{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,10]],"date-time":"2026-10-10T15:12:52Z","timestamp":1791645172879,"version":"4.3.4"},"reference-count":34,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"19","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Circulation"],"published-print":{"date-parts":[[2011,11,8]]},"abstract":"<jats:sec>\n            <jats:title>Background\u2014<\/jats:title>\n            <jats:p>Previous studies have suggested that there is a novel dyslipidemic profile consisting of isolated low high-density lipoprotein cholesterol (HDL-C) level that is associated with increased risk of coronary heart disease, and that this trait may be especially prevalent in Asian populations.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods and Results\u2014<\/jats:title>\n            <jats:p>\n              Individual participant data from 220 060 participants (87% Asian) in 37 studies from the Asia-Pacific region were included. Low HDL-C (HDL &lt;1.03 mmol\/L in men and &lt;1.30 mmol\/L in women) was seen among 33.1% (95% confidence interval [CI], 32.9\u201333.3) of Asians versus 27.0% (95% CI, 26.5\u201327.5) of non-Asians (\n              <jats:italic>P<\/jats:italic>\n              &lt;0.001). The prevalence of low HDL-C in the absence of other lipid abnormalities (isolated low HDL-C) was higher in Asians compared with non-Asians: 22.4% (95% CI, 22.2\u201322.5) versus 14.5% (95% CI, 14.1\u201314.9), respectively (\n              <jats:italic>P<\/jats:italic>\n              &lt;0.001). During 6.8 years of follow-up, there were 574 coronary heart disease and 739 stroke events. There was an inverse relationship between low HDL-C with coronary heart disease in all individuals (hazard ratio, 1.57; 95% CI, 1.31\u20131.87). In Asians, isolated low levels of HDL-C were as strongly associated with coronary heart disease risk as low levels of HDL-C combined with other lipid abnormalities (hazard ratio, 1.67 [95% CI, 1.27\u20132.19] versus 1.63 [95% CI, 1.24\u20132.15], respectively). There was no association between low HDL-C and stroke risk in this population (hazard ratio, 0.95 [95% CI, 0.78 to 1.17] with nonisolated low HDL-C and 0.81 [95% CI, 0.67\u20131.00] with isolated low HDL-C).\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusion\u2014<\/jats:title>\n            <jats:p>Isolated low HDL-C is a novel lipid phenotype that appears to be more prevalent among Asian populations, in whom it is associated with increased coronary risk. Further investigation into this type of dyslipidemia is warranted.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/circulationaha.111.028373","type":"journal-article","created":{"date-parts":[[2011,10,11]],"date-time":"2011-10-11T05:29:30Z","timestamp":1318310970000},"page":"2056-2064","update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":129,"title":["Isolated Low Levels of High-Density Lipoprotein Cholesterol Are Associated With an Increased Risk of Coronary Heart Disease"],"prefix":"10.1161","volume":"124","author":[{"given":"Rachel R.","family":"Huxley","sequence":"first","affiliation":[{"name":"From the George Institute (R.R.H., F.B., S.C., V.P., M.W.) and Boden Institute, Sydney Medical School (I.C.), University of Sydney, Sydney, Australia; Division of Epidemiology and Community Health, University of Minnesota, Minneapolis (R.R.H.); University of Hong Kong, School of Public Health\/Department of Community Medicine, Hong Kong (T.H.L.); Department of Nutrition, Ambroise Par\u00e9 Hospital and University of Versailles Saint Quentin en Yvelines, Boulogne-Billancourt, France (S.C.); Department of..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Federica","family":"Barzi","sequence":"additional","affiliation":[{"name":"From the George Institute (R.R.H., F.B., S.C., V.P., M.W.) and Boden Institute, Sydney Medical School (I.C.), University of Sydney, Sydney, Australia; Division of Epidemiology and Community Health, University of Minnesota, Minneapolis (R.R.H.); University of Hong Kong, School of Public Health\/Department of Community Medicine, Hong Kong (T.H.L.); Department of Nutrition, Ambroise Par\u00e9 Hospital and University of Versailles Saint Quentin en Yvelines, Boulogne-Billancourt, France (S.C.); Department of..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tai Hing","family":"Lam","sequence":"additional","affiliation":[{"name":"From the George Institute (R.R.H., F.B., S.C., V.P., M.W.) and Boden Institute, Sydney Medical School (I.C.), University of Sydney, Sydney, Australia; Division of Epidemiology and Community Health, University of Minnesota, Minneapolis (R.R.H.); University of Hong Kong, School of Public Health\/Department of Community Medicine, Hong Kong (T.H.L.); Department of Nutrition, Ambroise Par\u00e9 Hospital and University of Versailles Saint Quentin en Yvelines, Boulogne-Billancourt, France (S.C.); Department of..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sebastien","family":"Czernichow","sequence":"additional","affiliation":[{"name":"From the George Institute (R.R.H., F.B., S.C., V.P., M.W.) and Boden Institute, Sydney Medical School (I.C.), University of Sydney, Sydney, Australia; Division of Epidemiology and Community Health, University of Minnesota, Minneapolis (R.R.H.); University of Hong Kong, School of Public Health\/Department of Community Medicine, Hong Kong (T.H.L.); Department of Nutrition, Ambroise Par\u00e9 Hospital and University of Versailles Saint Quentin en Yvelines, Boulogne-Billancourt, France (S.C.); Department of..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xianghua","family":"Fang","sequence":"additional","affiliation":[{"name":"From the George Institute (R.R.H., F.B., S.C., V.P., M.W.) and Boden Institute, Sydney Medical School (I.C.), University of Sydney, Sydney, Australia; Division of Epidemiology and Community Health, University of Minnesota, Minneapolis (R.R.H.); University of Hong Kong, School of Public Health\/Department of Community Medicine, Hong Kong (T.H.L.); Department of Nutrition, Ambroise Par\u00e9 Hospital and University of Versailles Saint Quentin en Yvelines, Boulogne-Billancourt, France (S.C.); Department of..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tim","family":"Welborn","sequence":"additional","affiliation":[{"name":"From the George Institute (R.R.H., F.B., S.C., V.P., M.W.) and Boden Institute, Sydney Medical School (I.C.), University of Sydney, Sydney, Australia; Division of Epidemiology and Community Health, University of Minnesota, Minneapolis (R.R.H.); University of Hong Kong, School of Public Health\/Department of Community Medicine, Hong Kong (T.H.L.); Department of Nutrition, Ambroise Par\u00e9 Hospital and University of Versailles Saint Quentin en Yvelines, Boulogne-Billancourt, France (S.C.); Department of..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jonathan","family":"Shaw","sequence":"additional","affiliation":[{"name":"From the George Institute (R.R.H., F.B., S.C., V.P., M.W.) and Boden Institute, Sydney Medical School (I.C.), University of Sydney, Sydney, Australia; Division of Epidemiology and Community Health, University of Minnesota, Minneapolis (R.R.H.); University of Hong Kong, School of Public Health\/Department of Community Medicine, Hong Kong (T.H.L.); Department of Nutrition, Ambroise Par\u00e9 Hospital and University of Versailles Saint Quentin en Yvelines, Boulogne-Billancourt, France (S.C.); Department of..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hirotsugu","family":"Ueshima","sequence":"additional","affiliation":[{"name":"From the George Institute (R.R.H., F.B., S.C., V.P., M.W.) and Boden Institute, Sydney Medical School (I.C.), University of Sydney, Sydney, Australia; Division of Epidemiology and Community Health, University of Minnesota, Minneapolis (R.R.H.); University of Hong Kong, School of Public Health\/Department of Community Medicine, Hong Kong (T.H.L.); Department of Nutrition, Ambroise Par\u00e9 Hospital and University of Versailles Saint Quentin en Yvelines, Boulogne-Billancourt, France (S.C.); Department of..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paul","family":"Zimmet","sequence":"additional","affiliation":[{"name":"From the George Institute (R.R.H., F.B., S.C., V.P., M.W.) and Boden Institute, Sydney Medical School (I.C.), University of Sydney, Sydney, Australia; Division of Epidemiology and Community Health, University of Minnesota, Minneapolis (R.R.H.); University of Hong Kong, School of Public Health\/Department of Community Medicine, Hong Kong (T.H.L.); Department of Nutrition, Ambroise Par\u00e9 Hospital and University of Versailles Saint Quentin en Yvelines, Boulogne-Billancourt, France (S.C.); Department of..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sun Ha","family":"Jee","sequence":"additional","affiliation":[{"name":"From the George Institute (R.R.H., F.B., S.C., V.P., M.W.) and Boden Institute, Sydney Medical School (I.C.), University of Sydney, Sydney, Australia; Division of Epidemiology and Community Health, University of Minnesota, Minneapolis (R.R.H.); University of Hong Kong, School of Public Health\/Department of Community Medicine, Hong Kong (T.H.L.); Department of Nutrition, Ambroise Par\u00e9 Hospital and University of Versailles Saint Quentin en Yvelines, Boulogne-Billancourt, France (S.C.); Department of..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeetesh V.","family":"Patel","sequence":"additional","affiliation":[{"name":"From the George Institute (R.R.H., F.B., S.C., V.P., M.W.) and Boden Institute, Sydney Medical School (I.C.), University of Sydney, Sydney, Australia; Division of Epidemiology and Community Health, University of Minnesota, Minneapolis (R.R.H.); University of Hong Kong, School of Public Health\/Department of Community Medicine, Hong Kong (T.H.L.); Department of Nutrition, Ambroise Par\u00e9 Hospital and University of Versailles Saint Quentin en Yvelines, Boulogne-Billancourt, France (S.C.); Department of..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ian","family":"Caterson","sequence":"additional","affiliation":[{"name":"From the George Institute (R.R.H., F.B., S.C., V.P., M.W.) and Boden Institute, Sydney Medical School (I.C.), University of Sydney, Sydney, Australia; Division of Epidemiology and Community Health, University of Minnesota, Minneapolis (R.R.H.); University of Hong Kong, School of Public Health\/Department of Community Medicine, Hong Kong (T.H.L.); Department of Nutrition, Ambroise Par\u00e9 Hospital and University of Versailles Saint Quentin en Yvelines, Boulogne-Billancourt, France (S.C.); Department of..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vlado","family":"Perkovic","sequence":"additional","affiliation":[{"name":"From the George Institute (R.R.H., F.B., S.C., V.P., M.W.) and Boden Institute, Sydney Medical School (I.C.), University of Sydney, Sydney, Australia; Division of Epidemiology and Community Health, University of Minnesota, Minneapolis (R.R.H.); University of Hong Kong, School of Public Health\/Department of Community Medicine, Hong Kong (T.H.L.); Department of Nutrition, Ambroise Par\u00e9 Hospital and University of Versailles Saint Quentin en Yvelines, Boulogne-Billancourt, France (S.C.); Department of..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mark","family":"Woodward","sequence":"additional","affiliation":[{"name":"From the George Institute (R.R.H., F.B., S.C., V.P., M.W.) and Boden Institute, Sydney Medical School (I.C.), University of Sydney, Sydney, Australia; Division of Epidemiology and Community Health, University of Minnesota, Minneapolis (R.R.H.); University of Hong Kong, School of Public Health\/Department of Community Medicine, Hong Kong (T.H.L.); Department of Nutrition, Ambroise Par\u00e9 Hospital and University of Versailles Saint Quentin en Yvelines, Boulogne-Billancourt, France (S.C.); Department of..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"for the Asia Pacific Cohort Studies Collaboration and the Obesity in Asia Collaboration","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/0002-8703(91)90861-B"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.315.7110.722"},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.89.6.2533"},{"key":"e_1_3_3_5_2","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehm427"},{"key":"e_1_3_3_6_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.79.1.8"},{"key":"e_1_3_3_7_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.ATV.17.1.107"},{"key":"e_1_3_3_8_2","first-page":"A2","article-title":"The Munster Heart Study (PROCAM): results of follow-up at 8 years","volume":"19","author":"Assmann G","year":"1998","unstructured":"Assmann G, Cullen P, Schulte H. 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