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Background <p>Dyslipidemia is a major cardiovascular risk factor; however, disease patterns—particularly lipid profiles—remain understudied in high-altitude populations. On the Pamirs Plateau (&gt; 4000&#xa0;m), no relevant epidemiological studies have been conducted to date. This study investigates the disease patterns in this region, with an emphasis on dyslipidemia epidemiology.</p> Methods <p>We conducted a serial cross-sectional study (2021–2024) using annual health examination data from Tashkurgan County, Pamirs Plateau. Adults aged ≥ 18&#xa0;years residing ≥ 1&#xa0;year were included. We first examined the overall disease patterns, with a focus on dyslipidemia. Age-standardized prevalence was calculated and stratified by sex and ethnicity. Subsequently, lipid profile distributions and temporal trends were analyzed. To place these findings in a global context, LDL-C levels were compared with populations from plains and other high-altitude regions. Finally, potential risk factors were identified using multivariate logistic regression and machine learning models.</p> Results <p>Among a representative subset (24.37%) of the Pamirs Plateau population, dyslipidemia was the most prevalent condition, followed by hypertension, sinus bradycardia, and fatty liver. The prevalence of dyslipidemia ranged from 25.24% to 37.64%. LDL-C levels were lower than those in plains and other high-altitude regions. Ethnic disparities were evident: the minority population (predominantly Tajik) maintained stable, favorable lipid profiles across ages, while non-minorities exhibited pronounced age-related fluctuations. Age 70 emerged as a potential inflection point at which sex-related differences in LDL-C levels reversed. Male, non-minority, older age, diabetes, frequent alcohol consumption, and higher education were significantly associated with dyslipidemia. Unexpectedly, improved living conditions (range hood use [OR: 1.839, 95% CI: 1.673–2.021], natural gas use [OR: 1.273, 95% CI: 1.152–1.406], tap water access [OR: 1.315, 95% CI: 1.204–1.436]) were linked to a higher risk, a “modernization paradox”. Additionally, distinct temporal fluctuations were observed: LDL-C levels sharply declined in 2022 before rebounding, coinciding with the COVID-19 lockdown period.</p> Conclusions <p>This first comprehensive analysis from “the roof of the world” reveals unique lipid patterns, including low LDL-C levels, pandemic-era fluctuations, ethnic disparities, unique age-sex patterns, and a paradoxical association between improved living conditions and increased dyslipidemia risk. These insights should inform context-specific lipid management strategies for this and similar vulnerable high-altitude populations globally.</p>

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A serial 4-year cross-sectional study of dyslipidemia on Pamirs Plateau, the roof of the world

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年12月29日

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  • Yisi Liu,
  • Yue Shu,
  • Xinyu Wang,
  • Bin Li,
  • Dai Su,
  • Chaoji Huangfu,
  • Zhu Huang,
  • Yuxin Wang,
  • Shuqian Zhang,
  • Taiwei Wang,
  • Chaoyue Gao,
  • Lin Luo,
  • Zexinyao Ren,
  • Rui Wang,
  • Yue Gao,
  • Wei Zhou

摘要

Background

Dyslipidemia is a major cardiovascular risk factor; however, disease patterns—particularly lipid profiles—remain understudied in high-altitude populations. On the Pamirs Plateau (> 4000 m), no relevant epidemiological studies have been conducted to date. This study investigates the disease patterns in this region, with an emphasis on dyslipidemia epidemiology.

Methods

We conducted a serial cross-sectional study (2021–2024) using annual health examination data from Tashkurgan County, Pamirs Plateau. Adults aged ≥ 18 years residing ≥ 1 year were included. We first examined the overall disease patterns, with a focus on dyslipidemia. Age-standardized prevalence was calculated and stratified by sex and ethnicity. Subsequently, lipid profile distributions and temporal trends were analyzed. To place these findings in a global context, LDL-C levels were compared with populations from plains and other high-altitude regions. Finally, potential risk factors were identified using multivariate logistic regression and machine learning models.

Results

Among a representative subset (24.37%) of the Pamirs Plateau population, dyslipidemia was the most prevalent condition, followed by hypertension, sinus bradycardia, and fatty liver. The prevalence of dyslipidemia ranged from 25.24% to 37.64%. LDL-C levels were lower than those in plains and other high-altitude regions. Ethnic disparities were evident: the minority population (predominantly Tajik) maintained stable, favorable lipid profiles across ages, while non-minorities exhibited pronounced age-related fluctuations. Age 70 emerged as a potential inflection point at which sex-related differences in LDL-C levels reversed. Male, non-minority, older age, diabetes, frequent alcohol consumption, and higher education were significantly associated with dyslipidemia. Unexpectedly, improved living conditions (range hood use [OR: 1.839, 95% CI: 1.673–2.021], natural gas use [OR: 1.273, 95% CI: 1.152–1.406], tap water access [OR: 1.315, 95% CI: 1.204–1.436]) were linked to a higher risk, a “modernization paradox”. Additionally, distinct temporal fluctuations were observed: LDL-C levels sharply declined in 2022 before rebounding, coinciding with the COVID-19 lockdown period.

Conclusions

This first comprehensive analysis from “the roof of the world” reveals unique lipid patterns, including low LDL-C levels, pandemic-era fluctuations, ethnic disparities, unique age-sex patterns, and a paradoxical association between improved living conditions and increased dyslipidemia risk. These insights should inform context-specific lipid management strategies for this and similar vulnerable high-altitude populations globally.