High-Density Lipoprotein Cholesterol Levels and the Risk of Acromegaly: A Nationwide Cohort Study

Large-scale population-based data on the association between low high-density lipoprotein cholesterol (HDL-C) levels and the development of acromegaly are lacking. We aimed to investigate the association between different HDL-C levels and incident acromegaly.

Retrospective Cohort study.

Using data from the National Health Insurance Services in Korea, we enroled adults without pre-existing acromegaly, who participated in the national health screening in 2009, were enroled and followed up until 2019. Participants were classified based on baseline HDL-C levels. Low HDL-C level was defined as HDL-C value < 40 mg/dL for men or < 50 mg/dL for women. The risk of acromegaly was also examined according to HDL-C levels in 10 mg/dL intervals.

Among a total 9,876,423 adults without acromegaly, 459 (4.6 cases per 100,000 people) participants developed acromegaly during the median follow-up period of 9.2 years. The risk of acromegaly was significantly higher in patients with low HDL-C (HR 1.45, 95% CI 1.19-1.78) compared to normal HDL-C group after adjusting for potential confounding variables, including total cholesterol levels and the use of lipid-lowering medication. Furthermore, when HDL-C levels were categorised into four groups at 10 mg/dL intervals, a dose-dependent association with acromegaly risk was observed, with the highest risk found in the low HDL-C group (grade 4, HR 1.78, 95% CI 1.30-2.43).

Low HDL-C levels were independently associated with an increased risk of acromegaly.