Longitudinal associations of high-density lipoprotein cholesterol or low-density lipoprotein cholesterol with metabolic syndrome in the Chinese population: a prospective cohort study

BMJ Open. 2018 May 9;8(5):e018659. doi: 10.1136/bmjopen-2017-018659.

Abstract

Objective: Currently, most studies only reveal the relationship between baseline high-density lipoprotein cholesterol (HDL-c) or low-density lipoprotein cholesterol (LDL-c) levels and metabolic syndrome (MetS). The relationship between dynamic changes in HDL-c or LDL-c and MetS remains unclear. We aimed to gain a deeper understanding of the relationship between the dynamic changes in HDL-c or LDL-c and MetS.

Design: A prospective study.

Setting: The Medical Centre of the Second Hospital affiliated with Dalian Medical University from 2010 to 2016.

Participants: A total of 4542 individuals who were initially MetS-free and completed at least two follow-up examinations as part of the longitudinal population were included.

Methods: The Joint Interim Statement criteria 2009 were used to define MetS. We used the Joint model to estimate the relative risks (RRs) of incident MetS.

Results: The cumulative incidence of MetS was 17.81% and was 14.86% in men and 5.36% in women during the 7 years of follow-up. In the Joint models, the RRs of the longitudinal decrease in HDL-c and the longitudinal increase in LDL-c for the development of MetS were 18.8781-fold (95% CI 12.5156 to 28.4900) and 1.3929-fold (95% CI 1.2283 to 1.5795), respectively.

Conclusions: The results highlight that the dynamic longitudinal decrement of HDL-c or the increment of LDL-c is associated with an elevated risk of MetS.

Keywords: high-density lipoprotein cholesterol; joint model; longitudinal cohort study; low-density lipoprotein cholesterol metabolic syndrome.

MeSH terms

  • Adult
  • China / epidemiology
  • Cholesterol, HDL / blood*
  • Cholesterol, LDL / blood*
  • Female
  • Humans
  • Incidence
  • Linear Models
  • Longitudinal Studies
  • Male
  • Metabolic Syndrome / blood*
  • Metabolic Syndrome / epidemiology*
  • Middle Aged
  • Prospective Studies
  • Risk Factors

Substances

  • Cholesterol, HDL
  • Cholesterol, LDL