title: Relationship between non-high-density lipoprotein cholesterol and the long-term mortality of cardiovascular diseases: NIPPON DATA 90.
abstract: BACKGROUND
  Non-high-density lipoprotein (HDL) cholesterol level, generally less affected by fasting status or serum triglyceride levels, may be useful for predicting future cardiovascular events in daily clinical practice. This study aimed to investigate the role of non-HDL cholesterol in the development of fatal coronary events and stroke in the general Japanese population.
  
  
  RESULTS
  From the NIPPON DATA 90 prospective cohort study, 8383 participants were followed up for 20years since 1990. After exclusion of 666 cases without lipid or covariates data, 561 cases who were 75years old or older, 274 cases with history of cardiovascular disease, and 181 cases with lipid-lowering treatment, 6701 participants were included in this analysis. Non-HDL cholesterol was defined as total cholesterol minus HDL cholesterol. Outcomes were death from coronary heart disease and stroke. During the period, 69 participants died from coronary heart disease and 112 from stroke. Compared with participants with non-HDL cholesterol level <3.9mmol/L, age- and sex-adjusted hazard ratios for mortality by coronary heart disease in those with non-HDL cholesterol levels of 3.9-4.3mmol/L, 4.4-4.8mmol/L and ≥4.9mmol/L were 1.27 (95% confidence interval [CI] 0.65-2.49), 1.81 (95% CI 0.92-3.55) and 2.40 (95% CI 1.30-4.43), respectively (P trend=0.010). This association remained significant even after adjusting for other cardiovascular risk factors (P trend=0.010). There was no clear association between non-HDL cholesterol levels and mortality by stroke (P trend=0.052).
  
  
  CONCLUSIONS
  Among the general Japanese population, non-HDL cholesterol levels were clearly associated with future mortality by coronary heart disease, but not by stroke.
authors.affiliation: Department of Public Health, Shiga University of Medical Science, Otsu, Japan.
authors.forename: Takahiro
authors.initials: T
authors.lastname: Ito
authors.affiliation: Department of Public Health, Shiga University of Medical Science, Otsu, Japan; Center for Epidemiologic Research in Asia, Shiga University of Medical Science, Otsu, Japan; Department of Preventive Medicine and Public Health, Faculty of Medicine, Fukuoka University, Fukuoka, Japan.
authors.forename: Hisatomi
authors.initials: H
authors.lastname: Arima
authors.affiliation: Department of Public Health, Shiga University of Medical Science, Otsu, Japan.
authors.forename: Akira
authors.initials: A
authors.lastname: Fujiyoshi
authors.affiliation: Department of Public Health, Shiga University of Medical Science, Otsu, Japan; Center for Epidemiologic Research in Asia, Shiga University of Medical Science, Otsu, Japan.
authors.forename: Katsuyuki
authors.initials: K
authors.lastname: Miura
authors.affiliation: Department of Public Health, Shiga University of Medical Science, Otsu, Japan.
authors.forename: Naoyuki
authors.initials: N
authors.lastname: Takashima
authors.affiliation: Department of Hygiene and Public Health, Teikyo University School of Medicine, Tokyo, Japan.
authors.forename: Takayoshi
authors.initials: T
authors.lastname: Ohkubo
authors.affiliation: Department of Public Health, Shiga University of Medical Science, Otsu, Japan; Center for Epidemiologic Research in Asia, Shiga University of Medical Science, Otsu, Japan.
authors.forename: Aya
authors.initials: A
authors.lastname: Kadota
authors.affiliation: Department of Hygiene and Preventive Medicine, Fukushima Medical University, Fukushima, Japan.
authors.forename: Takehito
authors.initials: T
authors.lastname: Hayakawa
authors.affiliation: Faculty of Nursing Science, Tsuruga City University of Nursing, Tsuruga, Japan.
authors.forename: Yoshikuni
authors.initials: Y
authors.lastname: Kita
authors.affiliation: Department of Public Health, Shiga University of Medical Science, Otsu, Japan.
authors.forename: Naoko
authors.initials: N
authors.lastname: Miyagawa
authors.affiliation: Research Institute of Strategy for Prevention, Tokyo, Japan.
authors.forename: Akira
authors.initials: A
authors.lastname: Okayama
authors.affiliation: Department of Preventive Medicine and Public Health, Keio University, Tokyo, Japan.
authors.forename: Tomonori
authors.initials: T
authors.lastname: Okamura
authors.affiliation: Department of Public Health, Shiga University of Medical Science, Otsu, Japan; Center for Epidemiologic Research in Asia, Shiga University of Medical Science, Otsu, Japan.
authors.forename: Hirotugu
authors.initials: H
authors.lastname: Ueshima
mesh_terms: D000368:Aged; D008078:Cholesterol, LDL / Q000097:blood; D003324:Coronary Artery Disease / Q000097:blood / Q000175:diagnosis / Q000401:mortality; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007564:Japan / Q000453:epidemiology; D008297:Male; D011446:Prospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D020521:Stroke / Q000097:blood / Q000175:diagnosis / Q000401:mortality; D016019:Survival Analysis
chemical_list: D008078:Cholesterol, LDL
keywords: Coronary heart disease; Mortality; Non-high-density lipoprotein (HDL) cholesterol; Stroke