Volpato S, Zuliani G, Guralnik J M, Palmieri E, Fellin R
Second Department of Clinical and Experimental Medicine, Section of Internal Medicine, University of Ferrara, Italy.
Gerontology. 2001 Jan-Feb;47(1):36-45. doi: 10.1159/000052768.
The total cholesterol concentration decreases with age in older people. The reasons for this phenomenon are controversial. This study investigated the hypothesis that poor health status is a determinant of the inverse association between age and cholesterol in older persons.
Cross-sectional study of 2,486 (53% women) older medical patients (> or =65 years) admitted at 35 centers of the Gruppo Italiano di Farmacovigilanza nell'Anziano (GIFA) study in Italy. Total cholesterol was measured on the first day after admission to the hospital. Disease burden and comorbidity were assessed by the Charlson index; low serum albumin and iron were considered markers of frailty and poor health.
In men there was a significant, inverse age-cholesterol relationship (-0.97 mg/dl per year, p<0.001). In women the association was nonlinear and cholesterol significantly decreased after the age of 75 (-0.95 mg/dl per year, p<0.005). In multiple linear regression analysis, indicators of poor health accounted for almost two thirds of the crude effect of age on the cholesterol level in both men and women (adjusted coefficients for age were: for men, -0.38 mg/dl per year, p = 0.044; for women after the age of 75, -0.37 mg/dl per year, p = 0.205). The unadjusted probability of having low cholesterol significantly increased with age among men (p for trend <0.005). In multiple logistic regression, indicators of poor health were strongly associated with low cholesterol in both men and women. After adjusting for indicators of poor health, the association between age and low cholesterol in men was no longer present.
These findings suggest that the age-dependent reduction of cholesterol often observed in clinical and epidemiologic studies is substantially explained by the effect of poor health status. Low cholesterol in older persons may be a marker of poor health.
老年人的总胆固醇浓度随年龄增长而降低。这种现象的原因存在争议。本研究调查了一种假设，即健康状况不佳是老年人年龄与胆固醇之间负相关关系的决定因素。
对意大利老年药物警戒研究组（GIFA）在35个中心收治的2486名（53%为女性）老年医学患者（≥65岁）进行横断面研究。入院后第一天测量总胆固醇。通过查尔森指数评估疾病负担和合并症；低血清白蛋白和铁被视为虚弱和健康状况不佳的标志物。
在男性中，年龄与胆固醇之间存在显著的负相关关系（每年-0.97mg/dl，p<0.001）。在女性中，这种关联是非线性的，75岁以后胆固醇显著降低（每年-0.95mg/dl，p<0.005）。在多元线性回归分析中，健康状况不佳的指标几乎占了年龄对胆固醇水平的粗略影响的三分之二（年龄的调整系数为：男性为每年-0.38mg/dl，p = 0.044；75岁以后的女性为每年-0.37mg/dl，p = 0.205）。男性中胆固醇水平低的未调整概率随年龄显著增加（趋势p<0.005）。在多元逻辑回归中，健康状况不佳的指标与男性和女性的低胆固醇密切相关。在调整了健康状况不佳的指标后，男性年龄与低胆固醇之间的关联不再存在。
这些发现表明，临床和流行病学研究中经常观察到的胆固醇随年龄下降现象，很大程度上是由健康状况不佳的影响所解释的。老年人胆固醇水平低可能是健康状况不佳的一个标志。
