Journal of Shandong University (Health Sciences) ›› 2019, Vol. 57 ›› Issue (8): 110-116.doi: 10.6040/j.issn.1671-7554.0.2019.287

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Association between longitudinal changes of HDL-C and coronary heart disease in a population with normal serum lipids: a retrospective cohort study

LI Mingzhuo1,2, SUN Xiubin1,2, WANG Chunxia3, YANG Yang4, LIU Xinhui1,2, LIU Yanxun1,2, XUE Fuzhong1,2, YUAN Zhongshang1,2   

  1. 1. Department of Biostatistics, School of Public Health, Shandong University, Jinan 250012, Shandong, China;
    2. Healthcare Big Data Institute of Shandong University, Jinan 250012, Shandong, China;
    3. Health Management Center, Affiliated Hospital of Jining Medical University, Jining 272000, Shandong, China;
    4. Department of Neurology, Shandong Provincial Hospital, Jinan 250021, Shandong, China
  • Published:2022-09-27

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Abstract: Objective To investigate the relationship between the longitudinal changes of high-density lipoprotein cholesterol(HDL-C)and coronary heart disease(CHD)in people with normal blood lipids. Methods Based on the large-scale health management cohort, a retrospective study cohort was constructed in the population aged 20 to 70 years at baseline, with at least two physical examination records before the diagnosis of CHD or when the cut-off events occurred, maintaining normal blood lipids during the follow-up, and having no important variables missing. Change in HDL-C was calculated by subtracting the baseline value from the level at the end of follow-up, and the subjects were 山 东 大 学 学 报 (医 学 版)57卷8期 -李明卓,等.血脂正常人群HDL-C纵向变化与冠心病的关联性分析:一项回顾性队列研究 \=-divided into 4 groups according to the quartiles of HDL-C change: Q1 is the HDL-C descending group, Q2 is the HDL-C stable group, Q3 is the HDL-C gently increasing group, while Q4 is the HDL-C increasing group. After that, Cox regression models were used to evaluate the correlation between the longitudinal changes of HDL-C and CHD by defining HDL-C change as a continuous variable or a categorical variable. Confounding factors were adjusted stepwisely. Results A total of 8 958 participants were enrolled in the study cohort. Total follow-up time was 43 527.26 person-years, with 124 new CHD cases. Incidence density was 2.85/1 000 person-years. When HDL-C change was considered as a continuous variable, HDL-C change was always a protective factor for CHD morbidity with adjustment for potential confounding factors(age, gender, hypertension, smoking, drinking, body mass index, fasting plasma glucose, baseline HDL-C, body mass index change, low density lipoprotein cholesterol change, etc.)step by step, and the hazard ratio(HR)and 95% confidence interval(CI)was 0.38(0.16-0.87); when HDL-C change was considered as a categorical variable, compared with Q1 group, Q4 group always had a lower risk of developing CHD, the HR(95% CI)of Q4 group in the all-adjusted Cox model was 0.43(0.24-0.78). Conclusion Longitudinal elevated HDL-C is an independent protective factor for CHD in people with normal blood lipids.

Key words: Longitudinal change of high-density lipoprotein cholesterol, Coronary heart disease, Cohort with normal blood lipids, Cox regression model

CLC Number: 

  • R541
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