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학술저널
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양여리 (가톨릭대학교) 한경도 (숭실대학교) 박상현 (가톨릭대학교(성의교정)) 김미경 (가톨릭대학교) 윤건호 (가톨릭대학교) 이승환 (가톨릭대학교)
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한국지질동맥경화학회(구 한국지질학회) 지질·동맥경화학회지 지질·동맥경화학회지 제10권 제1호
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2021.1
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74 - 87 (14page)

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High-Density Lipoprotein Cholesterol and the Risk of Myocardial Infarction, Stroke, and Cause-Specific Mortality: a Nationwide Cohort Study in Korea Yeoree Yang,1,2 Kyungdo Han,3 Sang Hyun Park,4 Mee Kyoung Kim,5 Kun-Ho Yoon,1,6 and Seung-Hwan Lee1,6 1Division of Endocrinology and Metabolism, Department of Internal Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea. 2Catholic Smart Health Care Center, The Catholic University of Korea, Seoul, Korea. 3Department of Statistics and Actuarial Science, Soongsil University, Seoul, Korea. 4Department of Medical Statistics, College of Medicine, The Catholic University of Korea, Seoul, Korea. 5Division of Endocrinology and Metabolism, Department of Internal Medicine, Yeouido St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea. 6Department of Medical Informatics, College of Medicine, The Catholic University of Korea, Seoul, Korea. Correspondence to Seung-Hwan Lee. Division of Endocrinology and Metabolism, Department of Internal Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, 222 Banpo-daero, Seocho-gu, Seoul 06591, Korea. Email: hwanx2@catholic.ac.kr Received September 05, 2020; Revised November 05, 2020; Accepted November 18, 2020. This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (https://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. See the editorial "HDL-C and Cardiovascular Risk: You Don't Need to Worry about Extremely High HDL-C Levels" in volume 10 on page 57. Go to: Abstract Objective We aimed to investigate the relationship between high-density lipoprotein cholesterol (HDL-C) level and the risk of myocardial infarction (MI), stroke, and cause-specific mortality. Methods Using the Korean National Health Insurance Service-National Sample Cohort, we identified 343,687 subjects (men, 176,243; women, 167,444) aged ≥20 years who underwent health examinations between 2009 and 2012. HDL-C levels were categorized based on the concentration with 10 mg/dL intervals, starting from levels <30 mg/dL, with levels ≥90 mg/dL considered the highest. The endpoints of the study were newly-diagnosed MI, stroke, or mortality. We used the Cox proportional hazards model with restricted cubic splines. Results During a median follow-up of 6.0 years, the number of cases of death, MI, and stroke were 6,617, 4,064, and 3,435 in men and 3,677, 2,804, and 2,891 in women, respectively. The risk of all-cause mortality, cancer mortality, other mortality, and stroke was the lowest at HDL-C concentrations of 57?76 mg/dL in the spline curves; inverse associations with increased risk were observed at the lower HDL-C levels. In contrast, the lowest risk of cardiovascular mortality and MI was observed at the extreme high end. In men, there was a significant inverse and graded increase in hazard ratios of all outcomes in the lower HDL-C categories compared to the reference group (50?59 mg/dL). In the higher HDL-C categories, no significant increase in outcomes was observed. Women showed similar trends. Conclusion The risk of mortality, MI, and stroke was high at low HDL-C levels in the Korean general population. However, extremely high HDL-C levels were not associated with an increased risk of mortality, MI, and stroke.
#Cholesterol #HDL #Mortality #Myocardial infarction #Stroke

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참고문헌 (29)

참고문헌 신청
Wilson PW / 1988 / High density lipoprotein cholesterol and mortality. The Framingham Heart Study / Arteriosclerosis 8:737~741 google schola Gordon DJ / 1989 / High-density lipoprotein--the clinical implications of recent studies / N Engl J Med 321:1311~1316 google schola Lincoff AM / 2017 / Evacetrapib and cardiovascular outcomes in high-risk vascular disease / N Engl J Med 376:1933~1942 google schola Schwartz GG / 2012 / Effects of dalcetrapib in patients with a recent acute coronary syndrome / N Engl J Med 367:2089~2099 google schola Agerholm-Larsen B / 2000 / Elevated HDL cholesterol is a risk factor for ischemic heart disease in white women when caused by a common mutation in the cholesteryl ester transfer protein gene / Circulation 101:1907~1912 google schola

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