{"doi":"10.3803/enm.2021.1259","title":"Association of High-Density Lipoprotein Cholesterol Phenotypes with the Risk of Cardiovascular Diseases and Mortality: A Cohort Study in Korea","abstract":"<jats:p>Background: We investigated whether low high-density lipoprotein cholesterol (HDL-C) and isolated and non-isolated low HDL-C levels are associated with the risk of cardiovascular diseases and all-cause mortality among Korean adults.Methods: We included 8,665,841 individuals aged ≥20 years who had undergone a health examination provided by the Korean National Health Insurance Service (NHIS) in 2009 and were followed up until the end of 2018. The hazard ratios (HRs) and 95% confidence intervals (CIs) for study outcomes were calculated using multivariable Cox proportional hazard regression analysis.Results: During the 8.2 years of mean follow-up, myocardial infarction (MI), stroke, and all-cause mortality occurred in 81,431, 110,996, and 244,309 individuals, respectively. After adjusting for confounding variables (model 3), individuals with low HDL-C and lower HDL quartiles were associated with significantly increased risks of all three outcomes, compared to those with normal HDL-C and highest HDL-C quartile (all P&lt;0.001), respectively. HRs for incident MI (1.28; 95% CI, 1.26 to 1.30), stroke (1.13; 95% CI, 1.11 to 1.15), and all-cause mortality (1.07; 95% CI, 1.05 to 1.08) increased in the non-isolated low HDL-C group compared to the normal HDL-C group. Isolated low HDL-C also showed an increase in the HRs of incident stroke (1.06; 95% CI, 1.04 to 1.08) and all-cause mortality (1.30; 95% CI, 1.28 to 1.32).Conclusion: Low HDL-C and non-isolated low HDL-C were associated with increased risk of MI, stroke, and all-cause mortality, and isolated low HDL-C was associated with incident stroke and all-cause mortality risk.</jats:p>","journal":"Endocrinology and Metabolism","year":2022,"id":599798,"datarank":0.3453877639491069,"base_score":2.302585092994046,"endowment":2.302585092994046,"self_citation_contribution":0.3453877639491069,"citation_network_contribution":0.0,"self_endowment_contribution":0.3453877639491069,"citer_contribution":0.0,"corpus_percentile":49.1,"corpus_rank":6639,"citation_count":9,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":true,"is_dataset_confidence":null,"is_data_producer":false,"deposit_databanks":null,"is_oa":false,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":null,"fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":1537308,"name":"Youn Huh","orcid":"0000-0001-8899-9637","position":1,"is_corresponding":false},{"id":1227869,"name":"Jin-Hyung Jung","orcid":null,"position":2,"is_corresponding":false},{"id":400064,"name":"Kyungdo Han","orcid":"0000-0002-6096-1263","position":3,"is_corresponding":false},{"id":1537309,"name":"Seon Mee Kim","orcid":"0000-0002-1957-2928","position":4,"is_corresponding":false},{"id":1471478,"name":"Ga Eun Nam","orcid":"0000-0002-6739-9904","position":0,"is_corresponding":false}],"reference_count":0,"raw_metadata":{"has_enrichment":true,"resolved":true,"title":"Association of High-Density Lipoprotein Cholesterol Phenotypes with the Risk of Cardiovascular Diseases and Mortality: A Cohort Study in Korea","abstract":"<jats:p>Background: We investigated whether low high-density lipoprotein cholesterol (HDL-C) and isolated and non-isolated low HDL-C levels are associated with the risk of cardiovascular diseases and all-cause mortality among Korean adults.Methods: We included 8,665,841 individuals aged ≥20 years who had undergone a health examination provided by the Korean National Health Insurance Service (NHIS) in 2009 and were followed up until the end of 2018. The hazard ratios (HRs) and 95% confidence intervals (CIs) for study outcomes were calculated using multivariable Cox proportional hazard regression analysis.Results: During the 8.2 years of mean follow-up, myocardial infarction (MI), stroke, and all-cause mortality occurred in 81,431, 110,996, and 244,309 individuals, respectively. After adjusting for confounding variables (model 3), individuals with low HDL-C and lower HDL quartiles were associated with significantly increased risks of all three outcomes, compared to those with normal HDL-C and highest HDL-C quartile (all P&lt;0.001), respectively. HRs for incident MI (1.28; 95% CI, 1.26 to 1.30), stroke (1.13; 95% CI, 1.11 to 1.15), and all-cause mortality (1.07; 95% CI, 1.05 to 1.08) increased in the non-isolated low HDL-C group compared to the normal HDL-C group. Isolated low HDL-C also showed an increase in the HRs of incident stroke (1.06; 95% CI, 1.04 to 1.08) and all-cause mortality (1.30; 95% CI, 1.28 to 1.32).Conclusion: Low HDL-C and non-isolated low HDL-C were associated with increased risk of MI, stroke, and all-cause mortality, and isolated low HDL-C was associated with incident stroke and all-cause mortality risk.</jats:p>","is_dataset_classified":null,"base_score":2.1972245773362196,"endowment":2.1972245773362196,"datacite_reuse_total":0,"file_count":0,"downloads":0,"views":0,"has_version_chain":false,"is_dataset":false,"is_oa":false,"pmid":"35504601","pmcid":"PMC9081307","openalex_id":"https://openalex.org/W4225146397","authors":[],"funders":[{"funder_name":"Korean Society for the Study of Obesity","grant_id":"","title":null},{"funder_name":"Korean Society for the Study of Obesity","grant_id":"","title":null}],"total_grants":2,"fwci":0.9306,"citation_percentile":0.75600929,"influential_citations":0,"citation_trend":[{"year":2022,"count":1},{"year":2023,"count":1},{"year":2024,"count":2},{"year":2025,"count":3},{"year":2026,"count":1}],"oa_status":"gold","license":"cc-by-nc","oa_locations":[{"url":"https://www.e-enm.org/upload/media/enm-2021-1259-suppl1.pdf","host_type":"journal"},{"url":"https://www.e-enm.org/upload/media/enm-2021-1259-suppl1.pdf","host_type":"publisher"},{"url":"http://e-enm.org/upload/pdf/enm-2021-1259.pdf","host_type":"publisher"},{"url":"http://e-enm.org/journal/view.php?doi=10.3803/EnM.2021.1259","host_type":"publisher"},{"url":"https://doi.org/10.3803/enm.2021.1259","host_type":"journal"},{"url":"https://pubmed.ncbi.nlm.nih.gov/35504601","host_type":"repository"},{"url":"https://doaj.org/article/15bbfd9452f34ba49ac216ffc723fc03","host_type":"repository"},{"url":"https://www.ncbi.nlm.nih.gov/pmc/articles/9081307","host_type":"repository"},{"url":"https://europepmc.org/articles/PMC9081307","host_type":"Europe_PMC"},{"url":"https://europepmc.org/articles/PMC9081307?pdf=render","host_type":"Europe_PMC"}],"fields_of_study":["Diabetes, Cardiovascular Risks, and Lipoproteins","Lipoproteins and Cardiovascular Health","Adipokines, Inflammation, and Metabolic Diseases","Cardiovascular Diseases","Cause of Death","Cholesterol","Cholesterol, HDL","Cohort Studies","Humans","Myocardial Infarction","Phenotype","Risk Factors","Stroke"],"mesh_terms":["Cardiovascular Diseases","Cause of Death","Cholesterol","Humans","Cholesterol, HDL","Myocardial Infarction","Phenotype","Risk Factors","Cohort Studies","Stroke"],"keywords":["Medicine","Phenotype","Internal medicine","Cholesterol","Cohort","Atherosclerotic cardiovascular disease","Cohort study","Oncology","Bioinformatics","Genetics","Disease","Gene","Biology","Mortality","Myocardial infarction","Stroke","Low High-density Lipoprotein Cholesterol","Non-isolated Low High-density Lipoprotein Cholesterol","Isolated Low High-density Lipoprotein Cholesterol"],"sdg_mappings":[{"sdg_number":0,"sdg_label":"Good health and well-being"}],"linked_datasets":[],"clinical_trials":[],"software_tools":[],"database_accessions":[],"source":"live","citation_network_status":"fetched"},"created_at":"2026-07-29T11:15:55.794863Z","pmid":null,"pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}