title: Relationships between serum lipids and subsequent mortality in an insured population.
abstract: OBJECTIVE
  To investigate relationships between serum lipids and all-cause mortality in an insured population issued policies at standard rates using contemporary analytic techniques.
  
  
  BACKGROUND
  As with other preferred risk factors, differences in lipid profiles can be an important contributor to morbidity and mortality endpoints in the general and insured population. To better understand the independent contribution of different lipid profiles to mortality, contemporary researchers commonly employ multivariate statistical techniques. Studies on insured populations utilizing multivariate statistical procedures are not commonly published and are employed in this study of an insured cohort.
  
  
  METHODS
  We studied internal data on direct and reinsurance business issued at standard rates, or rated only for abnormal lipids, between 1975 and 2000 followed through anniversaries in 2001, or prior termination, with an average duration of 6 years per policy. Cox proportional hazards models were used to study the multivariate relationship between various lipid values (cholesterol, cholesterol/HDL ratio, triglycerides) and mortality.
  
  
  RESULTS
  Five hundred twenty deaths were observed during follow-up. Mortality was noted to vary by differing levels of all 3 of the predictor variables of interest. The relationship between an abnormal lipid profile and mortality was strongest in males and nonsmokers.
  
  
  CONCLUSIONS
  In this insured cohort, changes in lipid profiles are associated with significant differentials in mortality.
authors.affiliation: Swiss Re Life and Health America, Inc., 1700 Magnavox Way, Fort Wayne, IN 46804, USA.
authors.forename: Brian
authors.initials: B
authors.lastname: Ivanovic
authors.forename: C Allen
authors.initials: CA
authors.lastname: Pinkham
mesh_terms: D000206:Actuarial Analysis; D000328:Adult; D000368:Aged; D002784:Cholesterol / Q000097:blood*; D003324:Coronary Artery Disease / Q000097:blood / Q000191:economics / Q000401:mortality*; D005260:Female; D006801:Humans; D007348:Insurance, Health / Q000706:statistics & numerical data*; D008055:Lipids / Q000097:blood*; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D016016:Proportional Hazards Models; D012307:Risk Factors; D012737:Sex Factors
chemical_list: D008055:Lipids; D002784:Cholesterol