Association of Serum Non-HDL-C with Risk of Cardiovascular Disease Mortality

Objective To analyze the relationship between serum non-HDL-C levels and cardiovascular disease mortality in the general population.Methods Based on a retrospective cohort study design,we utilized electronic health record data from the health information platform of Yuecheng District, Shaoxing City, Zhejiang Province. The study population consists of community residents aged 40 years and above who underwent health examinations at healthcare institutions in Yuecheng District from January to December 2019 and had no previous history of cardiovascular disease. Follow-up was conducted until December 31,2023 to collect data on cardiovascular disease mortality. We used Cox regression model to calculate the hazard ratios (HRs) and 95% confidence intervals (95%CIs) for the association between non-HDL-C and risk of cardiovascular disease mortality.Results Overall, our study included a total of 39,038 participants, which comprising 19,085 males (48.9%) and 19,953 females (51.1%), with an average age of 73.64±9.10 years. The average follow-up time was 52.3 months. During the follow-up period, a total of 1,227 people died from cardiovascular disease. After adjusting for confounding factors, for every 1 mmol/L increase in non-HDL-C, the risk of mortality from total CVD, coronary heart disease and stroke increased by 89% (HR=1.89, 95%CI:1.56~2.30), 55%(HR=1.55，95%CI：1.26~1.99) and 82%(HR=1.82，95%CI: 1.31~2.55). When non-HDL-C was used as the classification variable and the ideal level as the reference, the HRs in the elevated group of non-HDL-C were 1.24(95%CI：1.08~1.42)、1.57(95%CI：1.34~1.85)and 2.31(95%CI：1.87~2.86), respectively, with all P values<0.05.Conclusion In this study, higher levels of non-HDL-C were associated with increased risk of mortality from cardiovascular disease. In future, we need large scale prospective stuides to confirm their causal relationship.