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      The Relationship between Very High Levels of Serum High-Density Lipoprotein Cholesterol and Cause-Specific Mortality in a 20-Year Follow-Up Study of Japanese General Population

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          Abstract

          Aims: There is no community-based cohort study to examine the effect of very high level of high-density lipoprotein cholesterol (HDL-C) on coronary heart disease (CHD) and other cause-specific mortality. Therefore, we investigated the relationship between HDL-C including very high level and cause-specific mortality in a 20-year cohort study of the representative sample of Japanese.

          Methods: We followed 7,019 individuals from the Japanese general population (2,946 men and 4,073 women). We defined HDL-C levels as follow: low (HDL-C < 1.04 mmol/L), reference (1.04–1.55 mmol/L), high (1.56–2.06 mmol/L), very high (≥ 2.07 mmol/L). The multivariate adjusted hazard ratio (HR) for all-cause or cause-specific mortality was calculated using a Cox proportional hazards model adjusted for other traditional risk factors.

          Results: During follow-up, we observed 1,598 deaths. No significant association was observed between HDL-C and all-cause mortality. Serum HDL-C also showed no association with stroke. In contrast, the risk for CHD among high HDL-C was lower than reference, HRs were 0.51 [95% confidence interval (CI): 0.21–1.23] in men, 0.33 (95% CI: 0.11–0.95) in women, and 0.41 (95% CI: 0.21–0.81) when men and women were combined. However, very high HDL-C did not show significant association with CHD and other cause-specific mortality.

          Conclusions: HDL-C was not associated with all-cause and stroke mortality. In contrast, high serum HDL-C levels, at least up to 2.06 mmol/L, were protective against CHD, although further high levels were not. However, sample size of cause-specific death in very high HDL-C group was not enough even in this 20-year follow-up of 7,019 Japanese; larger cohort studies should be warranted.

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          Author and article information

          Journal
          J Atheroscler Thromb
          J. Atheroscler. Thromb
          jat
          jat
          Journal of Atherosclerosis and Thrombosis
          Japan Atherosclerosis Society
          1340-3478
          1880-3873
          1 July 2016
          : 23
          : 7
          : 800-809
          Affiliations
          [1 ] Department of Preventive Medicine and Public Health, Keio University School of Medicine, Tokyo, Japan
          [2 ] Department of Public Health, Shiga University of Medical Science, Shiga, Japan
          [3 ] Center for Epidemiologic Research in Asia, Shiga University of Medical Science, Shiga, Japan
          [4 ] Department of Health and Nutrition, University of Human Arts and Sciences, Saitama, Japan
          [5 ] Department of Hygiene and Public Health Teikyo University School of Medicine, Tokyo, Japan
          [6 ] Research Institute of Strategy for Prevention, Tokyo, Japan
          Author notes
          Address for correspondence: Tomonori Okamura, Department of Preventive Medicine and Public Health, School of Medicine, Keio University, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan E-mail: okamura@ 123456z6.keio.jp
          Article
          PMC7399265 PMC7399265 7399265
          10.5551/jat.33449
          7399265
          26923252
          204f2711-debc-4fcb-a425-3ac2d59e496f
          2016 Japan Atherosclerosis Society
          History
          : 5 October 2015
          : 7 January 2016
          Page count
          Figures: 0, Tables: 3, References: 37, Pages: 10
          Categories
          Original Article

          Risk factors,Mortality,High-density lipoprotein cholesterol,Cohort studies

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