HDL-C, longitudinal change and risk of mortality in a Chinese cohort study

Area of Science:

• Cardiovascular Science
• Epidemiology
• Biochemistry

Background:

• High-density lipoprotein cholesterol (HDL-C) concentration and variability are critical determinants of cardiovascular disease (CVD) and mortality.
• Understanding the relationship between HDL-C dynamics and mortality risk is crucial for public health.

Purpose of the Study:

• To investigate the association between HDL-C concentration, longitudinal changes in HDL-C, and the risk of all-cause and cause-specific mortality.
• To identify specific HDL-C thresholds and variability patterns associated with increased mortality risk.

Main Methods:

• A cohort of 69,163 participants aged ≥40 years with HDL-C records from 2010-2014 was analyzed.
• Cox proportional hazards regression models were employed to estimate hazard ratios (HRs) and 95% confidence intervals (CIs).
• Non-linear associations between HDL-C levels/variability and mortality were examined.

Main Results:

• Non-linear associations were observed between HDL-C concentration and risks of non-accidental and CVD mortality.
• Extremely low (<1 mmol/L) and high (≥2 mmol/L) HDL-C levels were associated with increased CVD mortality risk.
• Significant decreases in HDL-C, particularly large ([-0.5, -0.3 mmol/L]) and very large (<-0.5 mmol/L) reductions, were strongly associated with higher non-accidental and CVD mortality risks.

Conclusions:

• Extremely low or high HDL-C concentrations and substantial decreases in HDL-C are associated with elevated risks of cause-specific mortality.
• Monitoring HDL-C levels and their changes over time may be valuable for identifying individuals at increased risk of mortality.