Title | High-density lipoprotein cholesterol and all-cause and cause-specific mortality among the elderly. |
Publication Type | Journal Article |
Year of Publication | 2019 |
Authors | Li, Z-H, Bin Lv, Y-, Zhong, W-F, Gao, X, Kraus, VByers, Zou, M-C, Zhang, X-R, Li, F-R, Yuan, J-Q, Shi, X-M, Wu, X-B, Mao, C |
Journal | Journal of Clinical Endocrinology and Metabolism |
ISSN Number | 1945-7197 |
Keywords | Cholesterol, Health Conditions and Status, Mortality |
Abstract | CONTEXT: The patterns of the association between high-density lipoprotein cholesterol (HDL-C) concentrations and mortality among the elderly are still unclear. OBJECTIVE: To examine the association of HDL-C concentrations with mortality, and to identify the optimal HDL-C concentration range that predicts the lowest risk of all-cause mortality among the elderly. DESIGN: This was a nationwide, community-based prospective cohort study. METHODS: This study included 7,766 elderly individuals (aged ≥65 years; mean age: 74.4 years) from the Health and Retirement Study. Cox proportional hazards models and Cox models with penalized smoothing splines were used to estimate hazard ratios (HRs) with 95% confidence intervals (CIs) for all-cause and cause-specific mortality. RESULTS: During a median follow-up of 5.9 years, 1,921 deaths occurred. After fully adjustment for covariates, a nonlinear (P for nonlinearity<0.001) association was found between HDL-C and all-cause mortality (minimum mortality risk at 71 mg/dL [1.84 mM]); the risk for all-cause mortality was significantly higher in the group with HDL-C concentration <61 mg/dL (1.58 mM) (HR: 1.18; 95% CI: 1.05-1.33) and in the group with HDL-C concentration >87 mg/dL (2.25 mM) (HR: 1.56; 95% CI: 1.17-2.07) than in the group with HDL-C concentrations ranging from 61 to 87 mg/dL (1.58-2.25 mM). Nonlinear associations of HDL-C concentrations with both cardiovascular and non-cardiovascular mortality were also observed (both P for nonlinearity<0.001). CONCLUSIONS: Among the elderly, nonlinear associations were found between HDL-C and all-cause and cardiovascular mortality. The single optimal HDL-C concentration and range were 71 mg/dL and 61 to 87 mg/dL, respectively. |
DOI | 10.1210/jc.2018-02511 |
User Guide Notes | |
Alternate Journal | J. Clin. Endocrinol. Metab. |
Citation Key | 10062 |
PubMed ID | 30869791 |