title: Associations between serum lipids and causes of mortality in a cohort of 3,499 urban Thais: The Electricity Generating Authority of Thailand (EGAT) study.
abstract: The association between serum lipids and mortality has not previously been established in Thailand. Baseline data from the Electricity Generating Authority of Thailand (EGAT) cohort study, plus a resurvey of the cohort 15 years later were analyzed. Participants were employees of EGAT: 2,702 men and 797 women. Total cholesterol (TC), high density lipoprotein cholesterol (HDL-C), low density lipoprotein cholesterol (LDL-C), and triglycerides (TG) were taken as predictive variables; age, sex, hypertension, diabetes, cigarette smoking, alcohol drinking, and body mass index were taken as confounders. Dependent variables were all-causes and specific causes of mortality over 17 years of follow-up. The major cause of death among men was cardiovascular disease (CVD); among women, it was cancer. Relative risks (RR) for specific causes of death, for a mmol/L increase in each lipid, were estimated after adjustment for confounding factors using Cox proportional hazards regression. TC and LDL-C were negatively associated with liver cirrhosis mortality, although it was likely that the low cholesterol concentration was a consequence of the disease. HDL-C was negatively associated with CVD mortality (RR = 0.59; 95% confidence interval [CI], 0.39-0.93), coronary heart disease (CHD) mortality (RR = 0.36; 95% CI, 0.17-0.75) and all cause-mortality (RR = 0.68; 95% CI, 0.54-0.87). TG was not associated with mortality. HDL-C is an important risk factor for CVD in middle-class urban Thais. Health promotion programs to improve lipid profiles, such as effective exercise campaigns and dietary advice, are required to increase HDL-C and to help prevent CVD and premature death in Thailand.
authors.affiliation: Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand. rapst@mahidol.ac.th
authors.forename: Piyamitr
authors.initials: P
authors.lastname: Sritara
authors.forename: Prisana
authors.initials: P
authors.lastname: Patoomanunt
authors.forename: Mark
authors.initials: M
authors.lastname: Woodward
authors.forename: Kulaya
authors.initials: K
authors.lastname: Narksawat
authors.forename: Supoj
authors.initials: S
authors.lastname: Tulyadachanon
authors.forename: Wipa
authors.initials: W
authors.lastname: Ratanachaiwong
authors.forename: Chanika
authors.initials: C
authors.lastname: Sritara
authors.forename: Federica
authors.initials: F
authors.lastname: Barzi
authors.forename: Sukit
authors.initials: S
authors.lastname: Yamwong
authors.forename: Supachai
authors.initials: S
authors.lastname: Tanomsup
mesh_terms: D000328:Adult; D002318:Cardiovascular Diseases / Q000209:etiology / Q000401:mortality*; D002423:Cause of Death; D002784:Cholesterol / Q000097:blood; D008076:Cholesterol, HDL / Q000097:blood; D008078:Cholesterol, LDL / Q000097:blood; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D050171:Dyslipidemias / Q000097:blood / Q000150:complications / Q000401:mortality*; D005260:Female; D005500:Follow-Up Studies; D005767:Gastrointestinal Diseases / Q000209:etiology / Q000401:mortality; D006801:Humans; D008055:Lipids / Q000097:blood*; D008107:Liver Diseases / Q000209:etiology / Q000401:mortality; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000209:etiology / Q000401:mortality; D016016:Proportional Hazards Models; D018570:Risk Assessment; D012307:Risk Factors; D013785:Thailand / Q000453:epidemiology; D013997:Time Factors; D014280:Triglycerides / Q000097:blood; D014505:Urban Population / Q000706:statistics & numerical data*
chemical_list: D008076:Cholesterol, HDL; D008078:Cholesterol, LDL; D008055:Lipids; D014280:Triglycerides; D002784:Cholesterol