Sex-Specific Prevalence and Associated Factors of Dyslipidemia in Korean Adults: A Cross-Sectional Study

This study aimed to examine the sex-specific prevalence of dyslipidemia and its components among Korean adults and to identify associated sociodemographic, behavioral, and clinical risk factors.

Data were analyzed from 7803 adults aged ≥ 20 years who participated in the 2022-2023 Korea National Health and Nutrition Examination Survey (KNHANES). Dyslipidemia was defined based on lipid thresholds for total cholesterol, LDL-C, HDL-C, and triglycerides. Multivariable logistic regression analyses were conducted separately by sex, accounting for the complex survey design.

The overall weighted prevalence of dyslipidemia was 29.9%, significantly higher in men (38.7%) than in women (22.2%). Men had markedly higher prevalence of low HDL-C and hypertriglyceridemia, while women showed a postmenopausal rise in dyslipidemia. In sex-stratified models, hypertension, diabetes, and abdominal obesity were consistently associated with higher odds of dyslipidemia in both sexes. Current smoking was associated with dyslipidemia for men (OR, 1.929) and women (OR, 1.471). Alcohol intake was inversely associated with dyslipidemia only in men. Aerobic physical activity was associated with slightly higher odds of dyslipidemia in men but not in women. Sociodemographic variables were not independently associated with dyslipidemia after adjustment.

Sex-specific differences in dyslipidemia prevalence and associated factors may reflect distinct biological and behavioral mechanisms. This study's findings highlight the importance of targeted interventions tailored by sex. Current smoking, hypertension, abdominal obesity, and diabetes were positively associated with dyslipidemia in both sexes, whereas alcohol consumption was inversely associated only in men. In women, current smoking and metabolic factors, including hypertension, abdominal obesity, and diabetes were significant, underscoring the need for comprehensive metabolic risk management in middle-aged and older women. These results support a life-course, sex-responsive approach to dyslipidemia prevention in Korea.