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KMID : 1200020230470010059
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Diabetes & Metabolism Journal
2023 Volume.47 No. 1 p.59 ~ p.71
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Association between Low-Density Lipoprotein Cholesterol Level and Cardiovascular Outcomes in Korean Adults: A Nationwide Cohort Study
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Noh Jung-Hyun
Moon Min-Kyong
Rhee Eun-Jung
Park Sang-Hyun
Kim Hyeon-Chang
Kim Byung-Jin
Kim Hae-Jin
Choi Seong-Hoon
Na Jin-Oh
Hyun Young-Youl
Kim Bum-Joon
Han Kyung-Do
Jeong In-Kyung
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Abstract
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Background : To validate the treatment target of low-density lipoprotein cholesterol (LDL-C) level according to the cardiovascular disease (CVD) risk which was recommended by Korean dyslipidemia guideline.
Methods : We used the Korean National Health Insurance Service database which included 3,958,048 people aged 20 to 89 years who underwent regular health screening. The primary outcome was incident CVD, defined as a composite of myocardial infarction and stroke during the follow-up period from 2009 to 2018.
Results : The risk of CVD increased from LDL-C level of 70 mg/dL in very high-risk and high-risk groups and from 130 mg/dL in moderate-risk and low-risk groups. Adjusted hazard ratios (HRs) of LDL-C ranges 70?99, 100?129, 130?159, 160?189, and ≥190 mg/dL were 1.20 (95% confidence interval [CI], 1.08?1.33), 1.27 (1.15?1.42), 1.39 (1.23?1.56), 1.69 (1.45?1.96), and 1.84 (1.49? 2.27) in very high-risk group, and 1.07 (1.02?1.13), 1.16 (1.10?1.21), 1.29 (1.22?1.36), 1.45 (1.36?1.55), and 1.73 (1.58?1.90) in high-risk group. Adjusted HRs (95% CI) of LDL-C ranges 130?159, 160?189, and ≥190 mg/dL were 1.15 (1.11?1.20), 1.28 (1.22? 1.34), and 1.45 (1.36?1.54) in moderate-risk group and 1.07 (1.02?1.13), 1.20 (1.13?1.26), and 1.47 (1.37?1.57) in low-risk group.
Conclusion : We confirmed the incidence of CVD was increased in higher LDL-C range. The risk of CVD increased from ≥70 mg/dL of LDL-C in very high-risk and high-risk groups, and from ≥130 mg/dL of LDL-C in moderate-risk and low-risk groups in Korean adults.
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KEYWORD
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Cardiovascular diseases, Cholesterol, LDL, Korea
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