The association between serum lipids and risk of premature mortality in Latin America: systematic review of population-based prospective cohort studies

Article type
Authors
Carrillo-Larco RM1, Albitres-Flores L2, Barengo NC3, Bernabe-Ortiz A4
1Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London
2Facultad de Medicina, Universidad Nacional de Trujillo
3Department of Medical and Population Health Sciences Research, Herbert Wertheim College of Medicine, Florida International University
4CRONICAS Center of Excellence in Chronic Diseases
Abstract
Background: an unfavourable serum lipid profile, such as increased total cholesterol or low-density lipoprotein (LDL)-cholesterol is an important determinant of cardiovascular diseases causing large negative health consequences in low- and middle-income countries.

Objectives: to synthesize the scientific evidence on the association between serum lipid and premature mortality in Latin America (LA).

Methods: we searched five databases from inception without language restrictions: MEDLINE, Embase, Global Health, Scopus and LILACS. We identified population-based studies following random sampling methods. The exposure variable were lipid biomarkers (e.g. total, LDL- or high-density lipoprotein (HDL)-cholesterol). The outcome was all-cause and cause-specific mortality. We assessed the risk of bias using the Newcastle-Ottawa criteria. We summarized our results qualitatively.

Results: the initial search resulted in 264 abstracts, five of which (N = 27,903) we included for the synthesis. Three papers reported on the same study from Puerto Rico (baseline in 1965), one was from Brazil (1996) and one from Peru (2007). All reports analysed different exposure variables and used different risk estimates (relative risks, hazard ratios or odds ratios). None of the revised reports showed strong association between individual lipid biomarkers and all-cause or cardiovascular mortality.

Conclusions: the available evidence is outdated, inconsistently reported on several lipid biomarker definitions, and used different methods to study the long-term mortality risk. These findings strongly support the need to ascertain the mortality risk associated with lipid biomarkers better in LA.