Lower levels of small HDL particles associated with increased infectious disease morbidity and mortality: A population-based cohort study of 30 195 individuals
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Lower levels of small HDL particles associated with increased infectious disease morbidity and mortality : A population-based cohort study of 30 195 individuals. / Harsløf, Mads; Pedersen, Kasper M.; Afzal, Shoaib; Davey Smith, George; Nordestgaard, Børge G.
I: Cardiovascular Research, Bind 119, Nr. 4, 2023, s. 957-968.Publikation: Bidrag til tidsskrift › Tidsskriftartikel › Forskning › fagfællebedømt
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TY - JOUR
T1 - Lower levels of small HDL particles associated with increased infectious disease morbidity and mortality
T2 - A population-based cohort study of 30 195 individuals
AU - Harsløf, Mads
AU - Pedersen, Kasper M.
AU - Afzal, Shoaib
AU - Davey Smith, George
AU - Nordestgaard, Børge G.
N1 - Publisher Copyright: © 2022 The Author(s). Published by Oxford University Press on behalf of the European Society of Cardiology. All rights reserved.
PY - 2023
Y1 - 2023
N2 - Aims: Low levels of HDL cholesterol have been associated with increased risk of infectious disease morbidity and mortality. Nuclear magnetic resonance (NMR) spectroscopy permits the measurement of HDL particle count and allows further subclassification according to particle size. We tested the hypothesis that low number of different HDL subfractions is associated with increased infectious disease morbidity and mortality. Methods and results: HDL particle counts were measured using NMR spectroscopy in 30 195 individuals aged 22-99 years from the Copenhagen General Population Study. Using multiple-event Cox regression and cause-specific hazard models, we assessed risk of hospitalizations due to infection and infectious disease-related death, from 2003 through 2018. During follow-up, 9303 individuals had one or more infectious disease events, and 1558 experienced infectious disease-related death. In multifactorial adjusted analyses, low number of small and medium HDL particles was associated with increased risk of any infection and infectious disease-related death, whereas low number of large and extra-large HDL particles was not. A very high number of small and medium HDL particles was also associated with increased risk of any infection, but not with infectious disease-related death. For small and medium HDL particles and compared to individuals in the 91-95th percentile, hazard ratios (HRs) in individuals in the lowest percentile were 2.31 (95% confidence interval: 1.75, 3.05) for any infection and 3.23 (2.08, 5.02) for infectious disease-related death. For the highest percentile, corresponding HRs were 1.36 (1.07, 1.74) and 1.06 (0.57, 1.98), respectively. Individuals in the lowest percentile had increased risk of pneumonia (HR: 1.86; 95% confidence interval: 1.30, 2.65), sepsis (2.17; 1.37, 3.35), urinary tract infection (1.76; 1.17, 2.63), skin infection (1.87; 1.24, 2.81), gastroenteritis (1.78; 1.01, 3.16), and other infections (2.57; 1.28, 5.16). Conclusion: Low number of the small HDL particles was associated with increased infectious disease morbidity and mortality.
AB - Aims: Low levels of HDL cholesterol have been associated with increased risk of infectious disease morbidity and mortality. Nuclear magnetic resonance (NMR) spectroscopy permits the measurement of HDL particle count and allows further subclassification according to particle size. We tested the hypothesis that low number of different HDL subfractions is associated with increased infectious disease morbidity and mortality. Methods and results: HDL particle counts were measured using NMR spectroscopy in 30 195 individuals aged 22-99 years from the Copenhagen General Population Study. Using multiple-event Cox regression and cause-specific hazard models, we assessed risk of hospitalizations due to infection and infectious disease-related death, from 2003 through 2018. During follow-up, 9303 individuals had one or more infectious disease events, and 1558 experienced infectious disease-related death. In multifactorial adjusted analyses, low number of small and medium HDL particles was associated with increased risk of any infection and infectious disease-related death, whereas low number of large and extra-large HDL particles was not. A very high number of small and medium HDL particles was also associated with increased risk of any infection, but not with infectious disease-related death. For small and medium HDL particles and compared to individuals in the 91-95th percentile, hazard ratios (HRs) in individuals in the lowest percentile were 2.31 (95% confidence interval: 1.75, 3.05) for any infection and 3.23 (2.08, 5.02) for infectious disease-related death. For the highest percentile, corresponding HRs were 1.36 (1.07, 1.74) and 1.06 (0.57, 1.98), respectively. Individuals in the lowest percentile had increased risk of pneumonia (HR: 1.86; 95% confidence interval: 1.30, 2.65), sepsis (2.17; 1.37, 3.35), urinary tract infection (1.76; 1.17, 2.63), skin infection (1.87; 1.24, 2.81), gastroenteritis (1.78; 1.01, 3.16), and other infections (2.57; 1.28, 5.16). Conclusion: Low number of the small HDL particles was associated with increased infectious disease morbidity and mortality.
KW - Infection/inflammation
KW - Lipoproteins
KW - NMR
KW - Sepsis
U2 - 10.1093/cvr/cvac194
DO - 10.1093/cvr/cvac194
M3 - Journal article
C2 - 36537045
AN - SCOPUS:85153697073
VL - 119
SP - 957
EP - 968
JO - Cardiovascular Research
JF - Cardiovascular Research
SN - 0008-6363
IS - 4
ER -
ID: 370794974