Socioeconomic Disparities and Other Factors in Dyslipidemia: Insights from NHANES 2017–2020 Data
Abstract
1. Introduction
2. Methods
2.1. Study Design and Data Source
2.2. Study Population
3. Variable Definitions
3.1. Dyslipidemia
3.2. Socioeconomic Status (SES)
3.3. Sociodemographic Factors
3.4. Examination/Measurement Variable
3.5. Lifestyle Variables
3.6. Medical Conditions
4. Statistical Analysis
5. Ethical Considerations
6. Results
6.1. Demographic and Clinical Characteristics
6.2. Socioeconomic Status and Dyslipidemia
6.3. Age and BMI as Predictors
6.4. Medical Conditions and SES
6.5. Subpopulation Analysis by SES
6.6. Gender-Specific Subgroup Analysis
7. Discussion
Strengths and Limitations
8. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Variables | Overall | No Dyslipidemia | Dyslipidemia | p Value |
---|---|---|---|---|
(n = 5862) | (n = 1685) | (n = 4177) | ||
Age | 50.85 (±17.20) | 42.73 (±16.97) | 53.94 (±16.26) | <0.0001 |
Systolic BP | 124.43 (±18.84) | 120.04 (±17.75) | 126.06 (±18.97) | |
Diastolic BP | 74.79 (±11.52) | 73.08 (±11.28) | 75.44 (±11.54) | |
Gender | 0.49 | |||
Male | 2899 (51.27) | 809 (50.19) | 2175 (51.18) | |
Female | 2755 (48.73) | 803 (49.81) | 2075 (48.82) | |
Race | <0.0001 | |||
Mexi-American | 679 (11.58) | 173 (10.73) | 506 (11.91) | |
Other Hispanic | 567 (9.67) | 142 (8.81) | 425 (10.00) | |
NH-White | 2285 (38.98) | 565 (35.05) | 1720 (40.47) | |
NH-Black | 1492 (25.45) | 510 (31.64) | 982 (23.11) | |
Multiracial | 839 (14.31) | 222 (13.77) | 617 (14.52) | |
Marital Status | <0.0001 | |||
Married/Partner | 3431 (58.53) | 870 (53.97) | 2561 (60.26) | |
Wid/Div/Sep | 1337 (22.81) | 278 (17.25) | 1059 (24.92) | |
Never Married | 1092 (18.63) | 464 (28.78) | 628 (14.78) | |
Education Level | <0.0001 | |||
High (≥College) | 1487 (25.37) | 457 (28.35) | 1030 (24.24) | |
Medium (High School < College) | 3465 (59.11) | 952 (59.06) | 2513 (59.13) | |
Low (<High School) | 910 (15.52) | 203 (12.59) | 707 (16.64) | |
Income Category | 0.20 | |||
Below Poverty | 1041 (17.76) | 311 (19.29) | 730 (17.18) | |
Near Poverty | 1519 (25.91) | 400 (24.81) | 1119 (26.33) | |
Low Income | 975 (16.63) | 265 (16.44) | 710 (16.71) | |
Middle Income | 661 (11.28) | 194 (12.03) | 467 (10.99) | |
High Income | 1666 (28.42) | 442 (27.42) | 1224 (28.80) | |
Adult Food Security | 0.73 | |||
Full Food Security | 3742 (63.83) | 1015 (62.97) | 2727 (64.16) | |
Marginal Food Security | 844 (14.40) | 243 (15.07) | 601 (14.14) | |
Low Food Security | 693 (11.82) | 188 (11.66) | 505 (11.88) | |
Very Low Food Security | 583 (9.95) | 166 (10.30) | 417 (9.81) | |
Covered by Health Insurance | <0.0001 | |||
Yes | 4959 (84.60) | 1305 (80.96) | 3654 (85.98) | |
No | 895 (15.27) | 303 (18.80) | 592 (13.93) | |
Hypertension | <0.0001 | |||
Yes | 2573 (43.89) | 416 (25.81) | 2157 (50.75) | |
No | 3093 (52.76) | 1111 (68.92) | 1982 (46.64) | |
Diabetes | <0.0001 | |||
Yes | 1130 (19.28) | 125 (7.75) | 1005 (23.65) | |
No | 4732 (80.72) | 1487 (92.25) | 3245 (76.35) | |
Obesity Category | <0.0001 | |||
Underweight | 71 (1.21) | 45 (2.79) | 26 (0.61) | |
Normal Weight | 1363 (23.25) | 604 (37.47) | 759 (17.86) | |
Overweight | 1842 (31.42) | 449 (27.85) | 1393 (32.78) | |
Obesity | 2586 (44.11) | 514 (31.89) | 2072 (48.75) | |
Waist Circumference | <0.0001 | |||
Normal WC | 2286 (39) | 920 (57.07) | 1366 (32.14) | |
Elevated WC | 3576 (61) | 692 (42.93) | 2884 (67.86) | |
Alcohol Status | <0.0001 | |||
Nonalcoholic | 1258 (21.46) | 259 (16.07) | 999 (23.51) | |
Rare Drinker | 2021 (34.48) | 547 (33.93) | 1474 (34.68) | |
Occasional Drinker | 1730 (29.51) | 530 (32.88) | 1200 (28.24) | |
Regular Drinker | 853 (14.55) | 276 (17.12) | 577 (13.58) | |
Smoking Status | <0.0001 | |||
Nonsmoker | 3177 (54.20) | 967 (59.99) | 2210 (52.00) | |
Smoker | 2683 (45.77) | 644 (39.95) | 2039 (47.98) | |
Physical Activity Status | <0.0001 | |||
Active | 4229 (72.14) | 1270 (78.78) | 2959 (69.62) | |
Inactive | 1633 (27.86) | 342 (21.22) | 1291 (30.38) | |
Age Group | <0.0001 | |||
20–29 | 859 (14.65) | 474 (29.40) | 385 (9.06) | |
30–39 | 897 (15.30) | 343 (21.28) | 554 (13.04) | |
40–49 | 959 (16.36) | 261 (16.19) | 698 (16.42) | |
50–59 | 1024 (17.47) | 221 (13.71) | 803 (18.89) | |
60–69 | 1165 (19.87) | 163 (10.11) | 1002 (23.58) | |
70 and above | 958 (16.34) | 150 (9.31) | 808 (19.01) |
Dyslipidemia | |||
SES Class: Middle | SES Class: High | SES Class: Low | |
Sociodemographic Factors | |||
Sex | |||
Male | Ref | Ref | Ref |
Female | 0.830 | 1.131 | 1.331 |
0.180 | 0.561 | 0.137 | |
Race | |||
Mexican-American | Ref | Ref | Ref |
Non-Hispanic White | 0.944 | 0.399 | 1.066 |
0.672 | 0.126 | 0.803 | |
Non-Hispanic Black | 0.624 ** | 0.264 * | 0.381 ** |
0.007 | 0.042 | 0.006 | |
Other Hispanic | 0.795 | 0.307 | 1.512 |
0.292 | 0.140 | 0.274 | |
Multiracial | 1.650 | 0.816 | 0.879 |
0.061 | 0.708 | 0.721 | |
Marital Status | |||
Married/Partner | Ref | Ref | Ref |
Widowed/Divorced/Separated | 0.779 | 0.860 | 0.789 |
0.291 | 0.721 | 0.286 | |
Never Married/Single | 0.655 * | 1.004 | 0.892 |
0.048 | 0.988 | 0.621 | |
Age | 1.035 *** | 1.060 *** | 1.028 *** |
<0.001 | <0.001 | <0.001 | |
BMI | 1.076 *** | 1.080 *** | 1.069 *** |
<0.001 | 0.005 | 0.002 | |
Lifestyle Variables | |||
Alcohol Status | |||
Nonalcoholic | Ref | Ref | Ref |
Rare Drinker | 1.196 | 0.916 | 1.171 |
0.462 | 0.848 | 0.494 | |
Occasional Drinker | 1.160 | 1.488 | 1.131 |
0.540 | 0.383 | 0.539 | |
Regular Drinker | 0.933 | 1.249 | 0.870 |
0.823 | 0.621 | 0.511 | |
Smoking Status | |||
Nonsmoker | Ref | Ref | Ref |
Smoker | 1.171 | 1.301 | 1.105 |
0.331 | 0.285 | 0.428 | |
Total MET Score | 1.000 | 1.000 | 1.000 * |
0.211 | 0.822 | 0.031 | |
Medical Conditions | |||
Diabetes | |||
No | Ref | Ref | Ref |
Yes | 1.806 * | 1.609 | 1.109 |
0.046 | 0.171 | 0.673 | |
Hypertension | |||
No | Ref | Ref | Ref |
Yes | 1.440 * | 1.462 | 1.942 * |
0.031 | 0.203 | 0.016 |
Dyslipidemia | ||
Gender: Female | Gender: Male | |
Socioeconomic Class | ||
Middle | Ref | Ref |
High | 0.968 | 0.780 |
0.784 | 0.253 | |
Low | 1.543 ** | 0.981 |
0.004 | 0.924 | |
Other Sociodemographic Factors | ||
Race | ||
Mexican-American | Ref | Ref |
Non-Hispanic White | 0.958 | 0.822 |
0.819 | 0.168 | |
Non-Hispanic Black | 0.609 * | 0.442 *** |
0.037 | <0.001 | |
Other Hispanic | 0.874 | 0.881 |
0.701 | 0.515 | |
Multiracial | 1.517 | 1.243 |
0.111 | 0.397 | |
Marital Status | ||
Married/Partner | Ref | Ref |
Widowed/Divorced/Separated | 0.954 | 0.590 |
0.765 | 0.051 | |
Never Married/Single | 0.762 | 0.820 |
0.245 | 0.313 | |
Age | 1.045 *** | 1.034 *** |
<0.001 | <0.001 | |
BMI | 1.063 *** | 1.092 *** |
<0.001 | <0.001 | |
Lifestyle Variables | ||
Alcohol Status | ||
Nonalcoholic | Ref | Ref |
Rare Drinker | 1.043 | 1.201 |
0.826 | 0.499 | |
Occasional Drinker | 1.023 | 1.411 |
0.904 | 0.149 | |
Regular Drinker | 1.148 | 0.931 |
0.493 | 0.791 | |
Smoking Status | ||
Nonsmoker | Ref | Ref |
Smoker | 1.398 * | 1.042 |
0.037 | 0.810 | |
Total MET Score | 1.000 | 1.000 |
0.536 | 0.180 | |
Medical Conditions | ||
Diabetes | ||
No | Ref | Ref |
Yes | 1.403 | 1.703 * |
0.324 | 0.025 | |
Hypertension | ||
No | Ref | Ref |
Yes | 1.328 | 1.591 ** |
0.116 | 0.008 |
Model 1 SES Class | Model 2 SES + Sociodemographic | Model 3 SES + SD + BMI | Model 4 SES + SD + BMI+ Lifestyle | Model 5 SES + SD + BMI + Lifestyle + Medical Condition | |
Socioeconomic Class | |||||
Middle | Ref | Ref | Ref | Ref | Ref |
High | 0.897 | 0.805 * | 0.862 | 0.872 | 0.895 |
0.185 | 0.013 | 0.094 | 0.134 | 0.225 | |
Low | 1.175 * | 1.104 | 1.127 | 1.103 | 1.058 |
0.019 | 0.177 | 0.112 | 0.201 | 0.463 | |
Sociodemographic Factors | |||||
Sex | |||||
Male | -- | Ref | Ref | Ref | Ref |
Female | -- | 1.037 | 0.969 | 0.942 | 0.987 |
0.569 | 0.629 | 0.381 | 0.845 | ||
Race | |||||
Mexican-American | -- | Ref | Ref | Ref | Ref |
Non-Hispanic White | 0.819 | 0.875 | 0.860 | 0.872 | |
0.070 | 0.232 | 0.182 | 0.231 | ||
Non-Hispanic Black | -- | 0.575 *** | 0.553 *** | 0.552 *** | 0.513 *** |
<0.001 | <0.001 | <0.001 | <0.001 | ||
Other Hispanic | -- | 0.917 | 0.979 | 0.975 | 0.976 |
0.536 | 0.884 | 0.862 | 0.869 | ||
Multiracial | -- | 1.068 | 1.321 * | 1.286 * | 1.237 |
0.612 | 0.036 | 0.059 | 0.113 | ||
Marital Status | |||||
Married/Partner | -- | Ref | Ref | Ref | Ref |
Widowed/Divorced/Separated | -- | 0.874 | 0.892 | 0.889 | 0.880 |
0.124 | 0.160 | 0.183 | 0.153 | ||
Never Married/Single | -- | 0.838 * | 0.858 | 0.857 | 0.844 |
0.035 | 0.076 | 0.077 | 0.052 | ||
Age | -- | 1.042 *** | 1.042 *** | 1.041 *** | 1.032 *** |
<0.001 | <0.001 | <0.001 | <0.001 | ||
BMI | -- | -- | 1.068 *** | 1.067 *** | 1.057 *** |
<0.001 | <0.001 | <0.001 | |||
Lifestyle Variables | |||||
Alcohol Status | |||||
Nonalcoholic | -- | -- | -- | Ref | Ref |
Rare Drinker | -- | -- | -- | 1.068 | 1.084 |
0.499 | 0.412 | ||||
Occasional Drinker | -- | -- | -- | 1.041 | 1.077 |
0.687 | 0.463 | ||||
Regular Drinker | -- | -- | -- | 0.863 | 0.896 |
0.194 | 0.339 | ||||
Smoking Status | |||||
Nonsmoker | -- | -- | -- | Ref | Ref |
Smoker | 1.188 * | 1.175 * | |||
0.013 | 0.021 | ||||
Total MET Score | -- | -- | -- | 1.000 ** | 1.000 * |
0.007 | 0.022 | ||||
Medical Conditions | |||||
Diabetes | |||||
No | -- | -- | -- | -- | Ref |
Yes | 1.515 *** | ||||
<0.001 | |||||
Hypertension | |||||
No | -- | -- | -- | -- | Ref |
Yes | -- | -- | -- | -- | 1.789 *** |
-- | <0.001 | ||||
AIC | 6555.09 | 6024.09 | 5825.78 | 5819.29 | 5759.91 |
Model 1 SES Class | Model 2 SES + Sociodemographic | Model 3 SES + SD + BMI | Model 4 SES + SD + BMI+ Lifestyle | Model 5 SES + SD + BMI + Lifestyle + Medical Condition | |
Socioeconomic Class | |||||
Middle | Ref | Ref | Ref | Ref | Ref |
High | 0.778 * | 0.740 * | 0.830 | 0.823 | 0.870 |
0.041 | 0.037 | 0.201 | 0.215 | 0.364 | |
Low | 1.160 | 1.218 * | 1.281 * | 1.259 * | 1.237 * |
0.082 | 0.049 | 0.031 | 0.038 | 0.048 | |
Sociodemographic Factors | |||||
Sex | |||||
Male | -- | Ref | Ref | Ref | Ref |
Female | -- | 0.991 | 0.977 | 0.951 | 0.995 |
0.931 | 0.828 | 0.645 | 0.966 | ||
Race | |||||
Mexican-American | -- | Ref | Ref | Ref | Ref |
Non-Hispanic White | 0.816 * | 0.905 | 0.889 | 0.883 | |
0.047 | 0.283 | 0.244 | 0.233 | ||
Non-Hispanic Black | -- | 0.558 *** | 0.535 *** | 0.538 *** | 0.501 *** |
<0.001 | <0.001 | <0.001 | <0.001 | ||
Other Hispanic | -- | 0.782 | 0.885 | 0.881 | 0.860 |
0.231 | 0.521 | 0.514 | 0.431 | ||
Multiracial | -- | 1.142 | 1.409 | 1.384 | 1.319 |
0.440 | 0.076 | 0.095 | 0.151 | ||
Marital Status | |||||
Married/Partner | -- | Ref | Ref | Ref | Ref |
Widowed/Divorced/Separated | -- | 0.759 | 0.798 | 0.794 | 0.788 |
0.083 | 0.160 | 0.165 | 0.175 | ||
Never Married/Single | -- | 0.745 * | 0.781 | 0.782 | 0.754 |
0.035 | 0.078 | 0.094 | 0.068 | ||
Age | -- | 1.046 *** | 1.046 *** | 1.045 *** | 1.473 *** |
<0.001 | <0.001 | <0.001 | <0.001 | ||
BMI | -- | -- | 1.085 *** | 1.083 *** | 1.075 *** |
<0.001 | <0.001 | <0.001 | |||
Lifestyle Variables | |||||
Alcohol Status | |||||
Nonalcoholic | -- | -- | -- | Ref | Ref |
Rare Drinker | -- | -- | -- | 1.102 | 1.116 |
0.577 | 0.530 | ||||
Occasional Drinker | -- | -- | -- | 1.161 | 1.205 |
0.381 | 0.285 | ||||
Regular Drinker | -- | -- | -- | 0.954 | 0.973 |
0.808 | 0.890 | ||||
Smoking Status | |||||
Nonsmoker | -- | -- | -- | Ref | Ref |
Smoker | 1.188 | 1.178 | |||
0.158 | 0.176 | ||||
Total MET Score | -- | -- | -- | 1.000 | 1.000 |
0.096 | 0.155 | ||||
Medical Conditions | |||||
Diabetes | |||||
No | -- | -- | -- | -- | Ref |
Yes | 1.537 ** | ||||
0.044 | |||||
Hypertension | |||||
No | -- | -- | -- | -- | Ref |
Yes | -- | -- | -- | -- | 1.515 *** |
-- | 0.004 |
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Ahmed, T.; Nath, A.; Jahan, N.; Khadka, A.; Kishore, J.; Farokhrouz, A.; Bowden, R.G. Socioeconomic Disparities and Other Factors in Dyslipidemia: Insights from NHANES 2017–2020 Data. Int. J. Transl. Med. 2025, 5, 18. https://doi.org/10.3390/ijtm5020018
Ahmed T, Nath A, Jahan N, Khadka A, Kishore J, Farokhrouz A, Bowden RG. Socioeconomic Disparities and Other Factors in Dyslipidemia: Insights from NHANES 2017–2020 Data. International Journal of Translational Medicine. 2025; 5(2):18. https://doi.org/10.3390/ijtm5020018
Chicago/Turabian StyleAhmed, Tanvir, Akhi Nath, Nusrat Jahan, Aakanksha Khadka, Jaimala Kishore, Ashley Farokhrouz, and Rodney G. Bowden. 2025. "Socioeconomic Disparities and Other Factors in Dyslipidemia: Insights from NHANES 2017–2020 Data" International Journal of Translational Medicine 5, no. 2: 18. https://doi.org/10.3390/ijtm5020018
APA StyleAhmed, T., Nath, A., Jahan, N., Khadka, A., Kishore, J., Farokhrouz, A., & Bowden, R. G. (2025). Socioeconomic Disparities and Other Factors in Dyslipidemia: Insights from NHANES 2017–2020 Data. International Journal of Translational Medicine, 5(2), 18. https://doi.org/10.3390/ijtm5020018