{
  "abstract": "Background Extremely low high-density lipoprotein cholesterol (HDL-C) is uncommon and may result from secondary conditions or rare genetic disorders. Data on persistently low HDL-C in Southeast Asians remain limited. We aim to determine the prevalence, clinical characteristics, underlying etiologies, and clinical outcomes of patients with persistent low HDL-C.Methods This retrospective cohort study evaluated adults with persistently low HDL-C (<30 mg/dL) identified via laboratory and electronic medical records between January 2020 and December 2024. Patients were stratified into two phenotypes based on baseline HDL-C severity: markedly low (20–29 mg/dL) or extremely low (<20 mg/dL).Results Among 217,481 individuals undergoing lipid testing (1,053,662 HDL-C measurements), 164 patients had persistently low HDL-C (mean age, 56.9 years; 68.9% male). The prevalence of persistently low and extremely low HDL-C was 0.08% and 0.008%, respectively. Concomitant hypertriglyceridemia affected ∼75% of patients. Most cases were associated with secondary conditions. Extremely low HDL-C was more frequently associated with liver disease (41.2%) and active malignancy (29.4%), whereas metabolic syndrome predominated among patients with markedly low HDL-C (42.2%). During a median follow-up of 2.57 years, all-cause mortality was higher in the extremely low HDL-C group (29.4% vs. 11.6%; hazard ratio, 4.33; 95% CI, 1.58–11.91; p = 0.004), while atherosclerotic cardiovascular disease rates were similar between groups (35.3% vs. 32.0%).Conclusions Persistently low HDL-C is an exceedingly rare phenotype driven primarily by secondary systemic conditions. An extremely low HDL-C level appears to be a marker of severe underlying systemic illness and was associated with higher short-term mortality.",
  "abstract_shown": true,
  "affiliations": [
    "Division of Endocrinology and Metabolism, Department of Medicine, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand",
    "Chakri Naruebodindra Medical Institute, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Samut Prakan, Thailand"
  ],
  "article_type": null,
  "arxiv": null,
  "author_total": 3,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Watcharapon Kiattikittikul"
    },
    {
      "affs": [
        1
      ],
      "name": "Kitti Thammakosol"
    },
    {
      "affs": [
        0
      ],
      "name": "Chutintorn Sriphrapradang"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/0yc5vxq1xzsjr.bib",
  "cited_by": 0,
  "doi": "10.1080/07853890.2026.2758510",
  "fulltext_url": "https://www.tandfonline.com/doi/10.1080/07853890.2026.2758510",
  "id": "0yc5vxq1xzsjr",
  "issns": [
    "1365-2060",
    "0785-3890"
  ],
  "landing_url": "https://doi.org/10.1080/07853890.2026.2758510",
  "language": "en",
  "licence": "CC-BY",
  "licence_label": "CC BY",
  "licence_source": "journal",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "lcc",
      "R"
    ],
    [
      "openalex",
      "2746|Lipoproteins and Cardiovascular Health"
    ]
  ],
  "openalex": "W7225247798",
  "pdf_url": null,
  "pmcid": null,
  "pmid": null,
  "published": "2026-11-05",
  "publisher": "Taylor & Francis Group",
  "ris": "https://research.draconitic.com/paper/0yc5vxq1xzsjr.ris",
  "sources": [
    {
      "first_seen": "2026-11-05T14:21:13Z",
      "native_id": "537908fe5fbe40be8ebbc4d48f711704",
      "source": "doaj",
      "url": "https://doi.org/10.1080/07853890.2026.2758510"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2746|Lipoproteins and Cardiovascular Health",
      "subfield": "surgery"
    }
  ],
  "title": "Prevalence, clinical characteristics, and etiologic spectrum of extremely low levels of high-density lipoprotein cholesterol in Thai patients: a single-center study",
  "title_text": "Prevalence, clinical characteristics, and etiologic spectrum of extremely low levels of high-density lipoprotein cholesterol in Thai patients: a single-center study",
  "type": "peer-reviewed",
  "updated_at": "2026-11-06T14:20:42Z",
  "url": "https://research.draconitic.com/paper/0yc5vxq1xzsjr",
  "venue": "Annals of Medicine",
  "versions": []
}