Longitudinal associations of high-density lipoprotein cholesterol or low-density lipoprotein cholesterol with metabolic syndrome in the Chinese population: a prospective cohort study

Objective Currently, most studies only reveal the relationship between baseline high-density lipoprotein cholesterol (HDL-c) or low-density lipoprotein cholesterol (LDL-c) levels and metabolic syndrome (MetS). The relationship between dynamic changes in HDL-c or LDL-c and MetS remains unclear. We aimed to gain a deeper understanding of the relationship between the dynamic changes in HDL-c or LDL-c and MetS. Design A prospective study. Setting The Medical Centre of the Second Hospital affiliated with Dalian Medical University from 2010 to 2016. Participants A total of 4542 individuals who were initially MetS-free and completed at least two follow-up examinations as part of the longitudinal population were included. Methods The Joint Interim Statement criteria 2009 were used to define MetS. We used the Joint model to estimate the relative risks (RRs) of incident MetS. Results The cumulative incidence of MetS was 17.81% and was 14.86% in men and 5.36% in women during the 7 years of follow-up. In the Joint models, the RRs of the longitudinal decrease in HDL-c and the longitudinal increase in LDL-c for the development of MetS were 18.8781-fold (95% CI 12.5156 to 28.4900) and 1.3929fold (95% CI 1.2283 to 1.5795), respectively. Conclusions The results highlight that the dynamic longitudinal decrement of HDL-c or the increment of LDL-c is associated with an elevated risk of MetS.