Factors associated with low HDL cholesterol in Brazilian adults according to the National Health Survey: a cross-sectional study

Background Dyslipidemia can be defined as abnormal concentrations of circulating lipids in the bloodstream, such as total cholesterol, triglycerides (TGs), low-density lipoproteins (LDLs), or high-density lipoproteins (HDLs). HDL is an Apo A lipoprotein complex with an anti-atherogenic role and possesses antiproliferative, antithrombotic, and anti-inflammatory properties, and its low concentration in the blood is associated with increased cardiovascular risk. Given the importance of HDL concentration, this study aimed to analyze the factors associated with low HDL cholesterol in Brazilian adults. Methods A cross-sectional study that used the database of laboratory tests from 8,520 individuals collected by the National Health Survey between 2014 and 2015. The prevalences of HDL-Cholesterol < 40 and ≥ 40 mg/dL were estimated, with the outcome variable being low HDL-Cholesterol (≤ 40 mg/dL) and the explanatory variables including sociodemographic factors (sex, age group, education level, race/skin color, regions of Brazil), anthropometric factors (BMI), lifestyle (abusive alcohol consumption, smoking, physical activity), chronic diseases (diabetes, kidney failure, hypertension, anemia), and self-reported health. To verify the associations, Poisson regression with robust variance was used, estimating crude and adjusted (PRa) prevalence ratios and 95% confidence intervals (95% CI). Results The prevalence of low HDL cholesterol was 34.81%. In the final multivariate model, the following factors were associated with the outcome: male sex (PRa = 2.00; 95% CI 1.84–2.16), intermediate education level—complete elementary or incomplete high school (PRa = 1.23; 95% CI 1.10–1.37), overweight (PRa = 1.46; 95% CI 1.33–1.61), obesity (PRa = 1.72; 95% CI 1.54–1.91), diabetes (PRa = 1.18; 95% CI 1.06–1.32), chronic kidney disease (PRa = 1.22; 95% CI 1.06–1.41), and hypertension (PRa = 1.18; 95% CI 1.08–1.29). Conclusion Low HDL cholesterol was associated with male sex, intermediate education level, overweight and obesity, diabetes, chronic kidney disease, and hypertension.