Sex differences in the non-linear association between BMI and LDL cholesterol in middle-aged and older adults: findings from two nationally representative surveys in China

Abstract Background The relationship between body mass index (BMI) and low-density lipoprotein cholesterol (LDL-C) has not been clearly elucidated in middle-aged and older adults. This study aimed to evaluate the non-linear dose-response relationship between BMI and LDL-C in males and females. Metho...

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Autores principales:	Haibin Li, Jiahui Ma, Deqiang Zheng, Xia Li, Xiuhua Guo, Jing Wang, Pixiong Su
Formato:	article
Lenguaje:	EN
Publicado:	BMC 2021
Materias:	BMI LDL-C Nonlinear relationship Sex differences Generalized additive models Nutritional diseases. Deficiency diseases RC620-627
Acceso en línea:	https://doaj.org/article/c77602fd145a4bfbbb9a13f6144cf20b
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spelling	oai:doaj.org-article:c77602fd145a4bfbbb9a13f6144cf20b2021-11-14T12:39:47ZSex differences in the non-linear association between BMI and LDL cholesterol in middle-aged and older adults: findings from two nationally representative surveys in China10.1186/s12944-021-01591-w1476-511Xhttps://doaj.org/article/c77602fd145a4bfbbb9a13f6144cf20b2021-11-01T00:00:00Zhttps://doi.org/10.1186/s12944-021-01591-whttps://doaj.org/toc/1476-511XAbstract Background The relationship between body mass index (BMI) and low-density lipoprotein cholesterol (LDL-C) has not been clearly elucidated in middle-aged and older adults. This study aimed to evaluate the non-linear dose-response relationship between BMI and LDL-C in males and females. Methods Data was obtained from two nationally representative surveys in China—the China Health and Nutrition Survey (CHNS, 2009) and China Health and Retirement Longitudinal Study (CHARLS, 2011–2012). To evaluate the sex differences in the association between BMI and LDL-C, the generalized additive models with a smooth function for continuous BMI and smooth-factor interaction for sexes with BMI were used. Segmented regressions were fitted to calculate the slopes with different estimated breakpoints among females and males. Results A total of 12,273 participants (47.1% male) aged 45 to 75 years were included. The generalized additive models revealed that a non-linear relationship between BMI and LDL-C level in both sexes after adjustment for age, residence, education levels, marital status, drinking, smoking status, and cohort (CHNS or CHARLS). Slopes of the association between BMI and LDL-C association changed at BMI 20.3 kg/m2 (95% CI: 18.8 to 21.8) in females and 27.1 kg/m2 (95% CI: 25. 8 to 28.4) in males. Below these BMI breakpoints, LDL-C levels increased 1.84 (95% CI: 1.45 to 2.31) in males and 3.49 (95% CI: 1.54 to 5.45) mg/dL per kg/m2 in females. However, LDL-C levels declined − 1.50 (95% CI: − 2.92 to − 0.09) mg/dL per kg/m2 above BMI of 27.1 kg/m2 in males. The non-linear association BMI and LDL-C in males and females was varied by cohort source, age groups, and the number of metabolic syndrome criteria. Conclusions In the Chinese middle aged and older adults, the BMI and LDL-C relationship was inverted U-shaped with a high level of LDL-C at a BMI of 27.1 kg/m2 in males, and an approximately linear association was observed in females.Haibin LiJiahui MaDeqiang ZhengXia LiXiuhua GuoJing WangPixiong SuBMCarticleBMILDL-CNonlinear relationshipSex differencesGeneralized additive modelsNutritional diseases. Deficiency diseasesRC620-627ENLipids in Health and Disease, Vol 20, Iss 1, Pp 1-12 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	BMI LDL-C Nonlinear relationship Sex differences Generalized additive models Nutritional diseases. Deficiency diseases RC620-627
spellingShingle	BMI LDL-C Nonlinear relationship Sex differences Generalized additive models Nutritional diseases. Deficiency diseases RC620-627 Haibin Li Jiahui Ma Deqiang Zheng Xia Li Xiuhua Guo Jing Wang Pixiong Su Sex differences in the non-linear association between BMI and LDL cholesterol in middle-aged and older adults: findings from two nationally representative surveys in China
description	Abstract Background The relationship between body mass index (BMI) and low-density lipoprotein cholesterol (LDL-C) has not been clearly elucidated in middle-aged and older adults. This study aimed to evaluate the non-linear dose-response relationship between BMI and LDL-C in males and females. Methods Data was obtained from two nationally representative surveys in China—the China Health and Nutrition Survey (CHNS, 2009) and China Health and Retirement Longitudinal Study (CHARLS, 2011–2012). To evaluate the sex differences in the association between BMI and LDL-C, the generalized additive models with a smooth function for continuous BMI and smooth-factor interaction for sexes with BMI were used. Segmented regressions were fitted to calculate the slopes with different estimated breakpoints among females and males. Results A total of 12,273 participants (47.1% male) aged 45 to 75 years were included. The generalized additive models revealed that a non-linear relationship between BMI and LDL-C level in both sexes after adjustment for age, residence, education levels, marital status, drinking, smoking status, and cohort (CHNS or CHARLS). Slopes of the association between BMI and LDL-C association changed at BMI 20.3 kg/m2 (95% CI: 18.8 to 21.8) in females and 27.1 kg/m2 (95% CI: 25. 8 to 28.4) in males. Below these BMI breakpoints, LDL-C levels increased 1.84 (95% CI: 1.45 to 2.31) in males and 3.49 (95% CI: 1.54 to 5.45) mg/dL per kg/m2 in females. However, LDL-C levels declined − 1.50 (95% CI: − 2.92 to − 0.09) mg/dL per kg/m2 above BMI of 27.1 kg/m2 in males. The non-linear association BMI and LDL-C in males and females was varied by cohort source, age groups, and the number of metabolic syndrome criteria. Conclusions In the Chinese middle aged and older adults, the BMI and LDL-C relationship was inverted U-shaped with a high level of LDL-C at a BMI of 27.1 kg/m2 in males, and an approximately linear association was observed in females.
format	article
author	Haibin Li Jiahui Ma Deqiang Zheng Xia Li Xiuhua Guo Jing Wang Pixiong Su
author_facet	Haibin Li Jiahui Ma Deqiang Zheng Xia Li Xiuhua Guo Jing Wang Pixiong Su
author_sort	Haibin Li
title	Sex differences in the non-linear association between BMI and LDL cholesterol in middle-aged and older adults: findings from two nationally representative surveys in China
title_short	Sex differences in the non-linear association between BMI and LDL cholesterol in middle-aged and older adults: findings from two nationally representative surveys in China
title_full	Sex differences in the non-linear association between BMI and LDL cholesterol in middle-aged and older adults: findings from two nationally representative surveys in China
title_fullStr	Sex differences in the non-linear association between BMI and LDL cholesterol in middle-aged and older adults: findings from two nationally representative surveys in China
title_full_unstemmed	Sex differences in the non-linear association between BMI and LDL cholesterol in middle-aged and older adults: findings from two nationally representative surveys in China
title_sort	sex differences in the non-linear association between bmi and ldl cholesterol in middle-aged and older adults: findings from two nationally representative surveys in china
publisher	BMC
publishDate	2021
url	https://doaj.org/article/c77602fd145a4bfbbb9a13f6144cf20b
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Sex differences in the non-linear association between BMI and LDL cholesterol in middle-aged and older adults: findings from two nationally representative surveys in China

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