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NDSP 05: Prevalence and pattern of dyslipidemia in urban and rural areas of Pakistan; a sub analysis from second National Diabetes Survey of Pakistan (NDSP) 2016–2017

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Abstract

Objectives

Dyslipidemia is a major risk issue for the development of cardiovascular disease. The aim of our study was to observe the pattern and prevalence of dyslipidemia in Pakistani population.

Methodology

This is a sub analysis of a population based second National Diabetes Survey of Pakistan (NDSP) 2016–2017 in adults aged 20 years or above, carried out from February 2016 to August 2017 across Pakistan. Multi stage sampling technique was used for the stratification of population, based on rural and urban domains. District wise clusters and sub clusters were selected i.e. 27 and 46 in number. Subjects, consented to participate were requested to come after an overnight fast for anthropometric measurements, oral glucose tolerance test and fasting lipid profile (except for subjects with self-reported diabetes). Dyslipidemia was identified using Adult Treatment Panel III guidelines.

Results

A total of 10,834 subjects (43.8% male and 56.2% female) having mean age of 43.8 ± 14.0 years, participated in the survey. Of the subjects studied, 39.3% had hypercholesterolemia, 48.9% had hypertriglyceridemia, 39.7% had high LDL-C levels while 83.9% men and 90% women had low HDL levels. High cholesterol and triglyceride levels were highest in 50–59 years age group, while high LDL and low HDL was most common in 40–49 years age group. Diabetes, obesity and hypertension were found to be the significant determinants for dyslipidemia.

Conclusion

Prevalence of dyslipidemia seems to be very high in Pakistan, necessitating an urgent call for early screening and effective management through lifestyle intervention and appropriate lipid lowering drugs to prevent this important cardiovascular risk factor.

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Acknowledgements

We acknowledge the support of clinical research laboratory and department of research from Baqai Institute of Diabetology and Endocrinology (BIDE), Baqai Medical University, for the data management. NDSP team would also grateful to Mr. Muhammad Sohail and Mr. Abdul Rashid from PHRC, Karachi. We are thankful to all survey participants for their contribution in the second NDSP (2016-2017).

NDSP members (with surnames in alphabetical order);

1. Dr. Mujeeb Ur Rehman Abro, Assistant Professor of Medicine, Chandka Medical College, Shaheed Mohtarma Benazir Bhutto Medical University, Larkana – Sindh.

2. Dr. Khawaja Ishfaq Ahmed, Ex-PGR, Pakistan Institute of Medical Sciences, Islamabad - Punjab.

3. Dr. Khurshid Ahmed, Consultant Physician, Zahid Medical Centre, Hub - Baluchistan.

4. Prof. Ahmed Bilal, Professor and Head of Medical Department Faisalabad Medical College, Faisalabad – Punjab.

5. Dr. Anam Butt, Research Officer, Baqai Institute of Diabetology and Endocrinology, Baqai Medical University, Karachi - Sindh.

6. Prof. Bikha Ram Devrajani, Chairman, Department of Medicine and Director Sindh Institute of Endocrinology and Diabetes, Liaquat University of Medical and Health Sciences, Jamshoro - Sindh.

7. Mr. Ijaz Hayder, Research Officer, Pakistan Health Research Council, Karachi - Sindh.

8. Dr. Yasir Humayun, EPI coordinator, DHO Office, Mansehra - Khyber Pakhtunkhwa.

9. Mrs. Rabia Irshad, Research Officer, Pakistan Health Research Council, Karachi - Sindh.

10. Dr. Riasat Ali Khan, Diabetologist, Canada Medical Group Hospital, Defence, Karachi - Sindh.

11. Dr. Asima Khan, Head of Diabetes Department, Sindh Government Hospital, New Karachi, Karachi – Sindh.

12. Dr. Aamir Akram Khowaja, Postgraduate Resident, Sindh Government Qatar Hospital - Karachi - Sindh.

13. Dr. Raheela Khowaja, Postgraduate Resident, Baqai Institute of Diabetology and Endocrinology, Baqai Medical University, Karachi - Sindh.

14. Prof. Qazi Masroor, Professor of Medicine and Head of Department, Quaid-e-Azam Medical College, Bahawalpur - Punjab.

15. Dr. Maqsood Mehmood, Head of Department, Fatma tu Zahra Hospital, Gujranwala - Punjab.

16. Mr. Hassan Moin, Statistician, Baqai Institute of Diabetology and Endocrinology, Baqai Medical University, Karachi - Sindh.

17. Ms. Nida Mustafa, Statistician, Baqai Institute of Diabetology and Endocrinology, Baqai Medical University, Karachi - Sindh.

18. Dr. Wasif Noor, Diabetologist, Akhuwat Health Services Diabetes Centre, Lahore – Punjab.

19. Dr. Huma Qureshi, Ex-Director, Pakistan Health Research Council, Islamabad, Punjab.

20. Mr. Ibrar Rafique, Research Officer, Pakistan Health Research Council, Islamabad, Punjab.

21. Dr. Tahir Rasool, Diabetologist, Akhuwat Health Services Diabetes Centre, Lahore – Punjab.

22. Mrs. Rubina Sabir, Laboratory Manager, Baqai Institute of Diabetology and Endocrinology, Baqai Medical University, Karachi - Sindh.

23. Dr. M. Arif N. Saqib, Senior Research Officer, Pakistan Health Research Council, Islamabad, Punjab.

24. Dr. Pir Alam Said, Medical Specialist DHQ, Sawabi - Khyber Pakhtunkhwa.

25. Prof. Abrar Shaikh, Head Department of Medicine, Ghulam Muhammad Mahar Medical College, Sukkur – Sindh.

26. Prof. AS Shera, Secretary General, Diabetic Association of Pakistan and WHO Collaborating Centre, Karachi - Sindh.

27. Mr. Bilal Tahir, NDSP Coordinator, Baqai Institute of Diabetology and Endocrinology, Baqai Medical University, Karachi - Sindh.

28. Prof. Bilal Bin Younus, Head of Sakeena Institute of Diabetes & Endocrine Research, Lahore – Punjab.

29. Prof. Salma Tanveer, Professor of Medicine, In-charge Diabetes and Endocrinology, Nishter Medical University, Multan - Punjab.

30. Prof. Jamal Zafar, Professor of Medicine, Pakistan Institute of Medical Sciences, Islamabad – Punjab.

Funding

The funding source for the study remained same as in the second NDSP [2016–2017].3

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Contributions

AB: Concept, design, data interpretation, edited and approved the final manuscript.

SS: Concept, design, Literature search, wrote the manuscript.

MR: Concept, design, Literature search, interpretation of data, wrote the manuscript.

AF: Concept, design, interpretation of data, edited and approved the final manuscript.

NDSP members: Members were responsible for the supervision of the survey, concept, design, involved in the quality control and data management in their respective areas. All members approved the final submitted version.

Corresponding authors

Correspondence to Abdul Basit or Sobia Sabir.

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Basit, A., Sabir, S., Riaz, M. et al. NDSP 05: Prevalence and pattern of dyslipidemia in urban and rural areas of Pakistan; a sub analysis from second National Diabetes Survey of Pakistan (NDSP) 2016–2017. J Diabetes Metab Disord 19, 1215–1225 (2020). https://doi.org/10.1007/s40200-020-00631-z

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