1887
Volume 2025, Issue 4
  • ISSN: 0253-8253
  • EISSN: 2227-0426

Abstract

Cardiovascular disease (CVD) remains a major health concern in Qatar, with ischemic heart disease being the leading cause of mortality. Suboptimal cholesterol levels represent a major risk factor for CVD. Suboptimal cholesterol levels are highly prevalent among adults worldwide, including in the Middle East and North Africa region. Obesity, a major risk factor for suboptimal cholesterol, is highly prevalent in Qatar and contributes significantly to both mortality and morbidity.

To estimate the prevalence of total cholesterol (TC), low-density lipoprotein (LDL), and low high-density lipoprotein (HDL) levels in a specific population in Qatar, and to assess their associations with obesity.

Data for this cross-sectional study was derived from the Qatar Biobank, a population-based biobank that recruits Qatari nationals or long-term residents aged 18 years and above. Multivariable logistic and linear regression models were used to assess the associations between TC, LDL, HDL, and obesity levels defined by body mass index (BMI) and waist circumference (WC).

Of 1,000 participants, 920 were included in the study. Approximately 37% of women had higher TC (≥ 5.18 mmol/L), 28% had higher LDL (≥ 3.4 mmol/L), and 36% had lower HDL (<1.3 mmol/L). Among men, 43% had higher TC, 41% had higher LDL, and 22% had lower HDL. HDL levels were significantly associated with higher BMI and WC in both women (adjusted odds ratio [aOR] for obese vs normal weight = 3.60, 95% CI: 1.86–6.94; aOR for higher WC vs lower WC = 2.35, 95% CI: 1.42–3.90) and men (aOR for obese vs normal weight = 3.00, 95% CI: 1.48–6.11; aOR for higher WC vs lower WC = 2.12, 95% CI: 1.27–3.55). In men, higher BMI was significantly associated with increased odds of higher TC (aOR = 2.45, 95% CI: 1.38–4.36) and LDL (aOR = 2.56, 95% CI: 1.42–4.56), while no significant associations were found in women.

Both women and men with higher BMI and WC had significantly lower HDL levels. Additionally, men with higher BMI were at increased risk for higher TC and LDL levels, whereas no significant associations were observed in women. Further research is needed to examine the associations between cholesterol types and metabolic syndrome components in representative populations with adequate sample sizes.

Loading

Article metrics loading...

/content/journals/10.5339/qmj.2025.97
2025-12-01
2025-12-05

Metrics

Loading full text...

Full text loading...

/deliver/fulltext/qmj/2025/4/qmj.2025.97.html?itemId=/content/journals/10.5339/qmj.2025.97&mimeType=html&fmt=ahah

References

  1. Al-Kaabi SK, Atherton A. Impact of noncommunicable diseases in the State of Qatar. Clinicoecon Outcomes Res. 2015; 7:377–85.
    [Google Scholar]
  2. Global burden of 87 risk factors in 204 countries and territories, 1990-2019: a systematic analysis for the Global Burden of Disease Study 2019. Lancet (London, England). 2020; 396:(10258):1223–49.
    [Google Scholar]
  3. World Heart Federation . Risk factors 2019 [Available from: https://www.world-heart-federation.org/resources/risk-factors/.
    [Google Scholar]
  4. Lacey B, Herrington WG, Preiss D, Lewington S, Armitage J. The Role of Emerging Risk Factors in Cardiovascular Outcomes. Curr Atheroscler Rep. 2017; 19:(6):28.
    [Google Scholar]
  5. Group Sw, Collaboration ESCCr . SCORE2 risk prediction algorithms: new models to estimate 10-year risk of cardiovascular disease in Europe. Eur Heart J. 2021; 42:(25):2439–54.
    [Google Scholar]
  6. Jahangiry L, Farhangi MA, Rezaei F. Framingham risk score for estimation of 10-years of cardiovascular diseases risk in patients with metabolic syndrome. J Health Popul Nutr. 2017; 36:(1):36.
    [Google Scholar]
  7. Mendis S, Puska P, Norrving B, Organization WH. Global atlas on cardiovascular disease prevention and control: Geneva: World Health Organization; 2011.
    [Google Scholar]
  8. Jung E, Kong SY, Ro YS, Ryu HH, Shin SD. Serum Cholesterol Levels and Risk of Cardiovascular Death: A Systematic Review and a Dose-Response Meta-Analysis of Prospective Cohort Studies. Int J Environ Res Public Health. 2022; 19:(14).
    [Google Scholar]
  9. Schoeneck M, Iggman D. The effects of foods on LDL cholesterol levels: A systematic review of the accumulated evidence from systematic reviews and meta-analyses of randomized controlled trials. Nutr Metab Cardiovasc Dis. 2021; 31:(5):1325–38.
    [Google Scholar]
  10. Amerizadeh A, Javanmard SH, Sarrafzadegan N, Vaseghi G. Familial Hypercholesterolemia (FH) Registry Worldwide: A Systematic Review. Curr Probl Cardiol. 2022; 47:(10):100999.
    [Google Scholar]
  11. Barone Gibbs B, Hivert MF, Jerome GJ, Kraus WE, Rosenkranz SK, Schorr EN, et al. Physical Activity as a Critical Component of First-Line Treatment for Elevated Blood Pressure or Cholesterol: Who, What, and How?: A Scientific Statement From the American Heart Association. Hypertension. 2021; 78:(2):e26–e37.
    [Google Scholar]
  12. Booth HP, Prevost AT, Gulliford MC. Severity of obesity and management of hypertension, hypercholesterolaemia and smoking in primary care: population-based cohort study. J Hum Hypertens. 2016; 30:(1):40–5.
    [Google Scholar]
  13. Brinck J, Hagström E, Nåtman J, Franzén S, Eeg-Olofsson K, Nathanson D, et al. Cardiovascular Outcomes in Patients With Both Diabetes and Phenotypic Familial Hypercholesterolemia: A Nationwide Register-Based Cohort Study. Diabetes Care. 2022; 45:(12):3040–9.
    [Google Scholar]
  14. Adhikary D, Barman S, Ranjan R, Stone H. A Systematic Review of Major Cardiovascular Risk Factors: A Growing Global Health Concern. Cureus. 2022; 14:(10):e30119.
    [Google Scholar]
  15. Song P-k, Li H, Man Q-q, Jia S-s, Li L-x, Zhang JJN. Trends in determinants of hypercholesterolemia among Chinese adults between 2002 and 2012: results from the National Nutrition Survey. 2017; 9:(3):279.
    [Google Scholar]
  16. Mc Auley MT. Effects of obesity on cholesterol metabolism and its implications for healthy ageing. Nutr Res Rev. 2020; 33:(1):121–33.
    [Google Scholar]
  17. Yusuf S, Joseph P, Rangarajan S, Islam S, Mente A, Hystad P, et al. Modifiable risk factors, cardiovascular disease, and mortality in 155 722 individuals from 21 high-income, middle-income, and low-income countries (PURE): a prospective cohort study. Lancet (London, England). 2020; 395:(10226):795–808.
    [Google Scholar]
  18. Stadler JT, Marsche G. Obesity-Related Changes in High-Density Lipoprotein Metabolism and Function. Int J Mol Sci. 2020; 21:(23).
    [Google Scholar]
  19. Lamina C, Forer L, Schönherr S, Kollerits B, Ried JS, Gieger C, et al. Evaluation of gene-obesity interaction effects on cholesterol levels: a genetic predisposition score on HDL-cholesterol is modified by obesity. Atherosclerosis. 2012; 225:(2):363–9.
    [Google Scholar]
  20. Institute for Health Metrics and Evaluation . Qatar country profile [Available from: http://www.healthdata.org/qatar.
    [Google Scholar]
  21. Al-Kuwari MG, Al-Abdulla SA, Abdulla MY, Haj Bakri A, Mustafa Mohammed A, Chettiyam Kandy M, et al. Epidemiological health assessment in primary healthcare in the State of Qatar-2019. Qatar Med J. 2021; 2021:(3):57.
    [Google Scholar]
  22. Haj Bakri A, Al-Thani A. Chronic disease risk factor surveillance: Qatar STEPS report 2012. Qatar: The Supreme Council of Health. 2013.
    [Google Scholar]
  23. Rizk NM, Yousef M. Association of lipid profile and waist circumference as cardiovascular risk factors for overweight and obesity among school children in Qatar. Diabetes Metab Syndr Obes. 2012; 5:425–32.
    [Google Scholar]
  24. Azizi F, Hadaegh F, Hosseinpanah F, Mirmiran P, Amouzegar A, Abdi H, et al. Metabolic health in the Middle East and north Africa. Lancet Diabetes Endocrinol. 2019; 7:(11):866–79.
    [Google Scholar]
  25. Al Kuwari H, Al Thani A, Al Marri A, Al Kaabi A, Abderrahim H, Afifi N, et al. The Qatar Biobank: background and methods. BMC Public Health. 2015; 15:1208.
    [Google Scholar]
  26. Shi WD, Neubeck L, Gallagher R. Measurement matters: A systematic review of waist measurement sites for determining central adiposity. Collegian. 2017; 24:(5):513–23.
    [Google Scholar]
  27. Qatar Biobank . Home page n.d. Available from: https://www.qphi.org.qa/research/qphi-population-based-study
    [Google Scholar]
  28. Mayoclinic . Cholesterol test 2019. Available from: https://www.mayoclinic.org/tests-procedures/cholesterol-test/about/pac-20384601
    [Google Scholar]
  29. Al-Thani MH, Al-Thani AA, Cheema S, Sheikh J, Mamtani R, Lowenfels AB, et al. Prevalence and determinants of metabolic syndrome in Qatar: results from a National Health Survey. BMJ Open. 2016; 6:(9):e009514.
    [Google Scholar]
  30. Fujiyoshi N, Arima H, Satoh A, Ojima T, Nishi N, Okuda N, et al. Associations between socioeconomic status and the prevalence and treatment of hypercholesterolemia in a general Japanese population: NIPPON DATA2010. 2018; 25:(7):606–20.
    [Google Scholar]
  31. Lipsky AM, Greenland S. Causal Directed Acyclic Graphs. Jama. 2022; 327:(11):1083–4.
    [Google Scholar]
  32. Kawabe H, Shibata H, Hirose H, Tsujioka M, Saito I, Saruta T. Sexual differences in relationships between birth weight or current body weight and blood pressure or cholesterol in young Japanese students. Hypertension research : official journal of the Japanese Society of Hypertension. 1999; 22:(3):169–72.
    [Google Scholar]
  33. StataCorp . Stata Statistical Software: Release 18. College Station, TX: StataCorp LLC; 2023.
    [Google Scholar]
  34. Romero-Moraleda B, Peinado Lozano AB, Morencos Martínez E, López-Plaza B, Gómez Candela C, Calderón Montero FJ. Lipid profile response to weight loss program in overweight and obese patient is related with gender and age. Nutr Hosp. 2015; 31:(6):2455–64.
    [Google Scholar]
  35. Genua I, Minambres I, Puig R, Sarda H, Fernandez-Ananin S, Sanchez-Quesada JL, et al. Weight loss benefits on HDL cholesterol persist even after weight regaining. Surg Endosc. 2024; 38:(6):3320–8.
    [Google Scholar]
  36. Kim Y, Suh YK, Choi H. BMI and metabolic disorders in South Korean adults: 1998 Korea National Health and Nutrition Survey. Obes Res. 2004; 12:(3):445–53.
    [Google Scholar]
  37. Rosenbaum D, Hansel B, Bonnefont-Rousselot D, Bittar R, Girerd X, Giral P, et al. Waist circumference is a strong and independent determinant of the distribution of HDL subfractions in overweight patients with cardiovascular risk factors. Diabetes Vasc Dis Re. 2012; 9:(2):153–9.
    [Google Scholar]
  38. Shibata Y, Ojima T, Nakamura M, Kuwabara K, Miyagawa N, Saito Y, et al. Associations of Overweight, Obesity, and Underweight With High Serum Total Cholesterol Level Over 30 Years Among the Japanese Elderly: NIPPON DATA 80, 90, and 2010. J Epidemiol. 2019; 29:(4):133–8.
    [Google Scholar]
  39. Jin H, Nicodemus-Johnson JJN. Gender and age stratified analyses of nutrient and dietary pattern associations with circulating lipid levels identify novel gender and age-specific correlations. 2018; 10:(11):1760.
    [Google Scholar]
  40. Link JC, Reue K. Genetic Basis for Sex Differences in Obesity and Lipid Metabolism. Annu Rev Nutr. 2017; 37:225–45.
    [Google Scholar]
  41. Soares ALG, Banda L, Amberbir A, Jaffar S, Musicha C, Price A, et al. Sex and area differences in the association between adiposity and lipid profile in Malawi. BMJ Glob Health. 2019; 4:(5):e001542.
    [Google Scholar]
  42. Hozawa A, Okamura T, Oki I, Murakami Y, Kadowaki T, Nakamura K, et al. Relationship between BMI and all-cause mortality in Japan: NIPPON DATA80. Obesity (Silver Spring). 2008; 16:(7):1714–7.
    [Google Scholar]
  43. Ishikawa-Takata K, Ohta T, Moritaki K, Gotou T, Inoue S. Obesity, weight change and risks for hypertension, diabetes and hypercholesterolemia in Japanese men. European Journal of Clinical Nutrition. 2002; 56:601–7.
    [Google Scholar]
  44. Janssen I, Katzmarzyk PT, Ross R. Body mass index, waist circumference, and health risk: evidence in support of current National Institutes of Health guidelines. Archives of internal medicine. 2002; 162:(18):2074–9.
    [Google Scholar]
  45. Patterson RE, Frank LL, Kristal AR, White E. A comprehensive examination of health conditions associated with obesity in older adults. Am J Prev Med. 2004; 27:(5):385–90.
    [Google Scholar]
  46. Kromhout D, Menotti A, Kesteloot H, Sans S. Prevention of coronary heart disease by diet and lifestyle: Evidence from prospective cross-cultural, cohort, and intervention studies. Circulation. 2002; 105:893–8.
    [Google Scholar]
  47. Hall JE. The kidney, hypertension, and obesity. Hypertension. 2003; 41:(3 Pt 2):625–33.
    [Google Scholar]
  48. Powell-Wiley TM, Poirier P, Burke LE, Després JP, Gordon-Larsen P, Lavie CJ, et al. Obesity and Cardiovascular Disease: A Scientific Statement From the American Heart Association. Circulation. 2021; 143:(21):e984–e1010.
    [Google Scholar]
  49. Pirillo A, Casula M, Olmastroni E, Norata GD, Catapano AL. Global epidemiology of dyslipidaemias. Nat Rev Cardiol. 2021; 18:(10):689–700.
    [Google Scholar]
  50. El-Kebbi IM, Bidikian NH, Hneiny L, Nasrallah MP. Epidemiology of type 2 diabetes in the Middle East and North Africa: Challenges and call for action. World J Diabetes. 2021; 12:(9):1401–25.
    [Google Scholar]
  51. Aboul-Enein BH, Bernstein J, Neary AC. Dietary transition and obesity in selected Arabicspeaking countries: a review of the current evidence. East Mediterr Health J. 2017; 22:(10):763–70.
    [Google Scholar]
  52. Chaabane S, Chaabna K, Abraham A, Mamtani R, Cheema S. Physical activity and sedentary behaviour in the Middle East and North Africa: An overview of systematic reviews and meta-analysis. Sci Rep. 2020; 10:(1):9363.
    [Google Scholar]
/content/journals/10.5339/qmj.2025.97
Loading
/content/journals/10.5339/qmj.2025.97
Loading

Data & Media loading...

  • Article Type: Research Article
Keyword(s): biobankhigh-density lipoproteinlow-density lipoproteinobesityQatar and Total cholesterol
This is a required field
Please enter a valid email address
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error