Association of high-density lipoprotein cholesterol with all-cause and cause-specific mortality in a Chinese population of 3.3 million adults: a prospective cohort study

• DOI: 10.1016/j.lanwpc.2023.100874
• Publication Date: 2023-08-05T10:56:46Z
• Authors: Jiapeng Lu; Guiyuan Han; Xiaoying Liu; Bowang Chen; Ke Peng; Yu Shi; Mei Zhang; Yang Yang; Jianlan Cui; Lijuan Song; Wei Xu; Hao Yang; Wenyan He; Yan Zhang; Yuan Tian; Yichong Li; Xi Li

BackgroundHigh-density lipoprotein cholesterol (HDL-C) has been inversely associated with cardiovascular disease (CVD) risk, but recent evidence suggests that extremely high levels of HDL-C are paradoxically related to increased CVD incidence and mortality. This study aimed comprehensively examine the associations all-cause cause-specific mortality in a Chinese population.MethodsThe China Health Evaluation And risk Reduction through nationwide Teamwork (ChinaHEART) project included 3,397,547 participants aged 35–75 years median follow-up 3.9 years. Baseline were measured, data was ascertained from National Mortality Surveillance System Vital Registration Center for Disease Control Prevention.FindingsThis found U-shaped all-cause, cancer When compared groups lowest adjusted hazard ratios (95% CIs) <30 mg/dL 1.23 (1.17–1.29), 1.33 (1.23–1.45) 1.18 (1.09–1.28) mortality, respectively. For >90 mg/dL, corresponding HR 1.10 (1.05–1.15), 1.09 (1.01–1.18) 1.11 (1.03–1.19). Similar patterns also ischemic heart disease, stroke, liver cancer. About 3.25% could be attributed abnormal HDL-C. The major contributor (16.06 deaths per 100,000 persons, 95% UI: 10.30–22.67) <40 esophageal (2.29 0.57–4.77) >70 mg/dL.InterpretationBoth low risk. We recommended 50–79 as optimal range among adults. Individuals dyslipidemia might benefit proper management both HDL-C.FundingThe CAMS Innovation Fund Medical Science (2021-1-I2M-011), High Level Hospital Clinical Research Funding (2022-GSP-GG-4), Ministry Finance Commission China, 111 Project Education (B16005), Program Guangdong Introducing Innovative Enterpreneurial Teams (2019ZT08Y481), Sanming Medicine Shenzhen (SZSM201811096), Young Talent Academician Fund, Fuwai Academy Sciences, (YS-2022-006) Basic Applied Foundation (2023A1515010076 & 2021A1515220173).