Association between high-density-lipoprotein cholesterol and risk of abdominal aortic aneurysm among males and females aged 60 years and over

Whether high-density-lipoprotein cholesterol (HDL-c) has a protective role against abdominal aortic aneurysm (AAA) development in both older males and females remains uncertain. This study aims to assess the sex-specific association between HDL-c and incident AAA in older adults from the UK Biobank. This cohort study included 86,184 males and 95,682 females aged ≥60 years from the UK biobank. Baseline HDL-c was modelled either as a continuous or categorical variable. The primary outcome was incident AAA. Cox proportional-hazard models were used for sex-stratified analysis, adjusting for baseline confounders. Restricted cubic splines were plotted to visualise any non-linear relationship. Harrell’s C-index was calculated to assess the added value of HDL-c to the discrimination of model including age and smoking. Over a mean follow-up of 14.4 years, 1,549 and 328 incident AAA were observed in males and females, respectively. Adjusted HR (95%CI) for AAA with a 1 mmol/L HDL-c increase was 0.26 (0.21- 0.32) and 0.31 (0.21-0.46) in males and females, respectively, both p