BACKGROUND In low and middle-income countries (LMIC), the total and LDL cholesterol and triglyceride levels of residents of urban areas are reported to be higher than those of rural areas. This may be due to differences in lifestyle behaviors between residents of urban areas and rural areas in LMIC. In this study, our aims were to (1) examine whether or not LDL cholesterol, total/HDL ratios and triglyceride levels of individuals in densely populated areas are higher than those of individuals living in less-densely populated areas in a high-income country (HIC) and (2) investigate the potential mediating roles of physical activity and sedentary behavior. METHODS We used cross-sectional data from 2547 Dutch blood donors that participated in Donor InSight-III. Linear regression was used to analyze the association between population density and LDL cholesterol, total/HDL cholesterol ratio and HDL cholesterol. The mediating roles of moderate-to-vigorous physical activity (MVPA) and sedentary behavior were investigated in a subsample (n = 740) for which objectively measured MVPA/sedentary behavior data was available. Multiple mediation with linear regression analyses were performed and the product-of-coefficients method was used to calculate direct and indirect effects. RESULTS Mean LDL cholesterol and median total cholesterol/HDL cholesterol ratio and triglyceride levels were 2.89, 3.43 and 1.29 mmol/L, respectively. Population density was not associated with LDL cholesterol [β 0.00 (- 0.01; 0.01)], log transformed total/HDL cholesterol ratio [β 1.00 (1.00; 1.00)] and triglyceride levels [β 1.00 (0.99; 1.00)]. No statistically significant direct or indirect effects were found. CONCLUSION Contrary to previous findings in LMIC, no evidence was found that population density is associated with blood lipid levels in blood donors in the Netherlands or that MVPA and sedentary behavior mediate this association. This may be the result of socioeconomic differences and, in part, may be due to the good health of the study population and the relatively high population density in the Netherlands. Also, compared to LMIC, differences in physical activity levels in more versus less populated areas may be less pronounced in HIC.

中文翻译：

---

荷兰献血者人口密度与血脂水平之间的关联。

背景技术据报道，在低收入和中等收入国家(LMIC)，城市地区居民的总胆固醇、低密度脂蛋白胆固醇和甘油三酯水平高于农村地区居民。这可能是由于中低收入国家城市地区和农村地区居民生活方式行为的差异所致。在这项研究中，我们的目的是（1）检查高收入国家人口稠密地区个体的 LDL 胆固醇、总/HDL 比率和甘油三酯水平是否高于居住在人口密度较低地区的个体（HIC）和（2）研究体力活动和久坐行为的潜在中介作用。方法 我们使用了参与 Donor InSight-III 的 2547 名荷兰献血者的横断面数据。采用线性回归分析人口密度与LDL胆固醇、总/HDL胆固醇比值和HDL胆固醇之间的关联。在子样本 (n = 740) 中研究了中度至剧烈体力活动 (MVPA) 和久坐行为的中介作用，该子样本具有客观测量的 MVPA/久坐行为数据。进行了线性回归分析的多重中介，并使用系数乘积法来计算直接和间接效应。结果 平均 LDL 胆固醇、中位总胆固醇/HDL 胆固醇比值和甘油三酯水平分别为 2.89、3.43 和 1.29 mmol/L。人口密度与 LDL 胆固醇 [β 0.00 (- 0.01; 0.01)]、对数转换的总/HDL 胆固醇比率 [β 1.00 (1.00; 1.00)] 和甘油三酯水平 [β 1.00 (0.99; 1.00)] 无关。没有发现统计上显着的直接或间接影响。结论 与中低收入国家之前的研究结果相反，没有证据表明荷兰的人口密度与献血者的血脂水平相关，也没有证据表明 MVPA 和久坐行为介导了这种关联。这可能是社会经济差异的结果，部分原因可能是研究人群的健康状况良好以及荷兰相对较高的人口密度。此外，与中低收入国家相比，高收入国家中人口较多地区与人口较少地区的体力活动水平差异可能不太明显。