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14.05.2021 | Original Article

Low LDL-C levels are associated with risk of mortality in a Chinese cohort study

verfasst von: Jie-Ming Lu, Meng-Yin Wu, Zong-Ming Yang, Yao Zhu, Die Li, Zhe-Bin Yu, Peng Shen, Meng-Ling Tang, Ming-Juan Jin, Hong-Bo Lin, Li-Ming Shui, Kun Chen, Jian-Bing Wang

Erschienen in: Endocrine | Ausgabe 3/2021

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Abstract

Background and aims

Although low-density lipoprotein cholesterol (LDL-C) has been considered as a risk factor of atherosclerotic cardiovascular disease, limited studies can be available to evaluate the association of LDL-C with risk of mortality in the general population. This study aimed to examine the association of LDL-C level with risk of mortality using a propensity-score weighting method in a Chinese population, based on the health examination data.

Methods

We performed a retrospective cohort study with 65,517 participants aged 40 years or older in Ningbo city, Zhejiang. LDL-C levels were categorized as five groups according to the Chinese dyslipidemia guidelines in adults. To minimize potential biases resulting from a complex array of covariates, we implemented a generalized boosted model to generate propensity-score weights on covariates. Then, we used Cox proportional hazard regression models with all-cause and cause-specific mortality as the dependent variables to estimate hazard ratios (HRs) and 95% confidence intervals (95% CIs).

Results

During the 439,186.5 person years of follow-up, 2403 deaths occurred. Compared with the median LDL-C group (100–130 mg/dL), subjects with extremely low LDL-C levels (group 1) had a higher risk of deaths from all-cause (HR = 2.53, 95% CI:1.80–3.53), CVD (HR = 1.84, 95% CI: 1.28–2.61), ischemic stroke (HR = 2.29, 95% CI:1.32–3.94), hemorrhagic stroke (HR = 3.49, 95% CI: 1.57–7.85), and cancer (HR = 2.12, 95% CI: 1.04–4.31) while the corresponding HRs in LDL-C group 2 were relatively lower than that in group 1.

Conclusions

Low LDL-C levels were associated with an increased risk of all-cause, CVD, ischemic stroke, hemorrhagic stroke, and cancer mortality in the Chinese population.

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Titel: Low LDL-C levels are associated with risk of mortality in a Chinese cohort study
verfasst von: Jie-Ming Lu
Meng-Yin Wu
Zong-Ming Yang
Yao Zhu
Die Li
Zhe-Bin Yu
Peng Shen
Meng-Ling Tang
Ming-Juan Jin
Hong-Bo Lin
Li-Ming Shui
Kun Chen
Jian-Bing Wang
Publikationsdatum: 14.05.2021
Verlag: Springer US
Erschienen in: Endocrine / Ausgabe 3/2021
Print ISSN: 1355-008X
Elektronische ISSN: 1559-0100
DOI: https://doi.org/10.1007/s12020-021-02746-6

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