PURPOSE

To evaluate the association between high-density lipoprotein (HDL) cholesterol levels and the future risk of retinal artery occlusion (RAO).

DESIGN

Population-based cohort study.

METHODS

This study used data provided by the Korean National Health Insurance Service. A total of 9,316,212 individuals aged > 40 years who participated in the Korean National Health Screening Program in 2013 or 2014 were included. Data on risk factors – including age, sex, income level, systemic comorbidities, behavioral factors, and baseline lipid profiles – were collected from health screening results and claims data. Patients were followed up until December 2018 and incident cases of RAO were identified using registered diagnostic codes from claims data. A prospective association between HDL cholesterol level and incident RAO was investigated using the multivariable-adjusted Cox proportional hazard model.

RESULTS

During an average follow-up period of 4.93 years, 9878 patients were newly diagnosed with RAO. Compared with those with low HDL cholesterol levels (< 40 mg/dL), patients with high HDL cholesterol levels (≥ 60 mg/dL) had a lower risk of future RAO development, with a hazard ratio (95% CI) of 0.78 (0.73-0.83) in the age-adjusted and sex-adjusted model and 0.88 (0.83-0.95) in the full-adjusted model. The younger subgroup (< 60 years) had an HR of 0.81 in the high HDL cholesterol group compared with the low HDL cholesterol group, while the older subgroup (≥ 60 years) had an HR of 0.93 (P for interaction = .012).

CONCLUSION

A low HDL cholesterol level is an independent risk factor for the development of RAO.

中文翻译：

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高密度脂蛋白胆固醇和未来视网膜动脉阻塞发展的风险：一项全国性队列研究

目的

评估高密度脂蛋白 (HDL) 胆固醇水平与未来视网膜动脉闭塞 (RAO) 风险之间的关联。

设计

基于人群的队列研究。

方法

本研究使用了韩国国民健康保险局提供的数据。共纳入 2013 年或 2014 年参加韩国国家健康筛查计划的 9,316,212 名年龄 > 40 岁的人。从健康筛查结果和索赔数据中收集了有关风险因素的数据——包括年龄、性别、收入水平、系统性合并症、行为因素和基线血脂谱。对患者进行随访至 2018 年 12 月，并使用索赔数据中的注册诊断代码确定 RAO 事件病例。使用多变量调整的 Cox 比例风险模型研究了 HDL 胆固醇水平与事件 RAO 之间的前瞻性关联。

结果

平均随访4.93年，新诊断RAO患者9878例。与低 HDL 胆固醇水平 (< 40 mg/dL) 的患者相比，高 HDL 胆固醇水平 (≥ 60 mg/dL) 的患者未来发生 RAO 的风险较低，风险比 (95% CI) 为 0.78。在年龄调整和性别调整模型中为 0.73-0.83），在完全调整模型中为 0.88（0.83-0.95）。与低 HDL 胆固醇组相比，年轻亚组（<60 岁）在高 HDL 胆固醇组中的 HR 为 0.81，而年长亚组（≥ 60 岁）的 HR 为 0.93（交互作用P = .012）。

结论

低 HDL 胆固醇水平是发生 RAO 的独立危险因素。