Table 1 Characteristics of the cross-sectional studies

Abd Alamir, M. 2018

[15]

USA / MESA

healthy adults

3236 (45%)

50–70

PR for low HDL-C (1 mg/dL)

and multivessel CAC:

1.20 (1.02, 1.40), < 0.01

age, sex, race, high school education, smoking, hypertension, waist circumference, serum glucose level, serum insulin, serum CRP level, and Agatston’s calcium score

6

Al Rifai, M. 2018

[16]

USA, Brazil / MESA,

ELSA-Brasil

healthy adults (with LDL-C < 70 mg/d)

263 (43%)

58 ± 12

OR for HDL-C (per 1 SD increase) and CAC > 0:

0.80 (0.60, 1.07)

age, sex, race/ethnicity, education, and study site, cardiovascular risk factors

6

Al Rifai, M. 2022

[17]

USA / MASALA

healthy adults

1155 (52%)

56.8 ± 9.4

β coefficient for HDL-C (mg/dL) and CAC density and volume:

0.009 (0.001, 0.016)

-0.004 (-0.009, 0.001)

education, annual family income, birth country, years lived in the USA and statin medication use.

Results for CAC density were additionally adjusted for CAC volume while results for CAC volume were additionally adjusted for CAC density

6

Allison, M. A. 2005

[18]

USA

healthy adults

6086 (62%)

22–94

OR for HDL-C (5 mg/dL)

and CAC (men and women):

0.92 (0.89, 0.95)

0.93 (0.90, 0.96)

cardiovascular risk factors

7

Bittencourt, M. S. 2017

[11]

Brazil / ELSA-Brasil

healthy adults

3845 (46%)

49.9 ± 8.4

OR for HDL-C (per 1 SD increase) and CAC > 0:

1.02 (0.93, 1.13), 0.46

age, sex, diabetes, smoking, hypertension, systolic blood pressure, LDL-C, Log-transformed TG rich lipoproteins and HDL-C, BMI and log-transformed high sensitivity CRP

7

Chiu, T. Y. 2012

[12]

Taiwan

healthy adults

341 (62%)

53 ± 10

OR for HDL-C (1 mg/dL)

and CAC > 0:

0.98 (0.96, 1)

sex-specific age, BMI, FBS = 110 mg/dl, diabetes and use of lipid-lowering drugs

6

Den Harder, A. M. 2018

[19]

Netherlands /

UPOD

suspected or known CAD adults

1504 (64%)

53 ± 13

β coefficient for HDL-C (mmol/L) and CAC:

-0.05 (-0.17, 0.14), 0.559

age, sex, BMI, diabetes, GFR

6

Ditah, C. 2016

[20]

Israel

healthy adults

504 (64%)

25–74

OR for HDL-C (1 mg/dL)

and CAC ≥ 100 vs. CAC < 100:

0.59 (0.27, 1.29) 0.49

age, sex and ethnicity, BMI, diabetes, hypertension, smoking status, statin use, large and small LDL-P and medium VLDL-P

7

Freitas, W. M. 2015

[21]

Brazil / Brazilian Study on Healthy Aging

healthy adults

208 (18%)

85 ± 4

OR for HDL-C (1 mg/dL)

and CAC:

0.34 (0.15, 0.75), 0.008

age, sex, diabetes, blood pressure, smoking and statin therapy

6

Generoso, G. 2019

[22]

Brazil / ELSA-Brasil

healthy adults

3674 (46%)

49.8 ± 8.3

OR for HDL-C (per 1 SD increase) and CAC = 0 vs. CAC > 0 and CAC < 100 vs. CAC ≥ 100:

1.041 (0.933, 1.161)

0.940 (0.800, 1.105)

age, sex, smoking, hypertension, alcohol use, physical activity, LDL-C, TGs

7

Hirata, A. 2020

[23]

Japan / SESSA

healthy men

910 (100%)

63.6 ± 10.2

OR for HDL-C (1 mg/dL)

and CAC > 10:

1.03 (0.86, 1.22), 0.72

age, BMI, LDL-C, log-transformed TGs, log-transformed high sensitivity CRP, lipid-lowering medication use, diabetes, hypertension, smoking status, alcohol drinking status, and type of CT

6

Hisamatsu, T. 2014

[24]

Japan / SESSA

healthy men

851 (100%)

40–79

OR for HDL-C (1 mg/dL)

and CAC > 0:

0.56 (0.34, 0.91)

age, smoking status (former, current), ethanol consumption (g/day), BMI, blood glucose, systolic blood pressure, medication status (hypertension and diabetes), type of CT, exercise, and a family history of IHD

6

Kaplan, H. 2017

[25]

Bolivia

healthy adults

705 (50%)

57.6 (40–94)

IRR for HDL-C (mmol/L) and prediction of CAC absence:

–0.04 (–0.07, 0.00), 0.0474

age, sex

5

Kim, J. D. 2017

[26]

South Korea

healthy adults

16,493 (74%)

42.68 ± 8.79

OR for HDL-C (per 1 SD increase) and CAC ≥ 1:

0.87 (0.82, 0.93), < 0.05

age, sex, BMI

7

Kimani, C. 2019

[27]

Japan / SESSA

healthy men

1035 (100%)

69.5 ± 6.9

OR for HDL-C (per 1 SD increase) and CAC > 0:

0.98 (0.8, 1.2), < 0.955

age, BMI, systolic blood pressure, smoking (pack-year), alcohol intake, HbA1c, uric acid, GFR, serum lipids, and CRP

6

Lee, J. 2020

[28]

South Korea

healthy adults

2123 (70%)

55.4 ± 11.3

OR for HDL-C (1 mg/dL)

and CAC ≥ 100:

0.99 (0.97, 1), < 0.094

age, male, height, weight, abdominal circumference, BMI, blood pressure, high sensitivity CRP, FBS, HbA1c, Bilirubin, GGT, ALP, LDH, AST, ALT, BUN, Creatinine, GFR, total cholesterol, TG, LDL-C, WBC, hemoglobin, MCV, Platelet count

7

Martin, S. S. 2011

[29]

USA / SIRCA

healthy adults

803 (52.8%)

48 ± 6

tobit regression for HDL-C (per 1 SD increase) and CAC:

0.89 (0.70, 1.11), 0.30

age, sex, medications, blood pressure, lipids, tobacco and alcohol use, exercise, family history of premature IHD, BMI, waist circumference, and high sensitivity CRP

6

Paramsothy, P. 2010

[30]

USA / MESA

healthy adults

4792

(47%)

45–84

RR for HDL-C (1 mg/dl) and CAC:

1.05 (0.98, 1.12)

age, race/ethnicity, sex, clinical site, education, history of hypertension, current smoking status, alcohol use, estrogen use among women, waist circumference, fasting glucose, fasting insulin, CRP, and creatinine

6

Pedrosa, J. F. 2019

[9]

Brazil / ELSA-Brasil

healthy adults

2388 (46%)

53.6 ± 13.4

OR for HDL-C (1 mg/dL)

and CAC > 0:

0.99 (0.98, 0.99), ≤ 0.05

LDL-C, HbA1c, blood pressure, antidiabetic, antihypertensive, and lipid lowering medications

7

Pletcher, M. J. 2013

[31]

USA / MESA

healthy adults

6757 (47%)

45–84

OR for HDL-C (per 10 mg/dl) and CAC presence and CAC extent:

0.892 (0.854, 0.931), < 0.001

0.006 (-0.038, 0.05), 0.791

conventional CHD risk factors, race/ethnicity

7

Sharma, A. 2011

[32]

Indonesia

healthy adults

104 (63.5%)

56 (10.3)

OR for HDL-C (1 mg/dL)

and CAC:

0.93 (0.87, 0.99), ≤ 0.0001

age, sex, diabetes, hypertension, dyslipidemia, smoker, family history of IHD, total cholesterol, LDL-C, TGs, abnormal Lipoprotein(a)

6

Sung, K. C. 2013

[33]

South Korea

healthy men

12,031 (100%)

29–79

OR for HDL-C (1 mg/dl) and CAC > 0:

0.78 (0.64, 0.94), 0.01

age, glucose, TG, LDL-C, systolic blood pressure, waist circumference, prior cerebrovascular accident, prior coronary artery disease, prior hypertension, alcohol consumption, smoking status and exercise

6

Swabe, G. 2021

[34]

USA / SWAN

midlife women

478 (0%)

50.9 ± 2.9

OR for HDL-C (1 mg/dL)

and CAC > 10:

1.04 (0.95, 1.12), 0.4

cycle day, hormone use, age, race, site, waist circumference, smoking, log TGs, systolic blood pressure, log glucose, LDL-C, menopausal status, education, and alcohol consumption

6

Wang, J. S. 2022 [47]

Taiwan

healthy adults

364 (82.7%)

58.4–72.1

OR for HDL-C (1 mg/dL)

and CAC > 100:

1.25 (0.97, 1.61), 0.09

age, sex, BMI, smoking, hypertension, diabetes, GFR, FBS

6

Woodard, G. A. 2011

[35]

USA / SWAN

midlife women

540 (0%)

50.2 ± 2.9

OR for HDL-C (1 mg/dL)

and CAC > 10 (premenopausal and postmenopausal):

0.99 (0.95, 1.03)

0.99 (0.96, 1.02)

age, site, race, systolic blood pressure, glucose, BMI, smoking, menopausal status and lipids

6