Stationary screen time, blood lipids, and atherosclerotic cardiovascular disease incidence

The associations between screen time exposure, blood lipids, and Atherosclerotic Cardiovascular Disease (ASCVD) incidence have been less studied. We aimed to examine the associations of exposure to screen time with blood total cholesterol (TC), HDL-C, LDL-C, triglycerides (TG), apolipoprotein A1 (ApoA1), apolipoprotein B (ApoB), and ASCVD risk score, and risk of subsequent ASCVD incidence.

A nationwide sample of 7124 China Health and Nutrition Survey 2009 participants were followed up to 2015 for ASCVD incidence. The stationary screen time exposure was assessed through self-reported daily hours of using television, and computers. A total of 292 ASCVD events occurred during 35,310 follow-up person-years. Per 1-h increases in daily screen time exposure were associated with a higher 0.34% (0.12% to 0.56%), 0.47% (0.09% to 0.86%), and 0.51% (0.19% to 0.83%) increases in blood TC, LDL-C, and ApoB levels. A higher risk of incident ASCVD was associated with per log-transformed unit increase in blood LDL-C (adjusted HR = 1.51, 95% CI 1.04 to 2.18), and ApoB (adjusted HR = 1.80, 95% CI 1.12 to 2.92). The elevated blood TC, blood LDL-C, blood ApoA1 and ApoB levels significantly mediated the association between screen time exposure and ASCVD incidence. Urban dwellers, middle-aged adults, and females were particularly associated with a higher ASCVD risk with screen time exposure.

The results of this nationwide cohort supported the associations of screen time exposure with elevated blood LDL-C, and ApoB levels, which consistently contributed to an increased risk of subsequent ASCVD incidence.