Department of Preventive Medicine and Public Health, Catholic Kwandong University College of Medicine, Gangneung, Republic of Korea.
Department of Neurology, Catholic Kwandong University College of Medicine, International St. Mary's Hospital, Incheon, Republic of Korea.
Int J Epidemiol. 2022 Aug 10;51(4):1178-1189. doi: 10.1093/ije/dyac029.
Limited information is available on detailed sex/age-specific associations between low-density lipoprotein cholesterol (LDL-C) and cardiovascular disease (CVD) mortality and 'the optimal range' associated with the lowest CVD mortality in the general population.
Korean adults (N = 14 884 975) who received routine health screenings during 2009-2010 were followed until 2018 for CVD mortality.
During 8.8 years (mean) of follow-up, 94 344 individuals died from CVD. LDL-C had U-curve associations with mortality from CVD and its subtypes, except haemorrhagic stroke. Optimal range was 90-149 mg/dL for CVD; 70-114 for ischaemic heart disease; 85-129 for ischaemic stroke; ≥85 for subarachnoid haemorrhage; ≥130 for intracerebral haemorrhage; 115-159 for hypertension and heart failure; and 100-144 for sudden cardiac death. Assuming linear associations between 100 and 300 mg/dL, LDL-C was positively associated with CVD mortality [hazard ratio (HR) per 39-mg/dL (1-mmol/L) higher LDL-C = 1.10], largely due to ischaemic heart disease (HR = 1.26), followed by sudden cardiac death (HR = 1.13), ischaemic stroke (HR = 1.11) and heart failure (HR = 1.05). Intracerebral haemorrhage (HR = 0.90), but not subarachnoid haemorrhage, had inverse associations. Women and older adults had weaker positive associations than men and younger adults (Pinteraction < 0.001 for both sex and age). Individuals aged 75-84 years had modest positive associations with CVD mortality, especially ischaemic heart disease and ischaemic stroke.
LDL-C had U-curve associations for CVD mortality. The associations and optimal ranges differed across CVD subtypes. Women and older adults had weaker positive associations than men and younger adults. Positive associations with ischaemic heart disease and ischaemic stroke were maintained in adults aged 75-84 years.
关于低密度脂蛋白胆固醇（LDL-C）与心血管疾病（CVD）死亡率之间的详细性别/年龄特定关联，以及与普通人群 CVD 死亡率最低相关的“最佳范围”，信息有限。
2009-2010 年接受常规健康检查的韩国成年人（N=14884975）随访至 2018 年，以观察 CVD 死亡率。
在 8.8 年（平均）的随访期间，有 94344 人死于 CVD。LDL-C 与 CVD 及其亚型的死亡率呈 U 型关联，除出血性卒中外。最佳范围为 CVD 90-149mg/dL；缺血性心脏病 70-114mg/dL；缺血性卒中 85-129mg/dL；蛛网膜下腔出血≥85mg/dL；颅内出血≥130mg/dL；高血压和心力衰竭 115-159mg/dL；心源性猝死 100-144mg/dL。假设 100-300mg/dL 之间存在线性关联，LDL-C 与 CVD 死亡率呈正相关[每 39mg/dL（1mmol/L）更高 LDL-C 的危险比（HR）=1.10]，主要与缺血性心脏病（HR=1.26）有关，其次是心源性猝死（HR=1.13）、缺血性卒中和心力衰竭（HR=1.05）。颅内出血（HR=0.90）而非蛛网膜下腔出血与 LDL-C 呈负相关。女性和老年人与男性和年轻人相比，正相关较弱（性别和年龄的 P 交互<0.001）。75-84 岁的成年人与 CVD 死亡率呈适度正相关，尤其是缺血性心脏病和缺血性卒中。
LDL-C 与 CVD 死亡率呈 U 型关联。关联和最佳范围因 CVD 亚型而异。女性和老年人与男性和年轻人相比，正相关较弱。75-84 岁的成年人与缺血性心脏病和缺血性卒中仍存在正相关。
