Abstract
The objective of this study is to assess the relationship between high-density lipoprotein cholesterol (HDL-C) concentrations, high-density lipoprotein particle (HDL-P) size, and concentrations of HDL-P subclasses with different sizes with new-onset idiopathic pulmonary fibrosis (IPF). The longitudinal study included 404,023 participants without prior IPF from UK Biobank. The study outcome was new-onset IPF. Participants were divided into low, moderate, and high IPF genetic risks according to the tertiles of IPF genetic risk scores, calculated using a weighted method by 13 single nucleotide polymorphisms. During a median follow-up of 12.4 years, 1850 (4.6‰) participants developed IPF. There was a non-significant inverse association between HDL-C concentrations and the risk of new-onset IPF (per standard deviation [SD] increment, adjusted hazard ratio [HR], 0.95; 95% confidence interval [CI]: 0.89-1.02). HDL-P average size (per SD increment, adjusted HR, 1.37; 95% CI: 1.16-1.63), very large-sized (per SD increment, adjusted HR, 1.22; 95% CI: 1.04-1.43), and large-sized HDL-P concentrations (per SD increment, adjusted HR, 1.30; 95% CI: 1.04-1.63) were significantly positively associated with the risk of new-onset IPF. Medium-sized HDL-P concentrations were not significantly associated with the risk of new-onset IPF (per SD increment, adjusted HR, 0.99; 95% CI: 0.83-1.20). Small-sized HDL-P concentrations were significantly inversely associated with the risk of new-onset IPF (per SD increment, adjusted HR, 0.86; 95% CI: 0.77-0.96), especially in participants with low or moderate genetic risks of IPF and without diabetes (all P interactions <0.05). Small-sized HDL-P concentrations were inversely associated with the risk of new-onset IPF, while HDL-P sizes and larger-sized HDL-P concentrations were positively associated with the risk of new-onset IPF.</p>