Cholesterol distribution among adults in Nigeria: A descriptive cross-sectional study in a rural tertiary hospital

Background There is an increasing burden of cardiovascular disease in the Nigerian population, but very little known about the cholesterol distribution within subgroups of the general population.

A cross-sectional study of adults was done in a tertiary hospital in the Southern region of Nigeria. Using results of blood tests over an 8-month period, the cholesterol distribution and prevalence of dyslipidaemias were determined.

A total of 46.8% of patients had raised total cholesterol (mean total cholesterol 198.93mg/dl (SD 57.81)), 14.6% had raised low-density lipoprotein cholesterol (LDL-C) (mean LDL-C 120.83mg/dl (SD 51.62)), and 27.9% of patients had raised triglycerides (mean triglycerides 128.83mg/dl (SD 75.26). Women had higher mean values than men, of total cholesterol (203.3mg/dl vs 193.4mg/dl), LDL-C (125.1mg/dl vs 115.5mg/dl), and non-HDL cholesterol (148.4mg/dl vs 141.1mg/dl). The 95th percentile values of total cholesterol and LDL-C in the general population were 294mg/dl (7.6mmol/L) and 205.7mg/dl (5.3mmol/L) respectively.

Hypercholesterolaemia is highly prevalent in the Nigerian general population, with a higher prevalence in women compared to men. The 95th percentile identified is likely to represent the thresholds associated with elevated risk of atherosclerotic cardiovascular disease risk within this population. What is already known on this topic There is a rising prevalence of cardiovascular disease (CVD) and CVD-related deaths in Nigeria, and a pressing need for targeted strategies and interventions to reduce this burden. However, there is lack of robust evidence on cholesterol distribution within subgroups of the Nigerian population. What this study adds This study described the distribution of cholesterol concentration in Nigerian adults by sex and age groups, and also determined the cholesterol 95th percentile thresholds which are likely to be associated with elevated risks of atherosclerotic cardiovascular disease risk within this population How this study might affect research, practice or policy Evidence from this study will aid appropriate targeting of interventions to reduce the burden of hypercholesterolaemia and consequent risk of atherosclerotic cardiovascular disease. Competing Interest Statement The authors have declared no competing interest. Funding Statement The author(s) received no specific funding for this work. Author Declarations I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained. Yes The details of the IRB/oversight body that provided approval or exemption for the research described are given below: Ethical approval for this study was granted by the ISTH Human Research and Ethics Committee (approval ID ISTH/HREC/20222609379). Medical records of patients were accessed retrospectively on 26 February 2023 and the study authors only had access to the fully anonymised records I confirm that all necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived, and that any patient/participant/sample identifiers included were not known to anyone (e.g., hospital staff, patients or participants themselves) outside the research group so cannot be used to identify individuals. Yes I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance). Yes I have followed all appropriate research reporting guidelines, such as any relevant EQUATOR Network research reporting checklist(s) and other pertinent material, if applicable. Yes Data Availability Data cannot be shared publicly, but may be made available on request from the ISTH Human Research and Ethics Committee for researchers who meet the criteria for access to confidential data.