{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,26]],"date-time":"2026-06-26T04:50:53Z","timestamp":1782449453775,"version":"3.54.5"},"reference-count":25,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,6,26]],"date-time":"2026-06-26T00:00:00Z","timestamp":1782432000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Endocrinol."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Although low high-density lipoprotein cholesterol (HDL-C) is associated with poor outcomes in heart failure, its specific prognostic role in non-ischemic dilated cardiomyopathy (DCM) remains undefined. This study aimed to investigate the association between HDL-C levels and long-term clinical outcomes in patients with DCM.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We retrospectively enrolled 297 patients with DCM who underwent cardiac magnetic resonance between January 2017 and October 2024. The primary endpoint was a composite of all-cause mortality and heart transplantation; the secondary endpoint additionally included heart failure readmission. The associations between HDL-C and clinical outcomes were assessed using Kaplan-Meier analysis, Cox regression, restricted cubic spline (RCS), and sensitivity analyses.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>During a median follow-up of 35 months, 41 (13.8%) and 97 (32.7%) patients experienced the primary and secondary endpoints, respectively. Kaplan-Meier analysis demonstrated that patients with higher HDL-C had significantly better event-free survival for both the primary and secondary endpoints (log-rank P &amp;lt; 0.001 for both). In multivariable Cox regression models, lower HDL-C was consistently and independently associated with an increased risk of the primary (hazard ratio [HR] 0.19, 95% confidence interval [CI]: 0.05\u20130.68, P\u00a0=\u00a00.011) and secondary (HR 0.15, 95% CI: 0.07\u20130.34, P &amp;lt; 0.001) endpoints. After further adjustment for echocardiographically estimated pulmonary artery systolic pressure, the effect estimate for the association between HDL\u2212C and clinical outcomes was attenuated (primary endpoint: HR 0.31, 95% CI: 0.08\u20131.11, P\u00a0=\u00a00.072; secondary endpoint: HR 0.19, 95% CI: 0.08\u20130.44, P &amp;lt; 0.001). RCS curves showed a linear relationship between HDL-C and both endpoints (P for nonlinearity &amp;gt; 0.05 for both). Sensitivity analyses confirmed the robustness of the results.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Lower HDL-C levels were independently associated with adverse outcomes in patients with non-ischemic DCM, an association partly attenuated by adjusting for pulmonary hypertension markers. As a readily available prognostic biomarker, HDL-C may inform risk stratification in this population.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fendo.2026.1843944","type":"journal-article","created":{"date-parts":[[2026,6,26]],"date-time":"2026-06-26T04:35:39Z","timestamp":1782448539000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["High-density lipoprotein cholesterol levels and prognosis in non-ischemic dilated cardiomyopathy"],"prefix":"10.3389","volume":"17","author":[{"given":"Chao","family":"Gong","sequence":"first","affiliation":[{"name":"Department of Cardiology, The First Affiliated Hospital of Zhengzhou University","place":["Zhengzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mengmeng","family":"Zhou","sequence":"additional","affiliation":[{"name":"Department of Anaesthesiology, West China Hospital, Sichuan University","place":["Chengdu, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shenzhen","family":"Gong","sequence":"additional","affiliation":[{"name":"Department of Cardiology, The First Affiliated Hospital of Zhengzhou University","place":["Zhengzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chunxiao","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Clinical Laboratory, The Eighth People\u2019s Hospital of Zhengzhou","place":["Zhengzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jinying","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Cardiology, The First Affiliated Hospital of Zhengzhou University","place":["Zhengzhou, 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