The U Shaped Relationship Between High-Density Lipoprotein Cholesterol and All-Cause or Cause-Specific Mortality in Adult Population.
The U Shaped Relationship Between High-Density Lipoprotein Cholesterol and All-Cause or Cause-Specific Mortality in Adult Population.
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DOI：
10.2147/cia.s271528
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发表时间：
2020
影响因子：
3.6
通讯作者：
Zhang B
中科院分区：
文献类型：
--
作者：
Huang YQ;Liu XC;Lo K;Liu L;Yu YL;Chen CL;Huang JY;Feng YQ;Zhang B
高密度脂蛋白胆固醇（HDL-C）与死亡率的关系尚不清楚。我们探讨了HDL-C与成人全因死亡率和病因特异性死亡率的关系。死亡分为全因死亡、心血管死亡和癌症死亡。进行生存曲线、多变量Cox回归和亚组分析，并进行风险比（HR）和95%置信区间（CI）分析。我们拟合了全因死亡率、心血管死亡率和癌症死亡率的Cox回归模型，以评估它们与HDL-C类别（≤30,31 - 40,41 - 50,51 - 60[参考文献]，61-70,bb0 - 70 mg/dL）的关系。共纳入受试者42,145例，其中男性20,415例（48.44%），平均年龄47.12±19.40岁。在平均97.52±54.03个月的随访中，全因死亡率、心血管死亡率和癌症死亡率分别为5061（12.01）、1081（2.56%）和1061（2.52%）。与对照组（HDL-C: 51-60 mg/dL）相比，全因死亡率呈明显的u型相关性，HDL-C浓度最低（≤30 mg/dL） （HR=1.33; 95% CI=1.14 - 1.56）和最高（70 mg/dL） （HR=1.14; 95% CI= 1.02-1.27）的参与者的风险增加。心血管和癌症死亡率的关联是非线性的。与对照组相比，HDL-C浓度最高的患者（HR=1.06; 95% CI-0.84-1.34）癌症死亡风险升高，但无统计学意义。HDL-C对死亡率的影响被一些传统的危险因素调整，包括年龄、性别、种族或合并症。在成人人群中，HDL-C与全因死亡率呈u型关系。
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. 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). 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. A U-shaped association was observed between HDL-C and all-cause mortality among an adult population.