Lipid parameters strongly depend on age and sex
Lipid and lipoprotein reference values from 133,450 Dutch Lifelines participants: Age- and gender-specific baseline lipid values and percentilesLiterature - Balder JW, de Vries JK, Nolte IM, et al., - J Clin Lipidol. 2017; 11 (4): 1055–1064.e6
- Women (n=79475, 60%) presented with an overall more favorable CV risk profile than men (54065, 40%), as seen by significantly lower mean systolic blood pressure (122 vs. 130 mmHg), lower median TC (193 vs. 197 mg/dL), lower median LDL-c (116 vs. 131 mg/dL), higher median HDL-c (62 vs. 50 mg/dL), lower TG (77 vs. 100 mg) and lower smoking rates (19.7% vs. 23.3%).
- At 20 years of age, men had significantly lower LDL-C levels than women (median: 85 vs. 97 mg/dL, 95th percentile: 139 vs. 151 mg/dL, P<0.001).
- In both genders, LDL-c (direct quantification) increases with age, but the pattern differs. In men LDL-c peaked at 45-49 years of age (median: 139 mg/dL, 95th percentile: 197 mg/dL). At higher ages, LDL-c showed a gradual decrease. In women, median LDL-c was stable until their mid-30s, after which a maximum level (median: 143 mg/dL, 95th percentile: 205 mg/dL) was seen at 55-59 years of age. Women showed no clear decline at higher ages.
- Friedewald-calculated LDL-c levels yielded lower values than direct LDL-c quantification, in both genders (median 7.0 mg/dL lower in men and 6.0 mg/dL lower in women).
- HDL-c did not significantly change with increasing age in men, while in women, median HDL-c increased from 54 mg/dL at young age (<20) to 66 mg/dL at the age of 50 years old. In women older than 50 years, no changes in HDL-c were noted.
- Of all lipids, the relation between TG and age differed most between men and women. Men showed a clear increase from young age (median: 71 mg/dL, 95th percentile: 153 mg/dL) to 40-44 years (median: 106 mg/dL, 95th percentile: 289 mg/dL), after which TG levels dropped rapidly with increasing age. This decline was most prominent at the higher end of the spectrum (75th, 90th and 95th percentiles), and almost absent at the 5th and 10th percentile. TG levels were relatively stable in women, and median levels fluctuated between 68 and 77 mg/dL between the ages of 20 and 50 years. TG levels increased moderately in women >50 years old.
- Reference values of all blood lipids for men and women at five years-intervals have been made available at my-cholesterol.care.
These data of the three-generation Lifelines cohort show prominent gender- and age-related differences in all main plasma lipids and lipoproteins, suggesting the need to correct for age and sex when evaluating a person’s lipid profile.
The prevalence of high LDL-c in young individuals was higher in this region of the Netherlands than anticipated. The presented data and the accompanying website can facilitate evaluation of (population) interventions or be used as a comparator for other prospective or retrospective lipid profile analyses in other geographic regions. The interactive website may serve as a tool to identify young individuals with atherogenic dyslipidemia.