| Title: | Association of high-density lipoprotein cholesterol with the top 10 causes of death |
| Journal: | European Journal of Preventive Cardiology |
| Published: | 24 Nov 2025 |
| Pubmed: | https://pubmed.ncbi.nlm.nih.gov/41284745/ |
| DOI: | https://doi.org/10.1093/eurjpc/zwaf749 |
| URL: | https://academic.oup.com/eurjpc/advance-article-pdf/doi/10.1093/eurjpc/zwaf749/65492527/zwaf749.pdf |
Publication 18798
WARNING: the interactive features of this website use CSS3, which your browser does not support. To use the full features of this website, please update your browser.
Abstract
AIM: Extremely high high-density lipoprotein cholesterol (HDL-C) may increase cardiovascular death risk, but whether such non-linear patterns extend to other major causes of death is unclear. This study examined dose-response associations between HDL-C and mortality from the ten leading global causes of death.</p>
METHODS: This study included 429,759 UK Biobank participants with baseline HDL-C data. Cause-specific deaths were obtained from national registries. HDL-C was modeled using Cox proportional hazards and Fine-Gray subdistribution hazard models. Restricted cubic splines assessed non-linear associations, stratified by sex.</p>
RESULTS: Over a median follow-up of 13.8 years, 37,785 deaths occurred. U-shaped associations were observed between HDL-C and death risk from ischemic heart disease, lower respiratory infections, trachea, bronchus, or lung cancers, diabetes mellitus, and kidney disease. The optimal HDL-C range for the lowest death risk from above causes was 58-74 mg/dL in females and 50-60 mg/dL in males. J-shaped curves were observed for chronic obstructive pulmonary disease and liver disease, with the lowest death risk at 30-50 mg/dL. Stroke and Alzheimer's disease/dementias death risk displayed sex-specific patterns: an L-shaped curve in females and U-shaped in males for stroke, and the reverse for Alzheimer's disease/dementias. Extremely high HDL-C levels were associated with increased risk of death across several causes.</p>
CONCLUSIONS: HDL-C is nonlinearly and sex-specifically associated with the top ten global causes of death. Both low and high HDL-C confer increased risk through different mechanisms. These findings highlight the importance of evaluating HDL functionality rather than just quantity in future research and clinical care.</p>
6 Authors
- Shanshan Shi
- Zhangyu Lin
- Yanjun Song
- Zixiang Ye
- Chenxi Song
- Kefei Dou
1 Application
| Application ID | Title |
|---|---|
| 97155 | Association of the life pattern with the risk of myocardial infarction (MI) in people without standard modifiable cardiovascular risk factors (SMuRFs) |
Enabling scientific discoveries that improve human health