{
  "abstract": "AIM: Isolated low high-density lipoprotein cholesterol (HDL-C) refers to low HDL-C levels with normal levels of triglycerides and low-density lipoprotein cholesterol. However, its prognostic significance remains controversial. This study aimed to investigate the association between isolated low HDL-C levels and the incidence of stroke and coronary artery disease (CAD). METHOD: This study included 496,973 Japanese individuals (mean age: 66.4 years) enrolled in municipal health insurance programs. Data on baseline clinical characteristics and cardiovascular outcomes were obtained from annual health checkup and health insurance claims data, respectively. Isolated low HDL-C was defined as HDL-C ＜40 mg/dL with normal levels of triglyceride and low-density lipoprotein cholesterol (LDL-C). RESULT: The frequency of isolated low HDL-C was 1.3%. Isolated low HDL-C was independently associated with the CAD incidence (hazard ratio [HR] = 1.87, P＜0.001). This association remained significant in age- and sex-separate analyses, as well as in the analysis of participants who were not taking lipid-lowering drugs and had severe comorbidities at baseline. Conversely, isolated low HDL-C levels were not associated with the incidence of ischemic stroke (HR = 1.08, P = 0.266) or hemorrhagic stroke (HR = 1.16, P = 0.223) in all participants. However, it showed a significant association with ischemic stroke in the subgroup analysis of those aged ＜65 years (HR = 2.21, P＜0.001) and men (HR = 1.17, P = 0.035). CONCLUSION: Isolated low HDL-C was associated with the incidence of CAD and ischemic stroke despite normal plasma levels of triglyceride and low-density lipoprotein cholesterol.",
  "abstract_shown": true,
  "affiliations": [],
  "article_type": null,
  "arxiv": null,
  "author_total": 4,
  "authors": [
    {
      "name": "Yasuharu Tabara"
    },
    {
      "name": "Sayaka Nagao-Sato"
    },
    {
      "name": "Aya Shoji-Asahina"
    },
    {
      "name": "Yoko Sato"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/7byxk9r68m2nq.bib",
  "cited_by": 0,
  "doi": "10.5551/jat.66249",
  "fulltext_url": "https://www.jstage.jst.go.jp/article/jat/advpub/0/advpub_66249/_article",
  "id": "7byxk9r68m2nq",
  "issns": [
    "1880-3873",
    "1340-3478"
  ],
  "landing_url": "https://www.jstage.jst.go.jp/article/jat/advpub/0/advpub_66249/_article",
  "language": null,
  "licence": "CC-BY-NC-SA",
  "licence_label": "CC BY-NC-SA",
  "licence_source": "journal",
  "licence_url": "https://creativecommons.org/licenses/by-nc-sa/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "jstage-journal",
      "medicine/cardiovascular"
    ],
    [
      "openalex",
      "2746|Lipoproteins and Cardiovascular Health"
    ]
  ],
  "openalex": "W7167418706",
  "pdf_url": "https://www.jstage.jst.go.jp/article/jat/advpub/0/advpub_66249/_pdf",
  "pmcid": null,
  "pmid": null,
  "published": "2026-07-06",
  "publisher": null,
  "ris": "https://research.draconitic.com/paper/7byxk9r68m2nq.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T12:17:22Z",
      "native_id": "10.5551/jat.66249",
      "source": "jstage",
      "url": "https://www.jstage.jst.go.jp/article/jat/advpub/0/advpub_66249/_article"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2746|Lipoproteins and Cardiovascular Health",
      "subfield": "surgery"
    }
  ],
  "title": "Isolated Low Levels of High-density Lipoprotein Cholesterol are Associated with an Increased Risk of Ischemic Cardiovascular Events: The Shizuoka Kokuho Database Study",
  "title_text": "Isolated Low Levels of High-density Lipoprotein Cholesterol are Associated with an Increased Risk of Ischemic Cardiovascular Events: The Shizuoka Kokuho Database Study",
  "type": "peer-reviewed",
  "updated_at": "2026-10-30T12:17:22Z",
  "url": "https://research.draconitic.com/paper/7byxk9r68m2nq",
  "venue": "Journal of Atherosclerosis and Thrombosis",
  "versions": []
}