Low-density lipoprotein cholesterol (LDL-C) independently impacts aging-related health outcomes and plays a critical role in cardiovascular diseases (CVDs). However, there are limited predictive data on all-cause mortality, especially for the Japanese community population. In this study, it was examined whether LDL-C is related to survival prognosis based on 7 or 10 years of follow-up. Participants included 1610 men (63 ± 14 years old) and 2074 women (65 ± 12 years old) who participated in the Nomura cohort study conducted in 2002 (first cohort) and 2014 (second cohort) and who continued throughout the follow-up periods (follow-up rates: 94.8 and 98.0%). Adjusted relative risk estimates were obtained for all-cause mortality using a basic resident register. The data were analyzed by a Cox regression with the time variable defined as the length between the age at the time of recruitment and that at the end of the study (the age of death or censoring), and risk factors including gender, age, body mass index (BMI), presence of diabetes, lipid levels, renal function, serum uric acid levels, blood pressure, and history of smoking, drinking, and CVD. Of the 3684 participants, 326 (8.8%) were confirmed to be deceased. Of these, 180 were men (11.2% of all men) and 146 were women (7.0% of all women). Lower LDL-C levels, gender (male), older age, BMI under 18.5 kg/m2, and the presence of diabetes were significant predictors for all-cause mortality. Compared with individuals with LDL-C levels of 144 mg/dL or higher, the multivariable-adjusted Hazard ratio (and 95% confidence interval) for all-cause mortality was 2.54 (1.58–4.07) for those with LDL-C levels below 70 mg/dL, 1.71 (1.15–2.54) for those with LDL-C levels between 70 mg/dL and 92 mg/dL, and 1.21 (0.87–1.68) for those with LDL-C levels between 93 mg/dL and 143 mg/dL. This association was particularly significant among participants who were male (P for interaction = 0.039) and had CKD (P for interaction = 0.015). There is an inverse relationship between LDL-C levels and the risk of all-cause mortality, and this association is statistically significant.

中文翻译：

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低密度脂蛋白胆固醇和全因死亡率：一项针对日本社区居民的研究结果

低密度脂蛋白胆固醇 (LDL-C) 独立影响与衰老相关的健康结果，并在心血管疾病 (CVD) 中发挥关键作用。然而，关于全因死亡率的预测数据有限，尤其是对于日本社区人口而言。在本研究中，基于 7 年或 10 年的随访检查 LDL-C 是否与生存预后相关。参与者包括 1610 名男性（63 ± 14 岁）和 2074 名女性（65 ± 12 岁），他们参加了 2002 年（第一组）和 2014 年（第二组）进行的野村队列研究，并在整个随访期间继续进行（跟踪率：94.8 和 98.0%）。使用基本居民登记册获得了全因死亡率的调整后相对风险估计值。通过 Cox 回归分析数据，时间变量定义为招募时的年龄与研究结束时的年龄（死亡或审查年龄）之间的长度，以及包括性别、年龄、身体在内的风险因素体重指数（BMI）、是否存在糖尿病、血脂水平、肾功能、血清尿酸水平、血压以及吸烟、饮酒和心血管疾病史。在 3684 名参与者中，有 326 人（8.8%）被确认死亡。其中，男性 180 人（占所有男性的 11.2%），女性 146 人（占所有女性的 7.0%）。较低的 LDL-C 水平、性别（男性）、年龄较大、BMI 低于 18.5 kg/m2 和糖尿病是全因死亡率的重要预测因素。与 LDL-C 水平为 144 mg/dL 或更高的个体相比，对于 LDL-C 水平低于 70 mg/dL 的患者，全因死亡率的多变量调整风险比（和 95% 置信区间）为 2.54（1.58-4.07），对于 LDL-C 水平低于 1.71（1.15-2.54）的患者LDL-C 水平在 70 mg/dL 和 92 mg/dL 之间，对于那些 LDL-C 水平在 93 mg/dL 和 143 mg/dL 之间的人来说，为 1.21 (0.87–1.68)。这种关联在男性参与者（交互作用 P = 0.039）和患有 CKD（交互作用 P = 0.015）的参与者中尤为显着。LDL-C 水平与全因死亡风险之间存在反比关系，并且这种关联具有统计学意义。这种关联在男性参与者（交互作用 P = 0.039）和患有 CKD（交互作用 P = 0.015）的参与者中尤为显着。LDL-C 水平与全因死亡风险之间存在反比关系，并且这种关联具有统计学意义。这种关联在男性参与者（交互作用 P = 0.039）和患有 CKD（交互作用 P = 0.015）的参与者中尤为显着。LDL-C 水平与全因死亡风险之间存在反比关系，并且这种关联具有统计学意义。