Quantifying the burden of Hypercholesterolemia among Adolescents in India

Abstract   Hypercholesterolemia is a kind of hyperlipidemia in which an individual's blood contains excessive non-high-density lipoprotein (non-HDL) cholesterol and low-density lipoprotein (LDL) cholesterol, which has emerged as a significant covariate of coronary heart disease. Descriptive, bivariate and multivariable regression analyses were used to unearth the current hypercholesterolemia levels, probable risk factors, and its impact on other metabolic diseases among adolescents using data on 35,830 adolescents aged 10-19 years from the Comprehensive National Nutrition Survey, India, 2016-18. Findings suggest that the mean lipid levels for total cholesterol, LDL, HDL, and triglycerides were 140.6, 84.1, 47.3, and 95.3, respectively, with females bearing the higher burden. The study further identified early adolescents, urban residents, and overweight individuals at a higher risk of having elevated non-HDL. Western and Eastern regions bore higher LDL levels. Further, for a unit increase in TSFT risk of having high LDL increased by 2.55 times. Zinc deficits are at 2.13 times higher risk compared to zinc sufficient. Adolescents consuming unhealthy diets were at higher risk of elevated LDL. The study contends that it is essential to prevent the increasing levels of lipid profiles among Indian adolescents. Vitamin and mineral deficiencies and unhealthy dietary habits are significantly associated with high LDL and non-HDL levels. In the longer run, this might cause the early onset of complex cardiometabolic disorders, which would disrupt the individual's social and economic well-being. Hence, appropriate interventions are needed to curtail these early onsets by primarily focusing on adolescents. Key messages Present study is primarily focussed upon the cholesterol levels among adolescents in India. How this imbalance in cholesterol levels among adolescents would affect the chronic conditions among adolescents in India.

Hypercholesterolemia is a kind of hyperlipidemia in which an individual's blood contains excessive non-high-density lipoprotein (non-HDL) cholesterol and low-density lipoprotein (LDL) cholesterol, which has emerged as a significant covariate of coronary heart disease. Descriptive, bivariate and multivariable regression analyses were used to unearth the current hypercholesterolemia levels, probable risk factors, and its impact on other metabolic diseases among adolescents using data on 35,830 adolescents aged 10-19 years from the Comprehensive National Nutrition Survey, India, 2016-18. Findings suggest that the mean lipid levels for total cholesterol, LDL, HDL, and triglycerides were 140.6, 84.1, 47.3, and 95.3, respectively, with females bearing the higher burden. The study further identified early adolescents, urban residents, and overweight individuals at a higher risk of having elevated non-HDL. Western and Eastern regions bore higher LDL levels. Further, for a unit increase in TSFT risk of having high LDL increased by 2.55 times. Zinc deficits are at 2.13 times higher risk compared to zinc sufficient. Adolescents consuming unhealthy diets were at higher risk of elevated LDL. The study contends that it is essential to prevent the increasing levels of lipid profiles among Indian adolescents. Vitamin and mineral deficiencies and unhealthy dietary habits are significantly associated with high LDL and non-HDL levels.
In the longer run, this might cause the early onset of complex cardiometabolic disorders, which would disrupt the individual's social and economic well-being. Hence, appropriate interventions are needed to curtail these early onsets by primarily focusing on adolescents.

Key messages:
Present study is primarily focussed upon the cholesterol levels among adolescents in India. How this imbalance in cholesterol levels among adolescents would affect the chronic conditions among adolescents in India.
Abstract citation ID: ckac130.041 Does neighbourhood crime mediate the relationship between neighbourhood SES and birth outcomes?

Background:
Previous studies have consistently found that women living in low socioeconomic status (SES) neighbourhoods are at higher risk of experiencing adverse birth outcomes compared to women from high SES areas. However, the mechanisms through which neighbourhood SES might influence health at birth remain poorly understood. One of the proposed pathways is the exposure to higher crime rates. The aim of this study is to investigate whether neighbourhood crime mediates the relationship between neighbourhood SES and birth outcomes.

Methods:
A retrospective cohort study including over 1.3 million singleton births occurred in the Netherlands between 2010 and 2017. Individual-level data from the Dutch perinatal registry was linked to quintiles of neighbourhood SES scores and neighbourhood-level crime rates. Using the mediational gformula, we estimated the total effect, natural direct effect, and natural indirect effect of neighbourhood SES on birth outcomes: small-for-gestational-age (SGA), low birth weight, and preterm birth. The neighbourhood SES intervention settings correspond with a hypothetical improvement in neighbourhood SES from the lowest to the highest quintile.

Results:
The hypothetical improvement in neighbourhood SES resulted in a 6.6% (CI = 5.6%; 7.5%) relative reduction in the proportion of SGA births, an 8.9% (CI = 7.6%; 10.3%) reduction in the proportion of low birth weight, and a 5.1% (CI = 4.0%; 6.1%) decrease of preterm birth. Neighbourhood crime accounted for 29.0% (CI = 25.1%; 32.8%) of the total effect of neighbourhood SES on SGA, and for 8.6% (CI = 5.1%; 11.6%) of the total effect on low birth weight. For preterm birth, we found no evidence of mediation by neighbourhood crime.

Conclusions:
Neighbourhood crime mediates the association between neighbourhood SES and key adverse birth outcomes. Interventions targeted at lowering neighbourhood crime rates could improve birth outcomes in disadvantaged areas. Key messages: Neighbourhood crime mediates the association between neighbourhood SES and adverse birth outcomes in the Netherlands.
Results from this study can provide guidance to neighbourhood-level strategies aiming at improving health at birth and reducing health inequalities.