PopulationsHumans5,283 participantsCohort study

Cumulative non-HDL cholesterol is linked to CVD risk

Each 100-unit increase in cumulative exposure was associated with an adjusted hazard ratio of 1.07 for cardiovascular disease over nine years, driven by earlier stages.

Figure 1 from Journal of Diabetes and Metabolic Disorders — Figure 1Ye et al.

Journal of Diabetes and Metabolic Disorders4 Oct 2026, 09:00 BST

In a nationwide study of 5,283 middle-aged and older adults in China, cumulative exposure to non-HDL cholesterol was associated with a higher risk of developing clinical cardiovascular disease. Researchers tracked participants from the China Health and Retirement Longitudinal Study who had cardiovascular-kidney-metabolic (CKM) syndrome stages 0 through 3. Cumulative exposure was calculated from repeated lipid measurements in 2011 and 2015, with participants followed for a median of 9.0 years.

During follow-up, 948 individuals progressed to clinical cardiovascular disease (CKM stage 4). The risk increase per 100-unit rise in cumulative exposure was stronger among participants starting at stage 0 (hazard ratio 1.18) and stage 1 (hazard ratio 1.17), while weaker associations were found in stage 2 and stage 3 (hazard ratio 1.03 for each).

Why it matters

Cardiovascular-kidney-metabolic syndrome reflects interconnected organ dysfunction that worsens across the lifespan. The results suggest that long-term atherogenic lipid exposure in early stages may accelerate progression to overt disease, highlighting potential targets for early cardiometabolic intervention.

Caveats

Because the investigation was observational, it cannot establish a causal link, and unmeasured confounding factors may have influenced the outcome. The findings also rely on a Chinese cohort and may not directly reflect risk profiles in other populations.