Very high high-density lipoprotein cholesterol is associated with increased all-cause mortality in South Koreans

Oh, In‐Hwan; Hur, Junho K.; Ryoo, Jae‐Hong; Jung, Ju Young; Park, Sung Keun; Yang, Hai; Choi, Joong-Myung; Jung, Kyu-Won; Won, Young‐Joo; Oh, Chang‐Mo

doi:10.1016/j.atherosclerosis.2019.01.035

Cited by 38 publications

(35 citation statements)

References 38 publications

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“…males with HDL cholesterol values of 58-76 mg/dL and females with HDL cholesterol values of 77-96 mg/dL) [7]. A slightly higher, though not statistically significant, risk for all-cause and cancer mortality was found in south Korean adults with HDL cholesterol levels > 85 mg/dL [6]. Increased allcause (HR = 1.56; 95% CI 1.08-2.26), CV (HR = 1.62; 0.86-3.05) and non-CV deaths (HR = 1.45; 0.93-2.27) were found in US elderly individuals with HDL cholesterol levels > 90 mg/dL [9].…”

Section: All-cause and Specific-cause Mortalitymentioning

confidence: 80%

“…Evidence from epidemiological studies has raised doubt about the protective role of high HDL cholesterol levels against CV disease (CVD) risk; intriguingly, U-shaped associations between HDL cholesterol concentrations and CVD risk and mortality have been reported [6][7][8][9][10][11]. The conformational and functional properties of HDL particles may be altered in individuals with extremely high HDL cholesterol and HDL functionality may be compromised such that those particles no longer function but rather cause harm [1].…”

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confidence: 99%

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Is HDL cholesterol protective in patients with type 2 diabetes? A retrospective population-based cohort study

et al. 2020

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Background: The protective role of high HDL cholesterol levels against cardiovascular diseases has been recently questioned. Limited data are available on this specific topic in patients with type 2 diabetes mellitus (T2DM). We aimed to evaluate the association of HDL cholesterol concentrations with all-cause and cause-specific mortality in a historical cohort of T2DM patients with 14 years of follow-up. Methods: This is a retrospective population-based cohort study involving 2113 T2DM patients attending the Diabetic Clinic of Asti. Survival analyses were performed to assess hazard ratios for overall and specific-cause mortality by HDL cholesterol tertiles, using the middle HDL cholesterol tertile as a reference. Results: The mean age was 66 ± 11 years; 51.4% of patients had low HDL-cholesterol levels. After a 14-year follow-up, 973/2112 patients had died (46.1%). The HDL cholesterol tertile cutoff points were 37.5 and 47.5 mg/dL (males) and 41.5 and 52.0 mg/dL (females). No associations between lower and upper HDL cholesterol tertiles respectively and all-cause (HR = 1.12; 95% CI 0.96-1.32; HR = 1.11; 0.95-1.30), cardiovascular (HR = 0.97; 0.77-1.23; HR = 0.94; 0.75-1.18) or cancer (HR = 0.92; 0.67-1.25; HR = 0.89; 0.66-1.21) mortality were found. A significantly increased risk for infectious disease death was found both in the lower (HR = 2.62; 1.44-4.74) and the upper HDL-cholesterol tertiles (HR = 2.05; 1.09-3.85) when compared to the reference. Individuals in the upper tertile showed an increased risk for mortality due to diabetes-related causes (HR = 1.87; 1.10-3.15). Conclusions: Our results corroborate the hypothesis that HDL cholesterol levels are nonprotective in T2DM patients. The U-shaped association between HDL-cholesterol levels and mortality associated with infectious diseases should be verified by further studies.

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Section: All-cause and Specific-cause Mortalitymentioning

confidence: 80%

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confidence: 99%

Is HDL cholesterol protective in patients with type 2 diabetes? A retrospective population-based cohort study

et al. 2020

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“…Results from a pooled analysis of 6 community-based cohorts found elevated hazards of total mortality in the highest categories of HDL-c in men 15 . Moreover, recent evidence from large cohorts depicted a U-shaped association between HDL-c levels and mortality risk 33,34 . However, none of these studies focused on age-modifying effects on the relationship between HDL-c levels and all-cause mortality.…”

Section: Discussionmentioning

confidence: 99%

Association between high-density lipoprotein cholesterol and all-cause mortality in the general population of northern China

Guan

Wang

et al. 2019

Sci Rep

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Recent studies proposed reasonable doubts about the good prognosis of very high levels of high-density lipoprotein cholesterol (HDL-c). We aimed to investigate the association between HDL-c levels and all-cause mortality using data from an observational cohort study in northern China from 2006 to 2015. The study population was stratified into six groups by HDL-c levels in mg/dl (<40, 40–49, 50–59, 60–69, 70–79, ≥80). Cox hazards regression models were used to estimate the association between HDL-c levels and all-cause mortality. In total, 100,070 participants (aged 51.9 ± 12.7 years) were included in the current analysis. During a mean follow-up of 8.76 years, 7,362 deaths were identified (mortality rate, 8.40 per 1000 person-years). There was a significant interaction effect between age and HDL-c levels (P for interaction < 0.001). Among individuals aged 65 and older, no significant association was found between HDL-c levels and total mortality. In contrast, HDL-c levels showed a U-shaped relationship with all-cause mortality in younger participants (<65 years old), and very high HDL-c levels (≥80 mg/dl) were independently associated with increased total mortality risk compared with the reference level (60 to 69 mg/dl). These findings suggest that very high HDL-c levels may not represent a good prognosis, especially in younger individuals.

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“…Notably, the reduction in HDLC may not be harmful, meta-analysis indicated that increasing HDLC levels were not associated with reduced all-cause mortality, coronary heart disease mortality, myocardial infarction, or stroke [30]. In fact, very high HDL-C level was associated with increased risk of all-cause death [31].…”

Section: Discussionmentioning

confidence: 99%

Anti-obesity effects of Spirulina platensis protein hydrolysate by modulating brain-liver axis in high-fat diet fed mice

et al. 2019

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Spirulina platensis is a blue-green algae with potential anti-obesity effects. In this study, the anti-obesity effects of whole Spirulina platensis (WSP), Spirulina platensis protein (SPP) and Spirulina platensis protein hydrolysate (SPPH) were compared in high-fat diet fed mice, and the potential acting mechanism of SPPH was also investigated. Totally, SPPH exhibited good anti-obesity effects (reducing 39.8%±9.7% of body weight), lowering 23.8%±1.6% of serum glucose, decreasing 20.8%±1.4% of total cholesterol, while positive drug Simvastatin had the corresponding values: 8.3%±4.6%, 24.8%±1.9% and -2.1%±0.2%, respectively. Subsequently, PCR array was used to conduct gene expression analysis in brain and liver tissues of SPPH-treated mice, which displayed distinctly different expression pattern. The most markedly changed genes included: Acadm (-34.7 fold), Gcg (2.5 fold), Adra2b (2 fold) and Ghsr (2 fold) in brain; Retn (39 fold), Fabp4 (15.5 fold), Ppard (6 fold) and Slc27a1 (5.4 fold) in liver. Further network analysis demonstrated that the significantly expressed genes in brain and liver tissues were mapped into an interacting network, suggesting a modulatory effect on brain-liver axis, major pathways were involved in the axis: PPAR, adipocytokine, AMPK, non-alcoholic fatty liver disease and MAPK. This study showed that Spirulina platensis protein hydrolysate possessed anti-obesity effect in mice.

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Very high high-density lipoprotein cholesterol is associated with increased all-cause mortality in South Koreans

Cited by 38 publications

References 38 publications

Is HDL cholesterol protective in patients with type 2 diabetes? A retrospective population-based cohort study

Is HDL cholesterol protective in patients with type 2 diabetes? A retrospective population-based cohort study

Association between high-density lipoprotein cholesterol and all-cause mortality in the general population of northern China

Anti-obesity effects of Spirulina platensis protein hydrolysate by modulating brain-liver axis in high-fat diet fed mice

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