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A nonlinear association of total cholesterol with all-cause and cause-specific mortality.


ABSTRACT:

Background

The link between total cholesterol (TC) and all-cause and specific mortality has not been elucidated. Herein, we aimed to evaluate the effect of TC levels on all-cause, cardiovascular disease (CVD), and cancer mortality.

Methods

All data analyzed were obtained from the National Health and Nutrition Examination Survey 1999-2014. The relationship between levels of TC and mortality was determined through Cox proportional hazard regression analysis coupled with multivariable adjustments. Two-piecewise linear regression models and Cox models with penalized splines were applied to explore nonlinear and irregular shape relationships. Kaplan-Meier survival curve and subgroup analyses were conducted.

Results

The sample studied comprised 14,662 men and 16,025 women, categorized as 25,429 adults aged 18-65 and 5,258 adults over 65 years old. A total of 2,570 deaths were recorded. All-cause, cardiovascular, and cancer mortality showed U-curve associations after adjusting for confounding variables in the restricted cubic spline analysis. Hazard ratios (HRs) of all-cause and cancer mortality were particularly negatively related to TC levels in the lower range?ConclusionsA nonlinear association of TC level with all-cause, cancer, and CVD mortality in the American population was observed, suggesting that too low or too high serum total cholesterol levels might correlate with adverse outcomes.

SUBMITTER: He GD 

PROVIDER: S-EPMC7945313 | biostudies-literature | 2021 Mar

REPOSITORIES: biostudies-literature

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Publications

A nonlinear association of total cholesterol with all-cause and cause-specific mortality.

He Guo-Dong GD   Liu Xiao-Cong XC   Liu Lin L   Yu Yu-Ling YL   Chen Chao-Lei CL   Huang Jia-Yi JY   Lo Kenneth K   Huang Yu-Qing YQ   Feng Ying-Qing YQ  

Nutrition & metabolism 20210310 1


<h4>Background</h4>The link between total cholesterol (TC) and all-cause and specific mortality has not been elucidated. Herein, we aimed to evaluate the effect of TC levels on all-cause, cardiovascular disease (CVD), and cancer mortality.<h4>Methods</h4>All data analyzed were obtained from the National Health and Nutrition Examination Survey 1999-2014. The relationship between levels of TC and mortality was determined through Cox proportional hazard regression analysis coupled with multivariabl  ...[more]

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