高密度脂蛋白胆固醇与死亡率：好事过头了？
High-Density Lipoprotein Cholesterol and Mortality: Too Much of a Good Thing?
机构信息
From the School of Sport, Exercise, and Health Sciences, Loughborough University, United Kingdom (M.H., G.O.); Department of Epidemiology and Public Health, University College London, United Kingdom (M.H., E.S.); and Charles Perkins Centre, Prevention Research Collaboration, School of Public Health, University of Sydney, Australia (E.S.).
出版信息
Arterioscler Thromb Vasc Biol. 2018 Mar;38(3):669-672. doi: 10.1161/ATVBAHA.117.310587. Epub 2018 Jan 11.
OBJECTIVE
The objective of this study was to examine the shape of the association between high-density lipoprotein cholesterol (HDL-C) and mortality in a large general population sample.
APPROACH AND RESULTS
Adult participants (n=37 059; age=57.7±11.9 years; 46.8% men) were recruited from general population household-based surveys (Health Survey for England and Scottish Health Survey). Individual participant data were linked with the British National Health Service Central Registry to record mortality. There were 2250 deaths from all causes during 326 016 person-years of follow-up. When compared with the reference category (HDL-C=1.5-1.99 mmol/L), a U-shaped association was apparent for all-cause mortality, with elevated risk in participants with the lowest (hazard ratio=1.23; 95% confidence interval, 1.06, 1.44) and highest (1.25; 0.97, 1.62) HDL-C concentration. Associations for cardiovascular disease were linear, and elevated risk was observed in those with the lowest HDL-C concentration (1.49; 1.15, 1.94).
CONCLUSIONS
A U-shaped association was observed between HDL-C and mortality in a large general population sample.
目的
本研究旨在探讨高密度脂蛋白胆固醇（HDL-C）与大样本普通人群死亡率之间的关联形态。
方法和结果
成年参与者（n=37059；年龄=57.7±11.9 岁；46.8%为男性）来自基于家庭的普通人群调查（英格兰健康调查和苏格兰健康调查）。将个体参与者数据与英国国家卫生服务中心登记处进行链接，以记录死亡率。在 326016 人年的随访中，共有 2250 人死于各种原因。与参考类别（HDL-C=1.5-1.99mmol/L）相比，全因死亡率呈现出明显的 U 形关联，最低（危险比=1.23；95%置信区间，1.06，1.44）和最高（1.25；0.97，1.62）HDL-C 浓度的参与者风险增加。心血管疾病的相关性呈线性，最低 HDL-C 浓度（1.49；1.15，1.94）的参与者风险增加。
结论
在大样本普通人群中，观察到 HDL-C 与死亡率之间呈 U 形关联。
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