp;1.72; 95% CI 1.54\u0026ndash;1.91), diabetes (PRa\u0026thinsp;=\u0026thinsp;1.18; 95% CI 1.06\u0026ndash;1.32), chronic kidney disease (PRa\u0026thinsp;=\u0026thinsp;1.22; 95% CI 1.06\u0026ndash;1.41), and hypertension (PRa\u0026thinsp;=\u0026thinsp;1.18; 95% CI 1.08\u0026ndash;1.29).\u003c/p\u003e\u003ch2\u003eConclusion\u003c/h2\u003e\u003cp\u003eLow HDL cholesterol was associated with male sex, intermediate education level, overweight and obesity, diabetes, chronic kidney disease, and hypertension.\u003c/p\u003e","manuscriptTitle":"Factors associated with low HDL cholesterol in Brazilian adults according to the National Health Survey: a cross-sectional study","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2025-09-11 08:01:12","doi":"10.21203/rs.3.rs-7293046/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"editorInvitedReview","content":"","date":"2025-09-23T01:35:59+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"48624366069244734987561741858966340270","date":"2025-09-16T05:57:05+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"174063300893201552577397551514561572900","date":"2025-09-13T11:20:35+00:00","index":"hide","fulltext":""},{"type":"reviewersInvited","content":"","date":"2025-09-04T11:48:26+00:00","index":"","fulltext":""},{"type":"editorInvited","content":"","date":"2025-08-10T14:17:42+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2025-08-07T04:37:42+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2025-08-07T04:36:49+00:00","index":"","fulltext":""},{"type":"submitted","content":"BMC Cardiovascular Disorders","date":"2025-08-04T15:59:40+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"bmc-cardiovascular-disorders","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"bcar","sideBox":"Learn more about [BMC Cardiovascular Disorders](http://bmccardiovascdisord.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/bcar/default.aspx","title":"BMC Cardiovascular Disorders","twitterHandle":"BMC_series","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"cb6fd45e-168a-49f1-90a8-5d1a0bca067f","owner":[],"postedDate":"September 11th, 2025","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"under-review","subjectAreas":[],"tags":[],"updatedAt":"2025-09-11T08:01:12+00:00","versionOfRecord":[],"versionCreatedAt":"2025-09-11 08:01:12","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-7293046","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-7293046","identity":"rs-7293046","version":["v1"]},"buildId":"XKTyCvWXoU3ODBz1xrDgd","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}