Real-world laboratory-based assessment of dyslipidaemia prevalence in Romanian adults: retrospective analysis with independent cross-sectional validation

Dyslipidemia is a major cardiovascular risk factor, yet its prevalence in unselected populations is often poorly characterized. Laboratory-based datasets can provide real-world insight beyond registry or clinically selected cohorts. This two-part analysis included a retrospective analysis of 219,888 Romanian adults with routine lipid measurements from multiple laboratory sites across the country. The independent cross-sectional validation cohort comprised 271 clinically healthy adults. Lipid parameters assessed included total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), and triglycerides (TG). High prevalence of lipid abnormalities exceeding guideline-recommended thresholds was observed. In the retrospective cohort, 41.94% had TC > 200 mg/dL, 61.08% had LDL-C > 100 mg/dL, 39.45% had decreased HDL-C, and 30.20% had TG > 150 mg/dL. Age- and sex-specific trends were consistent with known patterns: earlier atherogenic dyslipidemia in males and progressive increase in females with age. The validation cohort showed higher prevalence for elevated TC (47.23%) and LDL-C (84.13%), but lower prevalence for decreased HDL-C (13.65%) and elevated TG (22.87%). In the validation cohort, overall dyslipidemia prevalence was similar between sexes, except for elevated TG, which was approximately three times more prevalent in males. Additionally, in the validation cohort, only 10.7% of participants were free of dyslipidemia, while 62.3% had one trait, 21.7% had two traits, and 5.1% exhibited all three dyslipidemic traits. Dyslipidemia is highly prevalent among Romanian adults, with clear age- and sex-specific patterns. Differences between retrospective and independent cross-sectional data underscore the challenges of estimating population prevalence. Large laboratory databases provide a robust approach for real-world assessment of dyslipidemia burden.