We found a match
Your institution may have access to this item. Find your institution then sign in to continue.
- Title
High-density lipoprotein cholesterol and all-cause mortality by sex and age: a prospective cohort study among 15.8 million adults.
- Authors
Yi, Sang-Wook; Park, Se-Jun; Yi, Jee-Jeon; Ohrr, Heechoul; Kim, Hyeongsu
- Abstract
<bold>Background: </bold>The associations between high-density lipoprotein cholesterol (HDL-C) levels and all-cause mortality are unclear in young adults (<45 years) and in Asian populations.<bold>Methods: </bold>In total, 15 860 253 Korean adults underwent routine health examinations during 2009-10 and were followed until June 2018 for all-cause mortality. Hazard ratios (HRs) were calculated using Cox proportional hazard models.<bold>Results: </bold>During a mean 8.4 years of follow-up, 555 802 individuals died. U-curve associations were found between HDL-C levels and mortality, irrespective of sex or age. The HDL-C ranges associated with the lowest mortality were 40-59 and 50-69 mg/dL (1.03-1.54 and 1.29-1.80 mmol/L) in men aged <65 and ≥65 years, respectively, and the corresponding ranges were 40-69 and 50-79 mg/dL (1.03-1.80 and 1.29-2.06 mmol/L) in women aged <45 and ≥45 years, respectively. For HDL-C ranges of 60-149 mg/dL (1.55-3.86 mmol/L), each 39 mg/dL (1 mmol/L) increase in HDL-C was associated with higher mortality [men: HR = 1.39; 95% confidence interval (CI) = 1.36-1.42; women: HR = 1.15, 95% CI = 1.11-1.18], adjusting for age. These positive associations were generally stronger at younger than older ages, whereas inverse associations for HDL-C ranges <60 mg/dL (1.55 mmol/L) were strongest in middle age (45-64 years). The U-curve associations were generally unchanged after adjustment for various confounders.<bold>Conclusions: </bold>Korean adults showed U-curve associations of HDL-C with mortality, regardless of sex, and age. Younger adults had a lower optimal range and a stronger positive association with mortality than older adults in the high HDL-C range. Even moderately high HDL-C levels are not necessarily a sign of good health, especially in young adults.
- Subjects
HDL cholesterol; YOUNG adults; MORTALITY; ADULTS; OLDER people; COHORT analysis; OLDER men; LONGITUDINAL method; PROPORTIONAL hazards models
- Publication
International Journal of Epidemiology, 2021, Vol 50, Issue 3, p902
- ISSN
0300-5771
- Publication type
journal article
- DOI
10.1093/ije/dyaa243