Ramezankhani Azra, Azizi Fereidoun, Hadaegh Farzad
Prevention of Metabolic Disorders Research Center Research Institute for Metabolic and Obesity Disorders, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences Tehran Iran.
Endocrine Research Center Research Institute for Endocrine Disorders, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences Tehran Iran.
J Am Heart Assoc. 2025 Aug 5;14(15):e040554. doi: 10.1161/JAHA.124.040554. Epub 2025 Jul 17.
We investigated the associations between total cholesterol, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol (HDL-C), non-HDL-C, and triglycerides with all-cause and cardiovascular disease death among participants in the TLGS (Tehran Lipid and Glucose Study) cohort.
We included 8241 participants aged ≥30 years, who were followed until 2018. Lipid profiles were assessed as both continuous and categorical variables (quintiles) using the restricted cubic spline and Cox proportional hazards model.
During a median follow-up of 18.1 years, 1002 and 369 individuals died from all causes and cardiovascular disease, respectively. A U-shaped association was found between non-HDL-C and the risk of all-cause death. In the categorical analyses for all-cause death, individuals in quintile 1 of non-HDL-C had a hazard ratio (HR) of 1.35 (95% CI, 1.09-1.68), compared with quintile 2 (reference). Additionally, those in quintiles 1 and 3 of total cholesterol had HRs of 1.34 (95% CI, 1.08-1.67) and 1.25 (95% CI, 1.02-1.55), respectively, relative to quintile 2 (reference). Regarding cardiovascular disease death, linear associations were observed for total cholesterol, low-density lipoprotein cholesterol, and non-HDL-C. In categorical analysis, quintiles 3 and 5 of total cholesterol had HRs of 1.87 (95% CI, 1.30-2.70) and 1.78 (95% CI, 1.25-2.53), respectively, compared with quintile 2 (reference). Furthermore, compared with quintile 1 of low-density lipoprotein cholesterol (reference), individuals in quintiles 3 and 5 had HRs of 1.62 (95% CI, 1.08-2.42) and 1.81 (95% CI, 1.24-2.66), respectively. For non-HDL-C, the HR for quintile 5 was 1.43 (95% CI, 1.00-2.06) compared with quintile 1 (reference).
In the general population, low and high levels of non-HDL-C were associated with an increased risk of all-cause death.
我们在德黑兰血脂与血糖研究（TLGS）队列参与者中，研究了总胆固醇、低密度脂蛋白胆固醇、高密度脂蛋白胆固醇（HDL-C）、非HDL-C和甘油三酯与全因死亡和心血管疾病死亡之间的关联。
我们纳入了8241名年龄≥30岁的参与者，随访至2018年。使用受限立方样条和Cox比例风险模型将血脂谱评估为连续变量和分类变量（五分位数）。
在中位随访18.1年期间，分别有1002人和369人死于全因和心血管疾病。非HDL-C与全因死亡风险之间呈U形关联。在全因死亡的分类分析中，非HDL-C五分位数1的个体的风险比（HR）为1.35（95%CI，1.09-1.68），而五分位数2（参照组）为参照。此外，总胆固醇五分位数1和3的个体相对于五分位数2（参照组）的HR分别为1.34（95%CI，1.08-1.67）和1.25（95%CI，1.02-1.55）。关于心血管疾病死亡，观察到总胆固醇、低密度脂蛋白胆固醇和非HDL-C呈线性关联。在分类分析中，总胆固醇五分位数3和5相对于五分位数2（参照组）的HR分别为1.87（95%CI，1.30-2.70）和1.78（95%CI，1.25-2.53）。此外，与低密度脂蛋白胆固醇五分位数1（参照组）相比，五分位数3和5的个体的HR分别为1.62（95%CI，1.08-2.42）和1.81（95%CI，1.24-2.66）。对于非HDL-C，五分位数5相对于五分位数1（参照组）的HR为1.43（95%CI，1.00-2.06）。
在一般人群中，非HDL-C的低水平和高水平均与全因死亡风险增加相关。
