Endocrine Abstracts

JOINT1701

Introduction: The prevalence of hyperlipidemia among adolescents and young adults is rising globally, contributing to an increased risk of atherosclerotic cardiovascular disease (ASCVD) later in life. Identifying dyslipidemia requires understanding normal lipid ranges, which prior studies have defined in discrete age brackets: childhood and adolescence (≤19 years) and young adulthood (20-40 years). However, lipid concentrations likely change continuously with age. This study aims to describe lipid levels and associated factors in a population-wide cohort of multi-ethnic Asian males aged 16-25 years who underwent mandatory military health screening.

Methods: The study included more than 19,000 males aged 16-25 years eligible for military conscription from 1 July 2021 to 30 June 2022. Data collected comprised anthropometric variables (height, weight, body mass index [BMI], body fat percentage), clinical measures (blood pressure), and non-fasted lipid levels (total cholesterol [TC], triglycerides [TG], high-density lipoprotein cholesterol [HDL-C]). Low-density lipoprotein cholesterol (LDL-C) was estimated using the Friedewald equation. Subgroup analysis was performed on older adolescents (16-19 years). Hyperlipidemia prevalence was determined using National Cholesterol Education Program (NCEP) Adult Treatment Panel III criteria for the overall cohort and NCEP Pediatric Panel criteria for older adolescents.

Results: The mean lipid values were: TC (4.38 mmol/l), TG (1.23 mmol/l), HDL-C (1.37 mmol/l), and LDL-C (2.46 mmol/l). Nearly 44% of participants were overweight or obese. Body fat percentage and blood pressure were positively correlated with TC levels. The prevalence of hyperlipidemia was significant: 12.5% had TC >5.2 mmol/l, 19% had TG ≥1.7 mmol/l, 5.1% had HDL-C <1.0 mmol/l, and 35.6% had LDL-C >2.6 mmol/l. The prevalence of severe hypercholesterolemia (LDL-C ≥4.9 mmol/l) was 0.6%, and severe hypertriglyceridemia (TG ≥4.5 mmol/l) was 0.5%. Familial hypercholesterolemia was diagnosed in 0.3% of participants. In the older adolescent subgroup, 16.2% had abnormal TC levels, and 8.2% had abnormal LDL-C levels.

Conclusion: We described the lipid distribution in a population-wide cohort of Asian males aged between 16 to 25 years old. Unsurprisingly, mean lipid values appear to be between that described in childhood and adult populations. While the high proportion of older adolescents with dyslipidemia may be due to normative differences in that age range as compared to younger children, it is also matched by similarly high prevalence of dyslipidemia even when using adult thresholds - suggesting that the true prevalence of hyperlipidemia is indeed high and may portend future cardiovascular risk.