Population-based epidemiological study on characteristics of risk factors of hypercholesterolemia in Saudi Arabia

Objectives: To study the characteristics of risk factors for hypercholesterolemia among the Saudi population. Design: Population-based cross-sectional national epidemiological randomized household survey. Subject: 4548 Saudi subjects, aged 15 years and above. Sample was representative and in accordance with the national population distribution with respect to age, gender, regional and residency, urban vs. rural, population distribution. Measurement: Height and weight with calculation of body mass index, blood samples were drawn and assayed for glucose and total cholesterol concentration. Hypercholesterolemia (HC) was defined: borderline high HC (5.2-6.2 mmol l(-1)) and high HC (>6.2 mmol l(-1)). Univariate, multivariate, simple logistic, multiple logistic, odd ratio and chi-square were employed in the statistical analysis. Results: The risk of developing HC increased with age by 2% and 1% for each year increase in age for borderline high HC and high HC. The risk of developing HC was significantly higher among female subjects. There was no significant relation between the spectrum of BMI group, underweight to obesity, with risk of developing borderline high or high HC. There was a significant increase in the risk of developing HC among residents of urban communities. There was no significant regional variation for risk of borderline high HC, however, there was a significant increase in the risk of developing high HC among residents of Central and Eastern regions, compared with other regions. Conclusion: The characteristics of risk factors for HC among the Saudi population differ in many respects from other populations. Overweight and obesity are not significant risk factors for HC. Rural communities are more at risk of HC than urban communities. The population of the Eastern and Central regions were at significantly higher risk of developing HC. The relatively recent urbanization may account for the low prevalence of HC. It may partially explain the dissociation between obesity and HC. Food habits, both in quantity and quality in rural communities in genetically predisposed homogenous populations may account for the increase in the prevalence of HC in rural communities. There is a need to propagate information about the potential health hazard of obesity and HC among Saudi communities, at large, and specifically in the Eastern and Central regions. There is a need to study the food patterns of rural communities which may explain partially the relative increase in the prevalence of HC in rural communities. (C) 1997 Elsevier Science Ireland Ltd.