• Jan W Balder, Jeroen K de Vries, Ilja M Nolte, Peter J Lansberg, Jan A Kuivenhoven, and Pieter W Kamphuisen.
• Department of Pediatrics, Section Molecular Genetics, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands; Department of Vascular Medicine, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands.
• J Clin Lipidol. 2017 Jul 1; 11 (4): 1055-1064.e6.

BackgroundLipids and lipoproteins are recognized as the most important modifiable risk factors for cardiovascular disease. Although reference values for the major lipoproteins, low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol, and triglycerides, have been collected in numerous studies and cohorts, complete contemporary percentile-based reference values are underreported.ObjectiveWe set out to provide such reference lipid data using a large contemporary population-based cohort study.Study Design And SettingLifelines is a cross-sectional population-based Dutch cohort study. We analyzed 133,540 adult fasting participants without cardiovascular disease and without lipid-lowering drug use. Lipid levels were directly measured and selected percentiles of all lipid parameters were calculated. Friedewald LDL-C estimation was calculated as well.ResultsFrom 20 till 49 years of age, men were found to exhibit a steep 64% increase of LDL-C (median +54 mg/dL), while triglyceride levels increased almost two-fold. In women, LDL-C levels did not change from 18 till 35 years, followed by a steep 42% increase till 59 years (median +42 mg/dL). In contrast to men, triglycerides were stable in ageing women. Overall, Friedewald LDL-C levels are lower compared with the direct measurement, especially with increasing triglyceride levels.ConclusionsThis observational study highlights striking gender- and age-related differences in plasma lipid profiles. The given reference ranges of plasma lipids can assist in early identification of individuals with hypocholesterolemia and hypercholesterolemia, especially familial hypercholesterolemia. These reference ranges are available for physicians and patients at www.my-cholesterol.care/.Copyright © 2017 National Lipid Association. Published by Elsevier Inc. All rights reserved.

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