Research Article: Non-high-density lipoprotein cholesterol levels as a risk factor for short-term mortality in elderly Chinese: a large-scale, population-based cohort study
Abstract:
Objectives To explore the association between non-high-density lipoprotein (non-HDL) and mortality risk, both short-term and long-term, in Chinese people. Design A prospective cohort study. Setting The National Basic Public Health Service (BPHS) in China. Participants Including 621?164 elderly individuals around Hunan Province who underwent healthcare management receiving check-ups in China BPHS from 2010 to 2020. Exclusion criteria: (1) missing information on gender; (2) missing records of lipid screening; (3) missing information on key covariates; and (4) missing records of comorbidities (cardiovascular disease, hypertension, diabetes, cancer.) Primary and secondary outcome measures The study’s primary endpoint was all-cause and cause-specific mortality, sourced from Hunan’s CDC(Center for Disease Control and Prevention)-operated National Mortality Surveillance System, tracking participants until 24 February 2021. Results 26?758 (4.3%) deaths were recorded, with a median follow-up of 0.83 years. Association between non-HDL and mortality was non-linear after multivariable adjustment, with the optimum concentration (OC) being 3.29 and 4.85?mmol/L. Compared with OC, the risk increased by 1.12-fold for non-HDL <3.29?mmol/L (HR: 1.12 (1.09 to 1.15)) and 1.08-fold for non-HDL ?4.85?mmol/L (HR: 1.08 (1.02 to 1.13)) for all-cause mortality. Furthermore, there is also an increased risk of cardiovascular mortality (HR for non-HDL <3.29 : 1.10 (1.06 to 1.32) and HR for non-HDL ?4.85 : 1.07 (1.01 to 1.14)). However, cancer mortality risk was significantly increased only for non-HDL <3.29?mmol/L (HR: 1.11 (1.04 to 1.18)). Non-optimum concentration of non-HDL had significant effects on both the long-term and the short-term risk of mortality, especially for risks of mortality for all-cause (log HR:0 .086 (0.038 to 0.134)), cardiovascular (log HR:0 .082 (0.021 to 0.144)), and cancer (log HR:0 .187 (0.058 to 0.315)) within 3 months. A two-sided value of p <0.05 was considered to be statistically significant. Conclusions Non-HDL was non-linearly associated with the risk of mortality, and non-optimal concentrations of non-HDL significantly increased short-term mortality in elderly Chinese, which needs more attention for cardiovascular disease prevention.
Introduction:
Atherosclerotic cardiovascular diseases (ASCVD), characterised by atherosclerosis, including ischaemic heart disease and ischaemic stroke, are the major causes of death worldwide, 1–3 especially in elderly people. Dyslipidaemias are the primary cause and have a significant contribution to the initiation, development and complications of atherosclerosis. 4 High low-density lipoprotein (LDL) is commonly accepted as proatherogenic cholesterol, 5 and the prevailing view favours oxidised LDL particles promoting…
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