Association of lipoprotein levels with mortality in subjects aged 50 + without previous diabetes
or cardiovascular disease: a population-based register study
Sammanfattning
Objective. This study aimed to investigate the association of lipoprotein and triglyceride levels
with all-cause mortality in a population free from diabetes and cardiovascular disease (CVD) at
baseline. The European Guidelines on cardiovascular disease prevention state that in general total
cholesterol (TC) should be < 5 mmol/L (190 mg/dL) and low-density lipoprotein cholesterol (LDL-C)
should be < 3 mmol/L (115 mg/dL). Design. A population-based register study in the period 1999–2007
including 118 160 subjects aged 50 + without statin use at baseline. All-cause mortality was related
to lipoprotein and triglyceride levels and adjusted for statin use after inclusion. Results. All-cause
mortality was lower in the groups with TC or LDL-C above the recommended levels. Compared with
subjects with TC < 5 mmol/L, adjusted hazard ratios for the group aged 60–70 years ranged from 0.68
(95% confidence interval (CI) 0.61–0.77) for TC 5–5.99 mmol/L to 0.67 (95% CI 0.59–0.75) for TC 6–7.99
mmol/L and 1.02 (95% CI 0.68–1.53) for TC ? 8 mmol/L in males and from 0.57 (95% CI 0.48–0.67) to
0.59 (95% CI 0.50–0.68) and 1.02 (95% CI: 0.77–1.37) in females. For triglycerides, ratios compared
with the group < 1 mmol/L in the females aged 60–70 years ranged from 1.04 (95% CI 0.88–1.23) to
1.35 (95% CI 1.10–1.66) and 1.25 (95% CI 1.05–1.48) for triglycerides 1–1.39 mmol/L, 1.4–1.69 mmol/L,
and ? 1.7 mmol/L, respectively. Statin treatment after inclusion provided a survival benefit.
Conclusion. These associations indicate that high lipoprotein levels do not seem to be definitely
harmful in the general population. However, high triglyceride levels in females are associated with
decreased survival.