Gender Disparity in Lipid Testing Among Over 0.5 Million Adults from Pakistan: Females are Tested Much Later Despite Higher LDL-Cholesterol Levels

Glob Heart. 2025 Feb 21;20(1):16. doi: 10.5334/gh.1401. eCollection 2025.

Abstract

Background and aims: Dyslipidemia is the major risk factor for atherosclerotic cardiovascular disease (ASCVD); therefore, its early diagnosis and treatment is necessary. While previous studies in Pakistan focused on general lipid profiles, investigations into gender disparities in lipid testing remain scarce. Therefore, the present study aims to explore the gender disparity in lipid testing and lipid levels among the adult Pakistani population.

Methods: The lipid profile data was obtained from a tertiary care hospital and a diagnostic laboratory with centers across Pakistan. Dyslipidemia was defined based on the criteria provided by the National Cholesterol Education Program (NCEP) guidelines. Gender-based differences in lipid levels were analysed by copula decomposition, breaking down dyslipidemia differences into composition and structure effects.

Results: A total of 577,489 adults were included in this study. The highest number of tests (n = 86,709, 14.6%) were conducted in individuals aged between 50 to 54 years. Greater number of males (n = 203,415, 64.3%) were tested before the age of 50 years compared to females (n = 113,030, 35.7%). Conversely, after the age of 50 years, number of tests increased notably among females (n = 137,541, 52.7%) compared to males (n = 123,503, 47.3%; p < 0.001). For all comparisons, significant differences were observed for low density lipoprotein cholesterol (LDL-C), triglycerides (TG), and high-density lipoprotein cholesterol (HDL-C) levels between males and females (p < 0.001), where average levels of LDL-C, TC and HDL-C were higher in females while average TG levels were higher in males.

Conclusion: This study highlights the gender disparity in lipid testing in Pakistan, where females undergo lipid testing later in life, despite higher lipid levels compared to males.

Keywords: Cardiovascular disease; Dyslipidemia; Gender Disparity; Lipid testing; Opportunistic testing; Pakistan.

Publication types

  • Multicenter Study

MeSH terms

  • Adult
  • Cholesterol, LDL* / blood
  • Dyslipidemias* / blood
  • Dyslipidemias* / diagnosis
  • Dyslipidemias* / epidemiology
  • Female
  • Humans
  • Lipids* / blood
  • Male
  • Middle Aged
  • Pakistan / epidemiology
  • Risk Factors
  • Sex Distribution
  • Sex Factors

Substances

  • Cholesterol, LDL
  • Lipids

Grants and funding

The project was funded Pakistan Higher education (Grant 20-15760) and Slovenian Research Agency Grant Grants (J3-2536, P3-0343).