期刊
JOURNAL OF CLINICAL LIPIDOLOGY
卷 12, 期 3, 页码 674-684出版社
ELSEVIER SCIENCE INC
DOI: 10.1016/j.jacl.2018.01.014
关键词
High-density lipoprotein cholesterol; Cardiovascular disease; Atherosclerotic cardiovascular disease; Mortality; Epidemiology
资金
- Ministry of Health, Labour and Welfare, Health and Labor Sciences, Japan [H17-Kenkou-007, H18-Junkankitou [Seishuti]-Ippan-012, H19-Junkankitou [Seishuu]-Ippan-012, H20-Junkankitou [Seishut]-Ippan-013, H23-Junkankitou [Seishuu]-Ippan-005]
- Intramural Research Fund for Cardiovascular Diseases of National Cerebral and Cardiovascular Center [22-4-5]
- Comprehensive Research on Cardiovascular and Lifestyle-Related Diseases [H26-Junkankitou [Seisaku]-Ippan-001, H29-Junkankitou [Seishuu]-Ippan-003]
BACKGROUND: The effect of very high or extremely high levels of high-density lipoprotein cholesterol (HDL-C) on cardiovascular disease (CVD) is not well described. Although a few recent studies have reported the adverse effects of extremely high levels of HDL-C on CVD events, these did not show a statistically significant association between extremely high levels of HDL-C and cause specific CVD mortality. In addition, Asian populations have not been studied. OBJECTIVE: We examine the impact of extremely high levels of HDL-C on cause-specific CVD mortality using pooled data of Japanese cohort studies. METHODS: We performed a large-scale pooled analysis of 9 Japanese cohorts including 43,407 participants aged 40-89 years, dividing the participants into 5 groups by HDL-C levels, including extremely high levels of HDL-C >= 2.33 mmol/L (>= 90 mg/dL). We estimated the adjusted hazard ratio of each HDL-C category for all-cause death and cause-specific deaths compared with HDL-C 1.04-1.55 mmol/L (40-59 mg/dL) using a cohort-stratified Cox proportional hazards model. RESULTS: During a 12.1-year follow-up, 4995 all-cause deaths and 1280 deaths due to overall CVD were identified. Extremely high levels of HDL-C were significantly associated with increased risk of atherosclerotic CVD mortality (hazard ratio = 2.37, 95% confidence interval: 1.37-4.09 for total) and increased risk for coronary heart disease and ischemic stroke. In addition, the risk for extremely high HDL-C was more evident among current drinkers. CONCLUSION: We showed extremely high levels of HDL-C had an adverse effect on atherosclerotic CVD mortality in a pooled analysis of Japanese cohorts. (C) 2018 National Lipid Association. All rights reserved.
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