Small HDL particle count is linked to lower mortality
Top-quartile small HDL particle counts had all-cause mortality hazard ratios of 0.79 in men and 0.77 in women compared with bottom quartiles.
medRxiv
In a preprint analyzing 47,123 men and 97,589 women from the Mexico City Prospective Study, researchers tracked 11,264 male and 15,486 female deaths to evaluate how high-density lipoprotein (HDL) concentration and particle count relate to mortality. HDL cholesterol concentration showed a J-shaped association with all-cause mortality in men, driven by other deaths, and a U-shaped association in women, driven by cardiovascular disease deaths at lower concentrations and other deaths at higher concentrations. Small HDL particle count was associated with reduced risk of all-cause, cardiovascular disease, and other mortality in both sexes. Compared with the bottom quartile, participants in the top quartile of small HDL particle count had an all-cause mortality hazard ratio of 0.79 in men and 0.77 in women.
Why it matters
The findings indicate that HDL particle size and count may provide prognostic information about mortality risk that standard total HDL cholesterol concentration does not capture.
Caveats
This observational analysis cannot establish a causal relationship between HDL particles and mortality risk, and the preprint has not yet undergone peer review.
The paper
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Evelia Apolinar‐Jiménez, Catalina Medina, Pablo Antonio Kuri-Morales, Roberto Tapia‐Conyer,Universidad de Los Andes · Universidad Nacional Autónoma de México
medRxiv · 29 Sep 2026 · Preprint, not peer-reviewed