Assessing the Effect of Socioeconomic Factors on Prevalence of Dyslipidemia Among Iranian Adult Population; District Level Analysis From 2016 Steps National Study Using Small Area Estimation Publisher



Soleimani H^{1, 2} ; Ghasemi E¹ ; Saeedi Moghaddam S¹ ; Azadnajafabad S¹ ; Rezaei N^{1, 3} ; Masinaei M^{1, 4} ; Naderimagham S^{1, 3} ; Rezaei N^{1, 3} ; Malekpour MR¹ ; Keykhaei M^{1, 5} ; Gorgani F¹ ; Kazemi A^{1, 3} ; Tahmasebi S⁶ ; Makhdoom R⁷ Show All Authors Show Affiliations
Source: Journal of Diabetes and Metabolic Disorders Published:2022

Abstract

Background: Atherosclerotic Cardiovascular Disease (CVD) is the leading cause of death globally and dyslipidemia plays a critical role in the development of this condition. This study aimed to analyze the potential impact of socioeconomic factors on the prevalence of dyslipidemia at district level in Iran. Understanding these factors is important for development of future risk factor control programs. Methods: We used the nationwide Iran STEPwise approach to risk factor Surveillance (STEPS) 2016 survey as a representative dataset on the Non-Communicable Diseases (NCDs) risk factors in Iran. To obtain a district level dyslipidemia estimates, we utilized the small area estimation method with a Bayesian spatial hierarchical multilevel regression and multilevel mixed models. The principal component analysis was applied to derive household wealth index. For evaluation of education, successful years of schooling was calculated at district level. Urbanization ratio was defined as the proportion of residents in the urban area to the urban and rural areas for each district. Results: The highest difference was found for hypercholesterolemia coverage with 9.11 times difference among the lowest and highest prevalence across the country’s district for males. Men with lower income, lower urbanization, and lower education levels had lower values of high-density lipoprotein (HDL) cholesterol, and higher level of hypercholesterolemia, and hypertriglyceridemia (P-value < 0.001). Triglyceride levels were directly correlated with all analyzed socioeconomic factors in both females and males (P-value < 0.001). Conclusion: We demonstrated that there is an inverse relationship between socioeconomic levels and dyslipidemia indices as populations with higher socioeconomic levels consistently had higher mean dyslipidemia levels. Our findings provide an excellent fundamental framework for healthcare administrators and policymakers to set goals and pursue effective preventive strategies. © 2022, Springer Nature Switzerland AG.