Non-high-density lipoprotein cholesterol levels as a risk factor for short-term mortality in elderly chinese: a population-based cohort study

Background: Non-high density lipoprotein (non-HDL) levels were an important predictor of cardiovascular disease risk. However, it is unclear the relationship between non-HDL and mortality risk. This study explores the relationship between non-high-density lipoprotein levels and the risk of mortality, and the impact on long-term and short-term mortality risk. Methods: We analysis 621,164 elderly individuals from healthcare management receiving check-up in China basic public health service in 2010–2020. We analyzed the non-linear rela-tionship between non-HDL and all-cause and cause-specific mortality in patients receiving lipid-lowering treatment or not. Finally, the relationship between non-HDL and long-term or short-term mortality was investigated. Results: 26,758 (4.3%) deaths were recorded at a mean follow-up of 2.03 years. The association between non-HDL and mortality was non-linear for elderly individuals. After multivariable adjustment, individuals with non-HDL < 3.29 mmol/L and > = 4.85 mmol/L increase the risk of all-cause mortality and cardiovascular mortality compared to non-HDL of 3.29 - 4.85 mmol/L. Only non-HDL < 3.29 mmol/L significantly increase the risk of cancer mortality (HR: 1.11; 95% CI: 1. 04 - 1.18, P < 0.001) and other mortality (HR: 1.16; 95% CI: 1.10 - 1.22, P < 0.001). Non-optimal concentrations of non-HDL had significant effects on both the long-term and the short-term risk of mortality, but the effect was more powerful for short-term (3 months) mortality. The non-optimal concentrations of non-HDL significantly in-creased the risk of all-cause mortality, cardiovascular mortality, and cancer mortality within 3 months. The association between non-HDL and all-cause and cause-specific mortality was not statistically significant in the elderly population receiving lipid-lowering treatment. Conclusions: Non-HDL was non-linearly associated with the risk of mortality, and non-optimal con-centrations of non-HDL significantly increased short-term mortality in elderly Chinese. As the possibility of confounding may exist, further research is necessary.