• Users Online: 70
  • Print this page
  • Email this page


 
 Table of Contents  
ORIGINAL ARTICLE
Year : 2016  |  Volume : 1  |  Issue : 2  |  Page : 12-19

Screening for dyslipdemia among Saudi adults attending a primary health care in Saudi Arabia


Associate Professor, Family and Community Medicine Department, College of Medicine, King Khalid University, Abha, Kingdom of Saudi Arabia

Date of Web Publication8-Aug-2020

Correspondence Address:
MD, ABFM Hassan M Al-Musa
Associate Professor and Chairman Department of Family& Community Medicine, College of Medicine, King Khalid University, P.O. Box 641, Abha
Kingdom of Saudi Arabia
Login to access the Email id

Source of Support: None, Conflict of Interest: None


DOI: 10.4103/1658-743X.291740

Rights and Permissions
  Abstract 


Objectives: To assess the prevalence of dyslipidemia and to identify its association with obesity among Saudi adults attending a primary health care center in Abha City, Saudi Arabia. Subjects and Methods: This study followed a cross-sectional study design. A consecutive sample was applied to screen 457 apparently healthy Saudi adults aged above 20 years. Participants’ weight and height were assessed and their body mass index (BMI) was calculated. Results: Regarding dyslipidemia, 17.3% had hypercholesterolemia, 5% had hypertriglyceridemia, 47.9% had low HDL-C serum levels, 17.9% had high LDL-C serum levels, 12.3% had TC/HDL-C ratio >6, 30.9% had TG/HDL-C ratio >3.8 and 23.2% had LDL-C/HDL-C ratio >3.3. Male participants had significantly higher proportions of hypercholesterolemia, high LDL-C and TC/HDL-C ratio than females (20.9% and 10.9%, respectively, p=0.007 for hypercholesterolemia; 20.9%; and 12.7%, respectively, p=0.029 for high LDL-C and 15.8% and 6.1%, respectively, p=0.002 for TC/HDL-C). LDL-C serum levels were lowest among elderly participants and highest among youngest participants (p=0.007). Hypercholesterolemia, hypertriglyceridemia, LDL-C, TC/HDL-C ratio, TG/HDL-C ratio and LDL-C/HDL-C ratio were highest among obese and overweight participants (29.1% and 14.2%, respectively, p<0.001 for hypercholesterolemia; 8.2% and 5.3%, respectively, p=0.018 for hypertriglyceridemia; 26.9% and 14.2%, respectively, p=0.006, for LDL-C; 18.7% and 11.9%, respectively, p=0.004, for TC/HDL-C; 40.3% and 28.3%, respectively, p=0.014 for TG/HDL-C ratio; and 31.3% and 24.3%, respectively, p<0.001 for LDL-C/HDL-C ratio). Participants’ HDL-C and LDL-C serum levels differed significantly according to their family history of dyslipidemia (p=0.046 and p<0.001, respectively). Conclusions: Prevalence of dyslipidemia is high among Saudi adults attending primary health care centers, especially among males, obese and elderly subjects in addition to those with positive family history of dyslipidemia. Community-based intervention strategies are needed to prevent and manage cardiovascular risk factors. Health education for attendants of primary health care centers regarding healthier lifestyles should be emphasized.

Keywords: Dyslipidemia, Screening, Risk factors, Obesity and Overweight, Saudi Arabia.


How to cite this article:
Al-Musa HM. Screening for dyslipdemia among Saudi adults attending a primary health care in Saudi Arabia. King Khalid Univ J Health Sci 2016;1:12-9

How to cite this URL:
Al-Musa HM. Screening for dyslipdemia among Saudi adults attending a primary health care in Saudi Arabia. King Khalid Univ J Health Sci [serial online] 2016 [cited 2021 Sep 27];1:12-9. Available from: https://www.kkujhs.org/text.asp?2016/1/2/12/291740




  Introduction Top


Dyslipidemia is one of the most important risk factors for many chronic non-communicable diseases, including coronary heart disease and stroke, resulting in serious morbidity and mortality, and medical costs.[1],[2],[3]

It may be manifested by elevated blood levels of total cholesterol, the “bad” low-density lipoprotein cholesterol (LDL-C), cholesterol and the triglyceride concentrations, and the decrease in the “good” high-density lipoprotein-cholesterol (HDL-C) cholesterol concentrations.[4]

In recent decades, dyslipidemia has become apparent in the Kingdom of Saudi Arabia (KSA), as a result of the economic growth and associated sociodemographic, dietary, and lifestyle changes coupled with a reduced burden of infectious diseases.[5]

Screening for dyslipidemia is essential for early detection and proper management of lipid disorders. This will enable preventing the development of atherosclerotic plaques and would greatly minimize existing plaques. Moreover, the assessment of lipid profile allows the identification of asymptomatic adults who are eligible for cholesterol-lowering therapy. The preferred screening tests for dyslipidemia are total cholesterol (TC) and high-density lipoprotein cholesterol (HDL-C). A complete fasting lipoprotein panel (i.e., TC, HDL-C, low-density lipoprotein cholesterol [LDL-C] and triglycerides [TG]) is useful for persons with dyslipidemia identified through TC and HDL-C screening tests.[6]

Elevated body mass index is the leading risk factor for disability-adjusted life years in the Kingdom of Saudi Arabia (KSA).[7] The dramatic increase in the prevalence of obesity in KSA is linked to changes in lifestyle associated with modernization and socioeconomic development. Therefore, adverse changes in the profile of blood lipids are quite expected. Nevertheless, only few studies have addressed the issue of dyslipidemia in Saudi Arabia and its association with obesity.[8],[9],[10],[11]

This study aimed to assess the prevalence of dyslipidemia and to identify its association with obesity among the Saudi adults attending a primary health care center in Abha City.


  Subjects and Methods Top


This study was conducted during 2015 in Abha City, Kingdom of Saudi Arabia. Following a cross-sectional study design, a consecutive sample was followed to screen 457 apparently healthy Saudi adults aged above 20 years, who were registered at SPC Clinic Al Dabab, Abha, Saudi Arabia.

A data collection sheet was constructed by the researcher which comprised personal data (age and gender); participants’ lipid profile according to the available investigations at the primary health care center laboratory, i.e., TC, HDL-C, LDL-C and triglycerides; in addition to participants’ anthropometric measurements (i.e., weight and height).

Dyslipidemia among participants was considered according to Cortez-Diasa et al. (2013),[12] with hypercholesterolemia (TC ≥200 mg/dl); LDL-C (#130 mg/dl), hypertriglyceridemia (≥200 mg/dl); low HDL-C (<40 mg/dl).

Moreover, TC/HDL-C TG/HDL-C and LDL-C/HDL-C ratios were calculated. These calculated ratios are good predictors of a positive response to lipid-lowering intervention. High levels were observed for TC/HDL-C ratio (>6), high TG/HDL-C ratio (>3.8) and high LDL-C/HDL-C ratio (>3.3).[13]

Anthropometric measurements included participants’ (weight [in kg] and height [in m]), using a weighing scale and a measuring tape, respectively. All measurements were taken by the researcher. Body mass index (BMI) was calculated according to Ugwuja (2013)[14] in kg/m2. Based on the values of BMI, the participants were classified as underweight (BMI < 18.5 kg m2), normal (BMI 18.5-24.9 kg/m2), overweight (BMI 25-29.9 kg/m2) and obese (BMI > 30 kg/m2).

Collected data were analyzed using the Statistical Package for Social Sciences (SPSS, version 22). Descriptive statistics were calculated. Chi square test was applied to test significance of differences between categorical variables. Bivariate analysis was applied using the Chi square test. Level of significance was set at 0.05.


  Results Top


[Table 1] shows that the age of about half of participants (50.5%) was 40-60 years, while 30.4% aged <40 years and 19% aged >60 years. About two thirds of participants (63.9%) were males. About half of participants (49.5%) were overweight while 29.3% were obese. Almost one fourth of participants (22.3%) had positive family history of dyslipidemia among first degree relatives.
Table 1: Personal characteristics of study sample

Click here to view


[Table 2] shows that 17.3% had hypercholesterolemia (i.e., >200 mg/dl), 5% had hypertriglyceridemia (i.e., >200 mg/dl), 47.9% had low HDL-C serum levels (i.e., <40 mg/dl), 17.9% had high LDL-C serum levels (i.e., >130 mg/dl), and 12.3% had TC/HDL-C ratio >6, 30.9% had TG/HDL-C ratio >3.8 and 23.2% had LDL-C/HDL-C ratio >3.3.
Table 2: Lipid profile serum levels of participants

Click here to view


[Table 3] shows that male participants had significantly higher proportion of hypercholesterolemia than female participants (20.9% and 10.9%, respectively, p=0.007). Similarly, male participants had significantly higher proportion of high LDL-C than female participants (20.9% and 12.7%, respectively, p=0.029). Moreover, male participants had significantly higher proportion of TC/HDL-C ratio than female participants (15.8% and 6.1%, respectively, p=0.002). Triglycerides, HDL serum levels TG/HDL-C ratio and LDL-C/HDL-C ratio did not differ significantly according to participants’ gender.
Table 3: Lipid profile serum levels of participants according to their gender

Click here to view


[Table 4] shows that LDL-C serum levels were lowest among elderly participants (i.e., aged >60 years and highest among youngest participants (p=0.007). Total cholesterol, triglycerides, HDL-C, TC/HDL-C ratio and TG/HDL-C ratio and LDL-C/HDL-C ratio did not differ significantly according to participants’ age groups.
Table 4: Lipid profile serum levels of Participants according to their age groups

Click here to view


[Table 5] shows that hypercholesterolemia was highest among obese and overweight participants (29.1% and 14.2%, respectively, p<0.001). Similarly, hypertriglyceridemia was highest among obese and overweight participants (8.2% and 5.3%, respectively, p=0.018). Moreover, HDL-C was lowest among obese and overweight participants (58.2% and 48.7%, respectively, p<0.001). In addition, LDL-C was highest among obese and overweight participants (26.9% and 14.2%, respectively, p=0.006). Finally, TC/HDL-C ratio was highest among obese and overweight participants (18.7% and 11.9%, respectively, p=0.004), TG/HDL-C ratio was highest among obese and overweight participants (40.3% and 28.3%, respectively, p=0.014) and LDL-C/HDL-C ratio was highest among obese and overweight participants (31.3% and 24.3%, respectively, p<0.001).
Table 5: Lipid profile serum levels of participants according to their grades of body mass index

Click here to view


[Table 6] shows that participants’ HDL-C serum levels differed significantly according to their family history of dyslipidemia, with lower proportion among those with positive family history than those with negative family history (39.2% and 50.4%, respectively, p=0.046). Moreover, participants’ LDL-C serum levels differed significantly according to their family history of dyslipidemia, with higher proportion among those with positive family history than those with negative family history (37.2% and 12.4%, respectively, p<0.001). However, there were no significant differences between participants with positive family history of dyslipidemia and those with negative family history of dyslipidemia regarding their serum levels of TC, TG, TC/HDL-C ratio, TG/HDL-C ratio, or LDL/HDL-C ratio.
Table 6: Lipid profile serum levels of participants according to their family history of dyslipidemia

Click here to view



  Discussion Top


This study revealed a high prevalence of overweight and obesity among adult Saudi attendants of primary health care centers, who represent the Saudi population in Abha City. Almost half of the study sample (49.5%) were overweight while 29.3% were obese.

This finding is in agreement with several studies which revealed that overweight and obesity affect more than 75% of adult Saudi population.[15],[16],[17]

DeNicola et al. (2015)[18] explained this finding by stating that, over the past few decades, the Kingdom of Saudi Arabia has become progressively westernized and has currently obtained one of the highest prevalence rates of overweight and obesity. Modern cultural changes and the recent economic prosperity have created an “obesogenic” environment in Saudi Arabia.

Findings of this study showed that dyslipidemia is prevalent among participants. Almost half of participants (47.9%) had low serum levels of HDL-C while 17.9% had high serum levels of LDL-C and hypercholesterolemia was present among 17.3% of them.

These findings are in agreement with those reported by several researchers, who reported that prevalence of dyslipidemia among Saudi adults ranged from 20% to 44%.[8],[9],[10]

Khader et al. (2010)[19] reported that, among Adult Jordanian population, 48.8% had high TC level, 40.7% had high LDL-C, 40.1% had low HDL-C, 43.6% had high triglyceride levels

Erem et al. (2008)[20] reported that, regarding dyslipidemia among the Turkish adults, the prevalence rates for hypercholesterolemia, elevated LDL-C, low HDL-C, and hypertriglyceridemia were 37.5%, 44.5%, 21.1%, and 30.4%, respectively.

In Rio de Janeiro, Brazil, de Souza et al. (2003)[21] found that prevalence rates for hypercholesterolemia was 4.2%; for elevated LDL-C was 3.5%, for low HDL-C was 18.3%, while for hypertriglyceridemia was 17.1%.

Variations in prevalence rates of dyslipidemia were reported in several studies.[8],[15],[21],[22] This relatively large range in reported prevalence rates of dyslipidemia may be due to differences in definitions, followed methodologies, socioeconomic status, or study populations.

Results of the present study revealed that dyslipidemia differed significantly according to some personal characteristics of participants. Male participants had significantly higher proportion of hypercholesterolemia and a higher proportion of serum LDL. Moreover, male participants had higher proportion of TC/HDL-C ratio than females. Moreover, LDL-C serum levels were lowest among elderly participants.

Khader et al. (2010)[19] found that men were more likely to have high triglycerides and low HDL serum levels than women. Moreover, Al-Kaabba et al. (2012)[5] noted that about one third of males had high TC/HDL-C ratio, with the highest levels occurring between ages 45 - 54 years, indicating that elderly males are at higher risk of developing coronary disease. Nevertheless, several studies reported no significant difference in the prevalence of high LDL-C levels between males and females.[5],[23],[24

Bayram et al. (2014)[25] reported that the prevalence rates for high TC, LDL-C, and TG increases with age, with the highest prevalence among those aged 46-to-65-year-old.

The association of dyslipidemia with some personal characteristics, i.e., male gender and advancing age, detected in the present study, is in accordance with previous national[8][15] and international[13][20][27]studies.

Habib et al. (2005)[28] stated that lipoprotein profile differs significantly according to gender. Females have lower values of triglycerides, TC/HDL-C ratio and higher levels of HDL than men. They explained this finding by differences in levels of circulating sex hormones, especially estrogens and androgens in women versus men.

The present study showed that overweight and obese participants had significantly higher prevalence of dyslipidemia.

This finding is in accordance with that found by several Saudi[8],[9],[10],[15]; regional[19],[29] and international[13],[20],[26],[27] studies.

Khader et al. (2009)[19] and Thakur and Bisht (2010)[30] found that, compared with people with a body mass index less than 25 kg/m2, overweight and obese subjects had greater odds of having hypertriglycerdemia, hypercholesterolemia and low density lipoprotein cholesterol were significantly more prevalent among overweight and obese people. Similarly, Puavilai and Laoragpongse (2004)[31] reported that obese people have high serum triglycerides, total cholesterol and LDL-C and low HDL-C than non-obese people. Hence, Walatara et al. (2014)[32] concluded that obesity alone constitutes a major independent risk factor for altered lipid profile giving rise to atherogenic dyslipidemia.

It is to be noted that though this study showed that obesity and dyslipidemia were significantly associated among participants, it is difficult to consider dyslipidemia as a “cause” or an “effect” of obesity since the present study followed a cross sectional design.

This study revealed that positive family history of dyslipidemia was significantly associated with lower serum HDL-C serum levels and higher LDL-C serum levels among participants. These findings were in agreement with those of Sakurai et al. (2013)[33], who reported a significant association between family history and dyslipidemia.


  Conclusions Top


Prevalence of dyslipidemia is high among Saudi adults attending primary health care centers, especially among males, obese and elderly subjects in addition to those with positive family history of dyslipidemia. This urgently necessitates the institution of appropriate community-based intervention strategies to prevent and manage cardiovascular risk factors. There is a pressing need for conducting health education sessions for attendants of primary health care centers regarding healthier lifestyles, especially, good nutrition and weight reduction.



 
  References Top

1.
Stamler J, Daviglus ML, Garside DB, Dyer AR, Greenland P, et al. Relationship of Baseline Serum Cho-lesterol Levels in 3 Large Cohorts of Younger Men to Long-Term Coronary, Cardiovascular, and All-Cause Mortality and to Longevity. The Journal of the American Medical Association. 2000;284(3):311- 318.  Back to cited text no. 1
    
2.
World Health Organization, “Quantifying Selected Major Risks to Health,” World Health Organization, Geneva, 2002.  Back to cited text no. 2
    
3.
Smith D. Epidemiology of Dyslipidemia and Economic Burden on the Healthcare System. American Journal of Managed Care 2007; 13(S3):S68-S71.  Back to cited text no. 3
    
4.
Pu J, Romanelli R, Zhao B, Azar KMJ, Hastings KG, Nimbal V, Fortmann SP, Palaniappan LP. Dyslipidemia in Special Ethnic Populations. Cardiol Clin 2015; 33(2): 325–333.  Back to cited text no. 4
    
5.
Al-Kaabba AF, Al-Hamdan NA, El Tahir A, Abdalla AM, Saeed AA, Hamza MA. Prevalence and Correlates of Dyslipidemia among Adults in Saudi Arabia: Results from a National Survey. Open Journal of Endocrine and Metabolic Diseases, 2012, 2, 89-97  Back to cited text no. 5
    
6.
Gillespie CD, Keenan NL, Miner JB, Hong Y. Screening for Lipid Disorders Among Adults - National Health and Nutrition Examination Survey, United States, 2005–2008. Morbidity and Mortality Weekly Report (MMWR) 2012; 61 (2):26-31.  Back to cited text no. 6
    
7.
Memish ZA, El Bcheraoui C, Tuffaha M, Robinson M, Daoud F, Jaber S, et al. Obesity and Associated Factors - Kingdom of Saudi Arabia, 2013. Prev Chronic Dis 2014; 11:140236.  Back to cited text no. 7
    
8.
Abalkhail BA, Shawky S, Ghabrah TM, Milaat WA. Hypercholesterolemia and 5-Year Risk of Development of Coronary Heart Disease among University and School Workers in Jeddah, Saudi Arabia. American Journal of Preventive Medicine. 2000;31(4):390-395.  Back to cited text no. 8
    
9.
Al-Shehri SN, Saleh ZA, Salama MM, Hassan YM. Prevalence of Hyperlipidemia among Saudi School Children in Riyadh. Annals of Saudi Medicine. 2004; 24(1): 6-8.  Back to cited text no. 9
    
10.
Ogbeide DO, Karim A, Al-Khalifa IM, Siddique S. Population Based Study of Serum Lipid Levels in Al- Kharj Health Center, Saudi Arabia. Saudi Medical Journal. 2004;25(12): 1855-1857.  Back to cited text no. 10
    
11.
Al-Nozha MM, Al-Mazrou YY, Al-Maatouq MA, Arafah MR, Khalil MZ, Khan NB, Al-Marzouki K, Abdullah MA, Al-Khadra AH, Al-Harthi SS, Al- Shahid MS, Al-Mobeireek A, Nouh MS. Obesity in Saudi Arabia. Saudi Med J. 2005; 26(5):824-9.  Back to cited text no. 11
    
12.
Cortez-Diasa N, Martins SR, Belod A, Fiúzaa M. Characterization of lipid profile in primary health care users in Portugal. Rev Port Cardiol 2013;32(12):987-96.  Back to cited text no. 12
    
13.
Mahley RW, Palaoglu KE, Atak Z, Dawson-Pepin J, Langlois AM, Cheung V, Onat H, Fulks P, Mahley LL, Vakar F, Ozbayrakci S, Gokdemir O, Winkler W. Turkish Heart Study: Lipids, Lipoproteins, and Apolipoproteins. The Journal of Lipid Research 1995; 36(4): 839-859.  Back to cited text no. 13
    
14.
Ugwuja EI, Ogbonna NC, Nwibo AN, Onimawo IA. Overweight and Obesity, Lipid Profile and Atherogenic Indices among Civil Servants in Abakaliki, South Eastern Nigeria. Ann Med Health Sci Res. 2013; 3(1): 13–18.  Back to cited text no. 14
    
15.
Al-Nozha MM, Arafah MR, Al-Maatouq MA, Khalil MZ, Khan NB, Al-Marzouki K, Al-Mazrou YY, Abdullah M, Al-Khadra A, Al-Harthi SS, Al-Shahid MS, Al-Mobeireek A, Nouh MS. Hyperlipidemia in Saudi Arabia. Medical Journal 2008; 29(2): 282-287.  Back to cited text no. 15
    
16.
Al-Othaimeen AI, AL-Nozha M, Osman AK. Obesity: an emerging problem in Saudi Arabia. Analysis of data from national nutrition survey. Eastern Med Health J 2007; 13(2):441-48.  Back to cited text no. 16
    
17.
Al-Daghri NM, Al-Attas OS, Alokail MS, AlKharafy KM, Yousef M, Sabico SL, Chrousos GP. Diabetes Mellitus type 2 and other chronic non-communicable disease in central region, Saudi Arabia (Riyadh cohort 2): a decade of an epidemic. BMC Medicine 2011; 9:76.  Back to cited text no. 17
    
18.
DeNicola E, Aburizaiza OS, Siddique A Khwaja H, Carpenter1 DO. Obesity and public health in the Kingdom of Saudi Arabia. Reviews on Environmental Health 2015; 30(3): 191–205.  Back to cited text no. 18
    
19.
Khader YS, Batieha A, El-Khateeb M, Al Omari M, Ajlouni K. Prevalence of dyslipidemia and its associated factors among Jordanian adults. J Clin Lipidol. 2010;4(1):53-8.  Back to cited text no. 19
    
20.
Erem C, Hacihasanoglu A, Deger O, Kocak M, Topbas M. Prevalence of dyslipidemia and associated risk factors among Turkish adults: Trabzon lipid study. Endocrine 2008; 34(1): 36–51.  Back to cited text no. 20
    
21.
de Souza LJ, Filho JTDS, de Souza TF, Reis AFF, Neto CG, Bastos DA, Côrtes VA, Chalita FEB, Teixeira CL. Prevalence of dyslipidemia and risk factors in Campos dos Goytacazes, in the Brazilian State of Rio de Janeiro. Arq. Bras. Cardiol 2003; 81 (3): 257-64.  Back to cited text no. 21
    
22.
Pradeepa R, Deepa R, Rani SS, Premalatha G, Saroja R, Mohan V. Socioeconomic Status and Dyslipidaemia in a South Indian Population: The Chennai Urban Population Study (CUPS 11). National Medical Journal of India 2003; 16(2): 73-78.  Back to cited text no. 22
    
23.
Grabauskas V, Miseviciene I, Klumbiene J, Petkeviciene J, Milasauskiene Z, Plieskiene A, Margeviciene L. Prevalence of Dyslipidemias among Lithuanian Rural Population (CINDI Program). Medicina (Kaunas) 2003; 39(12): 1215-1222.  Back to cited text no. 23
    
24.
Polychronopoulos E, Panagiotakos DB, Polystipioti A. Diet, Lifestyle Factors and Hypercholesterolemia in Elderly Men and Women from Cyprus. Lipids in Health and Disease 2005; 4(17): 1-7.  Back to cited text no. 24
    
25.
Bayram F, Kocer D, Gundogan K, Kaya A, Demir O, Coskun R, Sabuncu T, Karaman A, Cesur M, Rizzo M, Toth PP, Gedik V. Prevalence of dyslipidemia and associated risk factors in Turkish adults. Journal of Clinical Lipidology 2014; 8(2): 206–216  Back to cited text no. 25
    
26.
Azizi F, Rahmani M, Ghanbarian A, Emami H, Salehi P, Mirmiran P, Sarbazi N. Serum Lipid Levels in an Iranian Adults Population: Tehran Lipid and Glucose Study. European Journal of Epidemiology 2003; 18(4): 311-319.  Back to cited text no. 26
    
27.
Zhao WH, Zhang J, Zhai Y, You Y, Man QQ, et al. Blood Lipid Profile and Prevalence of Dyslipidemia in Chinese Adults. Biomedical and Environmental Sciences 2007; 20(4): 329-335.  Back to cited text no. 27
    
28.
Habib SS, Aslam M, Hameed W. Gender differences in lipids and lipoprotein (a) profiles in healthy individuals and patients with type 2 diabetes mellitus. Pak J Physiol 2005;1(1-2).  Back to cited text no. 28
    
29.
Bener A, Zirie M, Janahi IM, Al-Hamaq OA, Musallam M. Prevalence of Diagnosed and Undiagnosed Diabetes Mellitus and Its Risk Factors in a Population Based Study of Qatar. Diabetes Research and Clinical Practice 2009; 84(1): 99-106.  Back to cited text no. 29
    
30.
Thakur JS, Bisht S. Blood lipid profile of obese and non-obese sedentary college men. VSRD Tech & Non-Tech 2010; 1(1), 26-29.  Back to cited text no. 30
    
31.
Puavilai W, Laoragpongse D. Is calculated LDL-C by using the new modified Friedewald equation better  Back to cited text no. 31
    
32.
Walatara K, Nusha F, Kaneshapillai A, Athiththan L, Perera R, Hettiaratchi U. Effect of central obesity on serum lipid profile in non-diabetic, non-hypertensive subjects - A preliminary study. IJMS 2014; 1 (1): 123-129.  Back to cited text no. 32
    
33.
Sakurai M, Nakamura K, Miura K, et al. Family history of diabetes, lifestyle factors, and the 7-year incident risk of type 2 diabetes mellitus in middle-aged Japanese men and women. Journal of Diabetes Investigation 2013; 4 (3):261-268.  Back to cited text no. 33
    



 
 
    Tables

  [Table 1], [Table 2], [Table 3], [Table 4], [Table 5], [Table 6]



 

Top
 
 
  Search
 
Similar in PUBMED
   Search Pubmed for
   Search in Google Scholar for
 Related articles
Access Statistics
Email Alert *
Add to My List *
* Registration required (free)

 
  In this article
   Abstract
  Introduction
  Subjects and Methods
  Results
  Discussion
  Conclusions
   References
   Article Tables

 Article Access Statistics
    Viewed745    
    Printed28    
    Emailed0    
    PDF Downloaded50    
    Comments [Add]    

Recommend this journal


[TAG2]
[TAG3]
[TAG4]