Risk Factors and Management Strategies for Early-Onset Dyslipidemia in Young Adults: A Systematic Review

Background: Dyslipidemia is an established modifiable risk factor for atherosclerotic cardiovascular disease (ASCVD). Increasing evidence suggests that dyslipidemia is becoming more prevalent among young adults, leading to prolonged exposure to atherogenic lipoproteins and increased lifetime cardiovascular risk. However, risk factors and optimal management strategies specific to early-onset dyslipidemia remain insufficiently consolidated.

Objective: To systematically review the evidence on risk factors and management strategies for early-onset dyslipidemia in young adults.

Methods: A systematic literature search was conducted in PubMed, PubMed Central, and major guideline repositories for studies published between 2010 and 2025. Observational studies, intervention studies, reviews, and international clinical guidelines addressing dyslipidemia in adults aged approximately 18–40 years were included. Study selection followed PRISMA 2020 recommendations. Data were extracted and synthesized narratively due to heterogeneity in study design and outcomes.

Results: Eighteen studies met the inclusion criteria for qualitative synthesis. The prevalence of dyslipidemia among young adults ranged from approximately 10% to over 30%, with higher rates observed in males, individuals with obesity, and those with metabolic comorbidities. Major risk factors included obesity, physical inactivity, unhealthy dietary patterns, smoking, insulin resistance, type 2 diabetes mellitus, and genetic predisposition, particularly familial hypercholesterolemia. Lifestyle modification—including dietary changes, increased physical activity, and weight reduction—was consistently identified as first-line therapy. Pharmacological treatment, primarily statin therapy, was recommended for selected high-risk individuals, such as those with familial hypercholesterolemia, markedly elevated low-density lipoprotein cholesterol levels, or diabetes mellitus. Special considerations were noted for women of childbearing age and long-term adherence in young adults.

Conclusions: Early-onset dyslipidemia is a growing public health concern with significant implications for lifetime ASCVD risk. Early identification through targeted screening, sustained lifestyle interventions, and selective pharmacological therapy for high-risk individuals are essential to reduce long-term cardiovascular burden. Further age-specific research is required to optimize screening strategies and long-term management in young adult populations.