The Demographic and Lifestyle Char-acteristics of Patients with Familial Hypercholesterolemia Referred to a Dyslipidemia Clinic: A Cross-Sectional Single-Center Study
,
Abstract
Background: Familial hypercholesterolemia (FH) is one of the most prevalent dyslipidemia disorders. This study investigated the demographic and lifestyle characteristics of patients with FH referred to a dyslipidemia clinic.
Methods: This 5-year, single-center cross-sectional study focused on patients with low-density lipoprotein cholesterol (LDL-C) levels higher than 190 mg/dL referred to a dyslipidemia clinic in Tehran, Iran, between 2017 and 2022. The study examined their demographics, physical activity, and anxiety within the FH cohort.
Results: A total of 1724 patients were referred to the dyslipidemia clinic. Of these patients, 44 were diagnosed with definite FH. The mean age and LDL-C level of the FH cohort were 38.84±16.85 years and 315.95±81.73 mg/dL, respectively. A significant correlation was found between LDL-C and body mass index (BMI) (correlation coefficient = -0.31, P=0.031) and total sleep duration (correlation coefficient = -0.40, P<0.000). No correlation was observed between age and physical activity or LDL-C levels. Additionally, no significant correlation was detected between the Dutch score and patients’ LDL-C, BMI, age, or physical activity. Regression analysis indicated that BMI and total sleep duration were independent predictors of LDL-C in the FH cohort.
Conclusion: Investigating and identifying patients’ demographic and lifestyle characteristics is the first step in planning efficient and effective management strategies for chronic diseases, such as FH. Establishing a patient registry for chronic diseases enhances understanding of the target population and enables healthcare providers to design and implement appropriate preventive and control strategies.
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2. Zheng J, Wang J, Zhang Y, Xia J, Guo H, Hu H, Shan P, Li T. The Global Burden of Diseases attributed to high low-density lipoprotein cholesterol from 1990 to 2019. Front Public Health 2022;10:891929.
3. Pirillo A, Casula M, Olmastroni E, Norata GD, Catapano AL. Global epidemiology of dyslipidaemias. Nat Rev Cardiol 2021;18:689-700.
4. Brunham LR, Trinder M. Polygenic risk scores for the diagnosis and management of dyslipidemia. Curr Opin Endocrinol Diabetes Obes 2022;29:95-100.
5. Ali N, Samadder M, Kathak RR, Islam F. Prevalence and factors associated with dyslipidemia in Bangladeshi adults. PLoS One 2023;18:e0280672.
6. Tada H, Kurashina T, Ogura M, Takegami M, Miyamoto Y, Arai H, Harada-Shiba M, Ishibashi S. Prospective Registry Study of Primary Dyslipidemia (PROLIPID): Rationale and Study Design. J Atheroscler Thromb 2022;29:953-969.
7. Chacón-Camacho OF, Pozo-Molina G, Méndez-Catalá CF, Reyes-Reali J, Méndez-Cruz R, Zenteno JC. Familial Hypercholesterolemia: Update and Review. Endocr Metab Immune Disord Drug Targets 2022;22:198-211.
8. Beheshti SO, Madsen CM, Varbo A, Nordestgaard BG. Worldwide Prevalence of Familial Hypercholesterolemia: Meta-Analyses of 11 Million Subjects. J Am Coll Cardiol 2020;75:2553-2566.
9. Al-Waili K, Al-Rasadi K, Zadjali F, Al-Hashmi K, Al-Mukhaini S, Al-Kindi M, Al-Sabti H, Al-Hinai AT, Farhan H, Al-Zakwani I. Clinical and Genetic Characteristics of Familial Hypercholesterolemia at Sultan Qaboos University Hospital in Oman. Oman Med J 2020;35:e141.
10. Varghese MJ. Familial hypercholesterolemia: A review. Ann Pediatr Cardiol 2014;7:107-117.
11. Thongtang N, Sukmawan R, Llanes EJB, Lee ZV. Dyslipidemia management for primary prevention of cardiovascular events: Best in-clinic practices. Prev Med Rep 2022;27:101819.
12. WHO Human Genetics Programme. (1999). Familial hypercholesterolaemia (FH): report of a second WHO consultation, Geneva, 4 September 1998. World Health Organization. https://iris.who.int/handle/10665/66346 (2023-06-12).
13. Craig CL, Marshall AL, Sjöström M, Bauman AE, Booth ML, Ainsworth BE, Pratt M, Ekelund U, Yngve A, Sallis JF, Oja P. International physical activity questionnaire: 12-country reliability and validity. Med Sci Sports Exerc 2003;35:1381-1395.
14. Vasheghani-Farahani A, Tahmasbi M, Asheri H, Ashraf H, Nedjat S, Kordi R. The Persian, last 7-day, long form of the International Physical Activity Questionnaire: translation and validation study. Asian J Sports Med 2011;2:106-116.
15. Zigmond AS, Snaith RP. The hospital anxiety and depression scale. Acta Psychiatr Scand 1983;67:361-370.
16. Bjelland I, Dahl AA, Haug TT, Neckelmann D. The validity of the Hospital Anxiety and Depression Scale. An updated literature review. J Psychosom Res 2002;52:69-77.
17. Montazeri A, Vahdaninia M, Ebrahimi M, Jarvandi S. The Hospital Anxiety and Depression Scale (HADS): translation and validation study of the Iranian version. Health Qual Life Outcomes 2003;1:14.
18. Toft-Nielsen F, Emanuelsson F, Benn M. Familial Hypercholesterolemia Prevalence Among Ethnicities-Systematic Review and Meta-Analysis. Front Genet 2022;13:840797.
19. Hu P, Dharmayat KI, Stevens CAT, Sharabiani MTA, Jones RS, Watts GF, Genest J, Ray KK, Vallejo-Vaz AJ. Prevalence of Familial Hypercholesterolemia Among the General Population and Patients With Atherosclerotic Cardiovascular Disease: A Systematic Review and Meta-Analysis. Circulation 2020;141:1742-1759.
20. Beheshti SO, Madsen CM, Varbo A, Nordestgaard BG. Worldwide Prevalence of Familial Hypercholesterolemia: Meta-Analyses of 11 Million Subjects. J Am Coll Cardiol 2020;75:2553-2566.
21. Vaseghi G, Taheri M, Heshmat-Ghahdarijani K, Rayati M, Zarfeshani S, Pourmoghaddas A, Khosravi A, Zarepour E, Keshavarzrad P, Arabi S, Azizi M, Haghjooy Javanmard S, Najafian J, Sarrafzadegan N. Familial Hypercholesterolemia (FH) in Iran: Findings from the Four-Year FH Registry. J Lipids 2021;2021:9913969.
22. Baila-Rueda L, Cenarro A, Lamiquiz-Moneo I, Perez-Calahorra S, Bea AM, Marco-Benedí V, Jarauta E, Mateo-Gallego R, Civeira F. Cholesterol oversynthesis markers define familial combined hyperlipidemia versus other genetic hypercholesterolemias independently of body weight. J Nutr Biochem 2018;53:48-57.
23. Vlad CE, Foia L, Florea L, Costache II, Covic A, Popescu R, Reurean-Pintilei D, Covic A. Evaluation of cardiovascular risk factors in patients with familial hypercholesterolemia from the North-Eastern area of Romania. Lipids Health Dis 2021;20:4.
24. Kuman Tunçel Ö, Kayıkçıoğlu M, Pırıldar Ş, Yılmaz M, Kaynar L, Aktan M, Durmuş RB, Gökçe C, Temizhan A, Özcebe Oİ, Karaağaç Akyol T, Okutan H, Sağ S, Öz Gül Ö, Yenerçağ M, Altunkeser BB, Kuku İ, Yılmaz Yaşar H, Kurtoğlu E, Demircioğlu S, Pekkolay Z, İlhan O, Tokgözoğlu L. Mental status and physical activity in patients with homozygous familial hypercholesterolemia: A subgroup analysis of a nationwide survey (A-HIT1 registry). J Clin Lipidol 2020;14:361-370.e2.
25. Kinnear FJ, Lithander FE, Searle A, Bayly G, Wei C, Stensel DJ, Thackray AE, Hunt L, Shield JPH. Reducing cardiovascular disease risk among families with familial hypercholesterolaemia by improving diet and physical activity: a randomised controlled feasibility trial. BMJ Open 2020;10:e044200.
26. Jones LK, Brownson RC, Williams MS. Applying implementation science to improve care for familial hypercholesterolemia. Curr Opin Endocrinol Diabetes Obes 2022;29:141-151.
27. Beyece İncazli S, Özer S, Kayikçioğlu M. Evaluation of the Effectiveness of Individually Tailored Lifestyle Intervention in Patients With Familial Hypercholesterolemia. J Cardiovasc Nurs 2022;37:465-474.
28. Alothman L, Bélanger AM, Ruel I, Brunham LR, Hales L, Genest J, Akioyamen LE. Health-related quality of life in homozygous familial hypercholesterolemia: A systematic review and meta-analysis. J Clin Lipidol 2022;16:52-65.
29. Kinnear FJ, Wainwright E, Perry R, Lithander FE, Bayly G, Huntley A, Cox J, Shield JP, Searle A. Enablers and barriers to treatment adherence in heterozygous familial hypercholesterolaemia: a qualitative evidence synthesis. BMJ Open 2019;9:e030290.
30. Chan MF, Ganesh A, Mahadevan S, Shamli SA, Al-Waili K, Al-Mukhaini S, Al-Rasadi K, Al-Adawi S. A Comprehensive Neuropsychological Study of Familial Hypercholesterolemia and Its Relationship with Psychosocial Functioning: A Biopsychosocial Approach. Brain Sci 2022;12:1127.
2. Zheng J, Wang J, Zhang Y, Xia J, Guo H, Hu H, Shan P, Li T. The Global Burden of Diseases attributed to high low-density lipoprotein cholesterol from 1990 to 2019. Front Public Health 2022;10:891929.
3. Pirillo A, Casula M, Olmastroni E, Norata GD, Catapano AL. Global epidemiology of dyslipidaemias. Nat Rev Cardiol 2021;18:689-700.
4. Brunham LR, Trinder M. Polygenic risk scores for the diagnosis and management of dyslipidemia. Curr Opin Endocrinol Diabetes Obes 2022;29:95-100.
5. Ali N, Samadder M, Kathak RR, Islam F. Prevalence and factors associated with dyslipidemia in Bangladeshi adults. PLoS One 2023;18:e0280672.
6. Tada H, Kurashina T, Ogura M, Takegami M, Miyamoto Y, Arai H, Harada-Shiba M, Ishibashi S. Prospective Registry Study of Primary Dyslipidemia (PROLIPID): Rationale and Study Design. J Atheroscler Thromb 2022;29:953-969.
7. Chacón-Camacho OF, Pozo-Molina G, Méndez-Catalá CF, Reyes-Reali J, Méndez-Cruz R, Zenteno JC. Familial Hypercholesterolemia: Update and Review. Endocr Metab Immune Disord Drug Targets 2022;22:198-211.
8. Beheshti SO, Madsen CM, Varbo A, Nordestgaard BG. Worldwide Prevalence of Familial Hypercholesterolemia: Meta-Analyses of 11 Million Subjects. J Am Coll Cardiol 2020;75:2553-2566.
9. Al-Waili K, Al-Rasadi K, Zadjali F, Al-Hashmi K, Al-Mukhaini S, Al-Kindi M, Al-Sabti H, Al-Hinai AT, Farhan H, Al-Zakwani I. Clinical and Genetic Characteristics of Familial Hypercholesterolemia at Sultan Qaboos University Hospital in Oman. Oman Med J 2020;35:e141.
10. Varghese MJ. Familial hypercholesterolemia: A review. Ann Pediatr Cardiol 2014;7:107-117.
11. Thongtang N, Sukmawan R, Llanes EJB, Lee ZV. Dyslipidemia management for primary prevention of cardiovascular events: Best in-clinic practices. Prev Med Rep 2022;27:101819.
12. WHO Human Genetics Programme. (1999). Familial hypercholesterolaemia (FH): report of a second WHO consultation, Geneva, 4 September 1998. World Health Organization. https://iris.who.int/handle/10665/66346 (2023-06-12).
13. Craig CL, Marshall AL, Sjöström M, Bauman AE, Booth ML, Ainsworth BE, Pratt M, Ekelund U, Yngve A, Sallis JF, Oja P. International physical activity questionnaire: 12-country reliability and validity. Med Sci Sports Exerc 2003;35:1381-1395.
14. Vasheghani-Farahani A, Tahmasbi M, Asheri H, Ashraf H, Nedjat S, Kordi R. The Persian, last 7-day, long form of the International Physical Activity Questionnaire: translation and validation study. Asian J Sports Med 2011;2:106-116.
15. Zigmond AS, Snaith RP. The hospital anxiety and depression scale. Acta Psychiatr Scand 1983;67:361-370.
16. Bjelland I, Dahl AA, Haug TT, Neckelmann D. The validity of the Hospital Anxiety and Depression Scale. An updated literature review. J Psychosom Res 2002;52:69-77.
17. Montazeri A, Vahdaninia M, Ebrahimi M, Jarvandi S. The Hospital Anxiety and Depression Scale (HADS): translation and validation study of the Iranian version. Health Qual Life Outcomes 2003;1:14.
18. Toft-Nielsen F, Emanuelsson F, Benn M. Familial Hypercholesterolemia Prevalence Among Ethnicities-Systematic Review and Meta-Analysis. Front Genet 2022;13:840797.
19. Hu P, Dharmayat KI, Stevens CAT, Sharabiani MTA, Jones RS, Watts GF, Genest J, Ray KK, Vallejo-Vaz AJ. Prevalence of Familial Hypercholesterolemia Among the General Population and Patients With Atherosclerotic Cardiovascular Disease: A Systematic Review and Meta-Analysis. Circulation 2020;141:1742-1759.
20. Beheshti SO, Madsen CM, Varbo A, Nordestgaard BG. Worldwide Prevalence of Familial Hypercholesterolemia: Meta-Analyses of 11 Million Subjects. J Am Coll Cardiol 2020;75:2553-2566.
21. Vaseghi G, Taheri M, Heshmat-Ghahdarijani K, Rayati M, Zarfeshani S, Pourmoghaddas A, Khosravi A, Zarepour E, Keshavarzrad P, Arabi S, Azizi M, Haghjooy Javanmard S, Najafian J, Sarrafzadegan N. Familial Hypercholesterolemia (FH) in Iran: Findings from the Four-Year FH Registry. J Lipids 2021;2021:9913969.
22. Baila-Rueda L, Cenarro A, Lamiquiz-Moneo I, Perez-Calahorra S, Bea AM, Marco-Benedí V, Jarauta E, Mateo-Gallego R, Civeira F. Cholesterol oversynthesis markers define familial combined hyperlipidemia versus other genetic hypercholesterolemias independently of body weight. J Nutr Biochem 2018;53:48-57.
23. Vlad CE, Foia L, Florea L, Costache II, Covic A, Popescu R, Reurean-Pintilei D, Covic A. Evaluation of cardiovascular risk factors in patients with familial hypercholesterolemia from the North-Eastern area of Romania. Lipids Health Dis 2021;20:4.
24. Kuman Tunçel Ö, Kayıkçıoğlu M, Pırıldar Ş, Yılmaz M, Kaynar L, Aktan M, Durmuş RB, Gökçe C, Temizhan A, Özcebe Oİ, Karaağaç Akyol T, Okutan H, Sağ S, Öz Gül Ö, Yenerçağ M, Altunkeser BB, Kuku İ, Yılmaz Yaşar H, Kurtoğlu E, Demircioğlu S, Pekkolay Z, İlhan O, Tokgözoğlu L. Mental status and physical activity in patients with homozygous familial hypercholesterolemia: A subgroup analysis of a nationwide survey (A-HIT1 registry). J Clin Lipidol 2020;14:361-370.e2.
25. Kinnear FJ, Lithander FE, Searle A, Bayly G, Wei C, Stensel DJ, Thackray AE, Hunt L, Shield JPH. Reducing cardiovascular disease risk among families with familial hypercholesterolaemia by improving diet and physical activity: a randomised controlled feasibility trial. BMJ Open 2020;10:e044200.
26. Jones LK, Brownson RC, Williams MS. Applying implementation science to improve care for familial hypercholesterolemia. Curr Opin Endocrinol Diabetes Obes 2022;29:141-151.
27. Beyece İncazli S, Özer S, Kayikçioğlu M. Evaluation of the Effectiveness of Individually Tailored Lifestyle Intervention in Patients With Familial Hypercholesterolemia. J Cardiovasc Nurs 2022;37:465-474.
28. Alothman L, Bélanger AM, Ruel I, Brunham LR, Hales L, Genest J, Akioyamen LE. Health-related quality of life in homozygous familial hypercholesterolemia: A systematic review and meta-analysis. J Clin Lipidol 2022;16:52-65.
29. Kinnear FJ, Wainwright E, Perry R, Lithander FE, Bayly G, Huntley A, Cox J, Shield JP, Searle A. Enablers and barriers to treatment adherence in heterozygous familial hypercholesterolaemia: a qualitative evidence synthesis. BMJ Open 2019;9:e030290.
30. Chan MF, Ganesh A, Mahadevan S, Shamli SA, Al-Waili K, Al-Mukhaini S, Al-Rasadi K, Al-Adawi S. A Comprehensive Neuropsychological Study of Familial Hypercholesterolemia and Its Relationship with Psychosocial Functioning: A Biopsychosocial Approach. Brain Sci 2022;12:1127.
| Files | ||
| Issue | Vol 19 No 3 (2024): J Teh Univ Heart Ctr | |
| Section | Original Article(s) | |
| DOI | https://doi.org/10.18502/jthc.v19i3.16862 | |
| Keywords | ||
| Familial hypercholesterolemia Hyperlipoproteinemia Type II Dyslipidemia | ||
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How to Cite
1.
Moshkani Farahani M, Samiei Nasr D, Nasiri A, Soltanpour J. The Demographic and Lifestyle Char-acteristics of Patients with Familial Hypercholesterolemia Referred to a Dyslipidemia Clinic: A Cross-Sectional Single-Center Study. J Tehran Heart Cent. 2024;19(3):192-197.
