Prevalence and associated factors of dyslipidemia in a multiethnic adolescent and young adult male population in Singapore.

BACKGROUND

The prevalence of dyslipidemia among adolescents and young adults is rising, increasing lifetime atherosclerotic cardiovascular disease (ASCVD) risk. Identifying dyslipidemia requires age-appropriate reference ranges.

OBJECTIVE

To describe lipid distributions, determine dyslipidemia prevalence, and identify associated factors in a cohort of Asian males.

METHODS

This retrospective study included 19,130 males aged 16 to 25 years who underwent pre-enlistment medical screening. As military service is mandatory in Singapore, the cohort represented a nationwide sample of young males. Demographics, anthropometrics, and clinical measurements were collected using standardized protocols. Nonfasted blood samples were analyzed for total cholesterol (TC), triglycerides (TG), and high-density lipoprotein cholesterol (HDL-C). Low-density lipoprotein cholesterol (LDL-C) was estimated using the Martin/Hopkins equation. Dyslipidemia was defined using local cutoffs aligned with the National Cholesterol Education Program Adult Treatment Panel III criteria. Individuals with significantly elevated cholesterol levels were referred for familial hypercholesterolemia (FH) assessment.

RESULTS

Mean lipid values were TC 169 ± 31 mg/dL, TG 109 ± 65 mg/dL, HDL-C 53 ± 11 mg/dL, and LDL-C 95 ± 28 mg/dL, and 44.3% of participants were overweight or obese. Dyslipidemia was present in 13.1%, including a substantial proportion without obesity. Severe hypercholesterolemia (LDL-C ≥190 mg/dL) was observed in 0.6%, and FH was diagnosed in 0.3%. Hypercholesterolemia was associated with older age, higher body fat, and grade 1 hypertension; hypertriglyceridemia and low HDL-C were associated with higher body fat, overweight or obesity, and grade 1 hypertension.

CONCLUSION

The high dyslipidemia prevalence highlights the importance of early detection and preventive interventions to reduce ASCVD risk.