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The U Shaped Relationship Between High-Density Lipoprotein Cholesterol and All-Cause or Cause-Specific Mortality in Adult Population
PURPOSE: The associations of high-density lipoprotein cholesterol (HDL-C) with mortality are still unclear. We explored the associations of HDL-C with all-cause and cause-specific mortality in an adult population. METHODS: Deaths were classified into all-cause, cardiovascular, and cancer mortality....
Autores principales: | , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Dove
2020
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7537851/ https://www.ncbi.nlm.nih.gov/pubmed/33061337 http://dx.doi.org/10.2147/CIA.S271528 |
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author | Huang, Yu-qing Liu, Xiao-cong Lo, Kenneth Liu, Lin Yu, Yu-ling Chen, Chao-lei Huang, Jia-yi Feng, Ying-qing Zhang, Bin |
author_facet | Huang, Yu-qing Liu, Xiao-cong Lo, Kenneth Liu, Lin Yu, Yu-ling Chen, Chao-lei Huang, Jia-yi Feng, Ying-qing Zhang, Bin |
author_sort | Huang, Yu-qing |
collection | PubMed |
description | PURPOSE: The associations of high-density lipoprotein cholesterol (HDL-C) with mortality are still unclear. We explored the associations of HDL-C with all-cause and cause-specific mortality in an adult population. METHODS: Deaths were classified into all-cause, cardiovascular, and cancer mortality. Survival curve, multivariate Cox regression, and subgroup analyses were conducted, and hazard ratio (HR) and 95% confidence interval (CI) were performed. We fitted Cox regression models for all-cause, cardiovascular, and cancer mortality to evaluate their associations with categories of HDL-C (≤30, 31–40, 41–50, 51–60 [reference], 61–70, >70 mg/dL). RESULTS: A total of 42,145 (20,415 (48.44%) males, mean age 47.12±19.40 years) subjects were enrolled. At an average follow-up of 97.52±54.03 months, all-cause, cardiovascular, and cancer mortality numbers were 5,061 (12.01), 1,081 (2.56%), and 1,061 (2.52%), respectively. When compared with the reference group (HDL-C: 51–60 mg/dL), a U-shaped association was apparent for all-cause mortality, with elevated risk in participants with the lowest (≤30 mg/dL) (HR=1.33; 95% CI=1.14– 1.56) and highest (>70 mg/dL) (HR=1.14; 95% CI=1.02–1.27) HDL-C concentration. Associations for cardiovascular and cancer mortality were non-linear. An elevated risk for cancer mortality was observed in those with the highest HDL-C concentration (HR=1.06; 95% CI–0.84–1.34) compared with the reference group, although it was not statistically significant. The effect of HDL-C on mortality was adjusted by some traditional risk factors including age, gender, race, or comorbidities. CONCLUSION: A U-shaped association was observed between HDL-C and all-cause mortality among an adult population. |
format | Online Article Text |
id | pubmed-7537851 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | Dove |
record_format | MEDLINE/PubMed |
spelling | pubmed-75378512020-10-14 The U Shaped Relationship Between High-Density Lipoprotein Cholesterol and All-Cause or Cause-Specific Mortality in Adult Population Huang, Yu-qing Liu, Xiao-cong Lo, Kenneth Liu, Lin Yu, Yu-ling Chen, Chao-lei Huang, Jia-yi Feng, Ying-qing Zhang, Bin Clin Interv Aging Original Research PURPOSE: The associations of high-density lipoprotein cholesterol (HDL-C) with mortality are still unclear. We explored the associations of HDL-C with all-cause and cause-specific mortality in an adult population. METHODS: Deaths were classified into all-cause, cardiovascular, and cancer mortality. Survival curve, multivariate Cox regression, and subgroup analyses were conducted, and hazard ratio (HR) and 95% confidence interval (CI) were performed. We fitted Cox regression models for all-cause, cardiovascular, and cancer mortality to evaluate their associations with categories of HDL-C (≤30, 31–40, 41–50, 51–60 [reference], 61–70, >70 mg/dL). RESULTS: A total of 42,145 (20,415 (48.44%) males, mean age 47.12±19.40 years) subjects were enrolled. At an average follow-up of 97.52±54.03 months, all-cause, cardiovascular, and cancer mortality numbers were 5,061 (12.01), 1,081 (2.56%), and 1,061 (2.52%), respectively. When compared with the reference group (HDL-C: 51–60 mg/dL), a U-shaped association was apparent for all-cause mortality, with elevated risk in participants with the lowest (≤30 mg/dL) (HR=1.33; 95% CI=1.14– 1.56) and highest (>70 mg/dL) (HR=1.14; 95% CI=1.02–1.27) HDL-C concentration. Associations for cardiovascular and cancer mortality were non-linear. An elevated risk for cancer mortality was observed in those with the highest HDL-C concentration (HR=1.06; 95% CI–0.84–1.34) compared with the reference group, although it was not statistically significant. The effect of HDL-C on mortality was adjusted by some traditional risk factors including age, gender, race, or comorbidities. CONCLUSION: A U-shaped association was observed between HDL-C and all-cause mortality among an adult population. Dove 2020-10-02 /pmc/articles/PMC7537851/ /pubmed/33061337 http://dx.doi.org/10.2147/CIA.S271528 Text en © 2020 Huang et al. http://creativecommons.org/licenses/by-nc/3.0/ This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License (http://creativecommons.org/licenses/by-nc/3.0/). By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms (https://www.dovepress.com/terms.php). |
spellingShingle | Original Research Huang, Yu-qing Liu, Xiao-cong Lo, Kenneth Liu, Lin Yu, Yu-ling Chen, Chao-lei Huang, Jia-yi Feng, Ying-qing Zhang, Bin The U Shaped Relationship Between High-Density Lipoprotein Cholesterol and All-Cause or Cause-Specific Mortality in Adult Population |
title | The U Shaped Relationship Between High-Density Lipoprotein Cholesterol and All-Cause or Cause-Specific Mortality in Adult Population |
title_full | The U Shaped Relationship Between High-Density Lipoprotein Cholesterol and All-Cause or Cause-Specific Mortality in Adult Population |
title_fullStr | The U Shaped Relationship Between High-Density Lipoprotein Cholesterol and All-Cause or Cause-Specific Mortality in Adult Population |
title_full_unstemmed | The U Shaped Relationship Between High-Density Lipoprotein Cholesterol and All-Cause or Cause-Specific Mortality in Adult Population |
title_short | The U Shaped Relationship Between High-Density Lipoprotein Cholesterol and All-Cause or Cause-Specific Mortality in Adult Population |
title_sort | u shaped relationship between high-density lipoprotein cholesterol and all-cause or cause-specific mortality in adult population |
topic | Original Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7537851/ https://www.ncbi.nlm.nih.gov/pubmed/33061337 http://dx.doi.org/10.2147/CIA.S271528 |
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