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Could “Good” Cholesterol Raise Infection Risk?

December 07, 2018

Low and high concentrations of high-density lipoprotein cholesterol (HDL-C) may be associated with an increased risk of infectious disease in the general population, according to new findings.

Researchers arrived at this conclusion following an analysis of data from the Copenhagen General Population Study (n = 97,166) and the Copenhagen City Heart Study (n = 9387). All participants included in the study had available HDL-C measurements at baseline.

Data from Danish health registries from baseline in 2003 to 2013 or 1991 to 1994 through 2014 were used to assess any infectious disease that required hospitalization.

Findings revealed that 9% and 31% of individuals from each study had at least 1 infectious disease event. Based on the use of restricted cubic splines, a U-shaped association was evident between HDL-C concentrations and the risk of any infection.

Multifactorial-adjusted hazard ratios (HRs) for participants with HDL-C of less than 0.8 mmol/L and more than 2.6 mmol/L were 1.75 and 1.43, respectively, compared with participants with HDL-C of 2.2 to 2.3 mmol/L.

Specifically, for Copenhagen City Heart Study participants, corresponding HRs for any infection were found to be 2.00 and 1.13.

“Low and high [HDL-C] concentrations found in 21% and 8% of individuals were associated with higher risk of infectious disease in the general population,” the researchers concluded.

However, they also noted that “these findings do not necessarily indicate causality.”

—Christina Vogt


Madsen CM, Varbo A, Tybjærg-Hansen A, Frikke-Schmidt R, Nordestgaard BG. U-shaped relationship of HDL and risk of infectious disease: two prospective population-based cohort studies. Eur Heart J. 2018;39(14):1181-1190.

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