Low serum cholesterol and mortality. Which is the cause and which is the effect?
Iribarren C, Reed DM, Chen R, Yano K, Dwyer JH
Circulation · 84 citas
Cómo se estudió
- Diseño
- Estudio de cohortes (indexado por PubMed)
- Estudiado en
- Personas
- Resultado principal
- Eventos clínicos como enfermedad o muerte
Quién lo pagó
- Financiación
- Financiación independiente
- Gobierno
- National Heart, Lung, and Blood Institute
- Gobierno
- NHLBI NIH HHS
- Subvenciones
- National Heart, Lung, and Blood Institute (N01 HV 02901); National Heart, Lung, and Blood Institute (N0 1-HC-02901)
Según 2 financiadores declarados.
Publicación
- Publicado
- 1995-11-01 · Circulation · vol. 92 · número 9 · págs. 2396–2403
- Editorial
- Lippincott Williams & Wilkins
- Citado
- 135 citas · más que el 98% de estudios similares · 9.2× el promedio de su campo
- Impacto
- Entre el 10 % más citado de su campo
- Referencias
- 76 trabajos
- Acceso
- De pago
- Áreas de investigación
- Lipoproteins and Cardiovascular Health · Cholesterol and Lipid Metabolism · Cancer, Lipids, and Metabolism
- Palabras clave
- low serum cholesterol, mortality, reverse causality, cancer mortality, liver disease mortality, all-cause mortality, Japanese-American men, Honolulu Heart Program
- MeSH
- humans, cardiovascular diseases, cholesterol, risk factors, survival analysis, cohort studies, follow-up studies, prospective studies, aged, middle aged, hawaii, japan, male, asian
5 autores
- Carlos Iribarren🇺🇸University of Southern California; Kuakini Medical Center; Buck Institute for Research on Aging
- DWAYNE M. REED🇺🇸University of Southern California; Kuakini Medical Center; Buck Institute for Research on Aging
- Randi Chen🇺🇸University of Southern California; Kuakini Medical Center; Buck Institute for Research on Aging
- Katsuhiko Yano🇺🇸University of Southern California; Kuakini Medical Center; Buck Institute for Research on Aging
- James H. Dwyer🇺🇸University of Southern California; Kuakini Medical Center; Buck Institute for Research on Aging
Resumen
El texto original del estudio, en el idioma en que se publicó.
Background
Many studies have reported an association between a low or lowered blood total cholesterol (TC) level and subsequent nonatherosclerotic disease incidence or death. The question of whether low TC is a true risk factor or alternatively a consequence of occult disease at the time of TC measurement remains unsettled. To shed new light onto this problem, we analyzed TC change over a 6- year period (from exam 1 in 1965 through 1968 to exam 3 in 1971 through 1974) in relation to subsequent 16-year mortality in a cohort of Japanese American men.
Methods and results
The study was based on 5941 men 45 to 68 years of age without prior history of coronary heart disease, stroke, cancer, or gastrointestinal-liver disease at exam 1 who also participated in exam 3 of the Honolulu Heart Program. The association of TC change with mortality end points was investigated with two different approaches (continuous and categorical TC change) with standard survival analysis techniques. Falling TC level was accompanied by a subsequent increased risk of death caused by some cancers (hemopoietic, esophageal, and prostate), noncardiovascular noncancer causes (particularly liver disease), and all causes. The risk-factor-adjusted rate of all-cause mortality was 30% higher (relative risk, 1.30; 95% CI, 1.06 to 1.59) among persons with a decline from middle (180 to 239 mg/dL) to low (< 180 mg/dL) TC than in persons remaining at a stable middle level. By contrast, there was no significant increase in all-cause mortality risk among cohort men with stable low TC levels. Nonillness mortality (deaths caused by trauma and suicide) was not related to either TC change or the average of TC levels in exams 1 and 3.
Conclusions
These results add strength to the reverse-causality proposition that catabolic diseases cause TC to decrease.
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