Tenth categories of total and HDL cholesterol fail to independently predict death risk in middle-aged Turkish adults

Abstract

The findings on TC deciles may be attributed to a comparatively higher death rate in the female (compared with male) bottom decile, reflecting the autoimmune process-induced elevated risk in the lowest decile. Observations on HDLC confirmed presumed pro-inflammatory conversion in levels >50 mg/dL. These results have important clinical implications.

HDL-C is associated with mortality from all causes, cardiovascular disease and cancer in a J-shaped dose-response fashion: a pooled analysis of 37 prospective cohort studies

“…The main characteristics of included studies are shown in Table 1. 5,16–24,28–34,36–42,45–49,53–60 These studies were published between 1990 5,30,31 and 2019. 16,17,32,45 The mean age of study population ranged from 39.9 years 23 to 85.0 years.…”

“…The Hedges Q statistic (a p < 0.10 indicating statistically significance) and the I 2 statistic (an I 2 of <50%, 50.0–75.0% and >75.0% indicating low, moderate and substantial heterogeneity, respectively) were used to qualitatively and quantitatively assess the statistical heterogeneity, respectively. For studies whose authors reported risk estimates by sex, 17,19,28,36–40 by race 33 or by study location, 41 we used a fixed-effects model to pool these stratum data for the main analysis if the reference category was identical in subgroups, 17,28,39–41 otherwise they were regarded as independent cohorts. 19,33,36–38 For one study, 42 whose authors provided risk estimates for cardiovascular and non-cardiovascular mortality separately, we used a fixed-effects model to pool these stratum data to approximate risk estimates for all-cause mortality.…”

“…The method proposed by Hamling and colleagues 44 was employed to achieve risk estimates conversion when the reference category reported was not the lowest category. For studies whose authors did not report person-years by HDL-C level, we estimated these data by multiplying the number of subjects in each HDL-C level with the mean 18,19,21,24,28,33,36,37,39,41,45–48 or median 16,17,20,49 follow-up duration. We next designated the HDL-C nadir level, which was determined by the above-mentioned non-linear dose–response analysis, as the reference, and then employed a random-effects dose–response meta-regression model proposed by Orsini and colleagues 50 to calculate hazard ratios and 95% CIs for each 10-mg/dL increase and decrease in HDL-C levels.…”

“…Twenty-four individual studies, 16–24,28–30,33,34,36,39,42,45–48,54–56 involving 3,367,943 subjects and 607,586 deaths, were included in the dose–response analysis of HDL-C levels and all-cause mortality. Overall, a J-shaped association was observed ( p non-linearity < 0.01), with the lowest risk observed at HDL-C levels of 54–58 mg/dL (Figure 2).…”

Risk Factors and Prevalence of Suicide Attempt in Patients with Type 2 Diabetes in the Mexican Population

“…The discrepancies of the outcomes could be due to various causes: these studies did not consider the differences on local dietary habits of the populations that may have an important bearing over cholesterol levels [ 52 , 53 ]. Other reason is that the studies did not consider confounder variables involved in the metabolism of cholesterol [ 54 , 55 ].…”