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Age-related trajectories of blood lipids and lipoproteins by sex, region, and waist circumference changes in Korea: a longitudinal cohort study
Mi Kyoung Son, Nam-Kyoo Lim, Joong-Yeon Lim, Hyun-Young Park
Epidemiol Health. 2025;47:e2025066.   Published online December 9, 2025
DOI: https://doi.org/10.4178/epih.e2025066
  • 4,448 View
  • 94 Download
AbstractAbstract AbstractSummary PDFSupplementary Material
Abstract
OBJECTIVES
This study aimed to evaluate the longitudinal trajectories of lipid and lipoprotein levels with aging according to sex and changes in waist circumference (ΔWC) from midlife to late life.
METHODS
We included 4,345 male and 4,804 female participants aged 40-69 years at baseline from the Korean Genome and Epidemiology Study (2001-2018). The annual ΔWC was estimated using linear regression. Marginal models were fitted using mixed-effects regression.
RESULTS
The trajectories of total cholesterol (TC), non-high-density lipoprotein cholesterol (non-HDL-C), and low-density lipoprotein cholesterol (LDL-C) levels displayed an increasing trend until the 60s age range in females (approximately 10-15 mg/dL) and the late 40s in males (approximately 3-5 mg/dL), with a subsequent decline. In females, HDL-C levels increased until the early 50s, declined thereafter, and rose again from the 70s onward, with a more pronounced rise in urban than in rural areas, while remaining relatively stable in males. Triglyceride (TG) levels decreased with advancing age in males, whereas in females they increased up to the age of 70 years, followed by a decrease. Females exhibited greater increases in TC, non-HDL-C, HDL-C, LDL-C, and TG across all ages compared with males. Both males and females with a decrease in waist circumference (WC) during follow-up showed improvements in lipid and lipoprotein profiles relative to those with stable or increased WC.
CONCLUSIONS
Trends in lipid and lipoprotein levels vary according to age and sex, and a decrease in WC significantly improves lipid and lipoprotein profiles.
Summary
Korean summary
• 40세 이상 한국 성인을 대상으로 한 전향적 코호트에서 지질 및 지단백 궤적은 연령, 성별, 지역에 따라 상이한 양상을 보였으며, 총콜레스테롤, 저밀도 지단백 콜레스테롤, 비고밀도 지단백 콜레스테롤 수준은 농촌 지역에 비해 도시 지역에서 전반적으로 불리한 양상으로 나타났다. • 여성은 남성에 비해 5개 지질 및 지단백 지표 전반에서 더 큰 증가 폭을 보였으며, 여성의 고밀도 지단백 콜레스테롤은 폐경 이행기를 전후로 감소한 이후 다시 증가하였다. • 허리둘레의 지속적인 감소는 지질 및 지단백 프로파일의 개선과 관련되었으며, 이러한 결과는 복부비만 관리에 있어 연령과 성별을 고려한 맞춤형 접근의 중요성을 시사한다.
Key Message
• In a prospective cohort analysis of Korean adults aged 40 years and older, lipid and lipoprotein trajectories varied by age, sex, and region, with total cholesterol, low- density llipoprotein cholesterol, and non-high-density lipoprotein cholesterol levels generally showing less favorable patterns in urban than rural areas. • Females exhibited greater increases across all five lipid and lipoprotein measures than males, while high-density cholesterol levels in females declined around the menopausal transition and increased again in later life. • A sustained decrease in waist circumference was associated with improvements in lipid and lipoprotein profiles, highlighting the importance of age- and sex-specific approaches to abdominal obesity management.
Non-linear association between serum folate concentrations and dyslipidemia: Korea National Health and Nutrition Examination Survey 2016-2018
Taiyue Jin, Eun Young Park, Byungmi Kim, Jin-Kyoung Oh
Epidemiol Health. 2022;44:e2022046.   Published online May 15, 2022
DOI: https://doi.org/10.4178/epih.e2022046
  • 25,258 View
  • 354 Download
  • 6 Web of Science
  • 7 Crossref
AbstractAbstract AbstractSummary PDFSupplementary Material
Abstract
OBJECTIVES
We aimed to evaluate the association between serum folate concentrations and the prevalence of dyslipidemia.
METHODS
A total of 4,477 adults (2,019 male and 2,458 female) enrolled in the Korea National Health and Nutrition Examination Survey (KNHANES) 2016-2018 were included. Serum samples were used to assess folate concentrations and total cholesterol (TC), triglyceride (TG), low-density lipoprotein (LDL)-cholesterol, and high-density lipoprotein (HDL)-cholesterol levels. Multivariate logistic regression with sampling weights was used to calculate odds ratios (ORs) and 95% confidence intervals (CIs).
RESULTS
Elevated TC, TG, LDL-cholesterol and HDL-cholesterol levels were observed in 506 (11.3%), 646 (14.4%), 434 (9.7%), and 767 (17.1%) participants, respectively. We found non-linear trends between serum folate concentrations and the prevalence of hypercholesterolemia and hyper-LDL cholesterolemia from the restricted cubic smoothing spline. A higher prevalence of hypercholesterolemia was observed among participants in the first tertile of serum folate concentrations (OR,1.38; 95% CI, 1.05 to 1.79) than among those in the second tertile. However, a higher prevalence of hyper-LDL cholesterolemia was identified for both the first and third serum folate concentration tertiles (OR, 1.49; 95% CI, 1.08 to 2.05 and OR, 1.63; 95% CI, 1.20 to 2.20, respectively); furthermore, in these tertiles, the prevalence of hyper-LDL cholesterolemia was more pronounced among obese participants.
CONCLUSIONS
Non-linear associations may exist between serum folate concentrations and the prevalence of hypercholesterolemia and hyper-LDL cholesterolemia in adults. The findings suggest that more accurate recommendations about folate intake and folic acid fortification and supplementation should be provided.
Summary
Korean summary
본 연구는 국민건강영양조사 자료를 활용하여 한국 성인에서 혈청 엽산 농도와 고콜레스테롤혈증 및 저밀도지단백 (LDL) 콜레스테롤혈증 유병률 간의 비선형 연관성을 확인하였다. 이 결과는 적정 혈청 엽산 농도와 정확한 엽산 권장섭취량을 추정하는데 근거로 활용될수 있을 것이다.
Key Message
1. The prevalence of hypercholesterolemia and hyper-LDL cholesterolemia were non-linearly associated with serum concentrations of folate in the Korean population. 2. An inverse association with a significant linear trend between serum folate concentrations and prevalence of hypo-HDL cholesterolemia was observed. 3. In relation to folate intake and folic acid fortification and supplementation, more accurate recommendations should be provided.

Citations

Citations to this article as recorded by  
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    The World Journal of Men's Health.2026; 44(1): 106.     CrossRef
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    Seok-Jae Oh, Kwon Woo Nam, Sangah Shin
    Frontiers in Nutrition.2026;[Epub]     CrossRef
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    Nutrients.2026; 18(12): 2024.     CrossRef
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    Journal of Affective Disorders.2025; 391: 119974.     CrossRef
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    European Journal of Nutrition.2024; 63(6): 2317.     CrossRef
  • A Review of Major Secondary Data Resources Used for Research in Traditional Korean Medicine
    Chunhoo Cheon, Bo-Hyoung Jang, Seong-Gyu Ko
    Perspectives on Integrative Medicine.2023; 2(2): 77.     CrossRef
  • The Utilization of Serum Folate and Homocysteine Tests and the Prevalence of Folate Deficiency in Reproductive-Age Korean Women during the COVID-19 Pandemic
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    Nutrients.2023; 15(14): 3236.     CrossRef
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