OBJECTIVETo describe the changes of serum total cholesterol (TC) and the prevalence of hypercholesterolemia from 1992 to 2007 in the general population from Chinese multi-provincial cohort study (CMCS).

METHODSCMCS database were established on participants aged 35-64 years from 11 provinces during the baseline examination on cardiovascular risk factors in 1992. Participants were followed up and invited to re-examine risk factors in 2007. Five thousand seven hundred and forty participants with complete data from these two examinations were included in this study for investigating the changes of serum TC level.

RESULTS(1) From 1992 to 2007, the mean level of TC increased from 4.65 mmol/L to 4.96 mmol/L for men, and from 4.40 mmol/L to 5.35 mmol/L for women. The prevalence of hypercholesterolemia increased from 5.1% (141/2 791) to 8.5% (237/2 791) in men, and from 4.9% (143/2 949) to 20.0% (590/2 949) in women. (2) Stratified by sex and age, the maximum increase in TC of 0.95 mmol/L was observed in women aged 35-44 years. Stratified by district, the maximum increase in TC of 0.88 mmol/L was observed in participants who had low baseline TC level living at rural area. Furthermore, baseline TC level was categorized into quintiles, the increases in TC level were highest in the lowest quintile both in men and women (0.93 mmol/L and 1.45 mmol/L, respectively). (3) Thirty-six point five percent (302/827) participants with hypercholesterolemia in 2007 developed from those with baseline TC 5.18-6.21 mmol/L, and 49.6% (410/827) developed from those with baseline TC < 5.18 mmol/L.

CONCLUSIONSFrom 1992 to 2007, the mean level of TC increased in both men and women. The greatest increases in TC were observed in the participants with the lowest quintile of baseline TC and those living in the rural area.