Geriatric Unit, Internal Medicine Service, Hospital Universitari de Bellvitge, IDIBELL, L'Hospitalet de Llobregat Primary Healthcare Centre El Plà CAP -I, Sant Feliu de Llobregat, Barcelona, Spain.
Geriatr Gerontol Int. 2011 Jul;11(3):358-64. doi: 10.1111/j.1447-0594.2010.00681.x. Epub 2011 Jan 17.
Little is known about the role of high-density lipoprotein cholesterol (HDL-C) in oldest-old subjects. The aim of this study is to evaluate the association between HDL-C levels and physical and cognitive performance indicators in nonagenarians, and also to determine the influence of HDL-C levels on the 3-year mortality risk.
The data analyzed were taken from the NonaSantfeliu Study. Functional status was determined by the Lawton-Brody Index (LI) for instrumental activities of daily living (IADL) and the Barthel Index (BI) for basic activities (BADL). Cognition was assessed using the Spanish version of the Mini-Mental State Examination (MEC).
The sample consisted of 49 women (79%) and 13 men, aged 94.3 ± 2.6 years. Mean HDL-C levels were 60 ± 16 mg/dL, and 16 subjects (25.8%) had low HDL-C values. HDL-C levels did correlate with BI (r = 0.28, P = 0.02) and LI (r = 0.32, P = 0.01), but not with MEC (r = 0.18, P = 0.15). Normal HDL-C levels at baseline were significantly associated with higher BI scores (P < 0.006, odds ratio [OR] = 1.03, 95% confidence interval [CI] = 1.01-1.05) and a lower number of prescription drugs used (P < 0.04, OR = 0.71, 95% CI = 0.49-0.99). Baseline HDL-C levels were significantly lower among the group of nonagenarians who died within the 3 years of follow up (P = 0.02). However, after adjusting for potential confounders, the association between HDL-C and mortality lost significance.
Higher levels of HDL-C correlate with better functional status and less use of prescribed drugs in nonagenarians. However, the relationship between low HDL-C levels and long-term mortality in this population remains unclear.
关于高龄人群中高密度脂蛋白胆固醇（HDL-C）的作用知之甚少。本研究旨在评估非高龄人群中 HDL-C 水平与身体和认知功能指标的相关性，并确定 HDL-C 水平对 3 年死亡率风险的影响。
分析的数据来自 NonaSantfeliu 研究。功能状态通过日常生活活动的 Lawton-Brody 指数（LI）评估工具（IADL）和日常生活活动的巴氏量表（BI）评估基本活动（BADL）。认知功能采用西班牙版简易精神状态检查（MEC）评估。
样本由 49 名女性（79%）和 13 名男性组成，年龄为 94.3±2.6 岁。平均 HDL-C 水平为 60±16mg/dL，16 名受试者（25.8%）的 HDL-C 值较低。HDL-C 水平与 BI（r=0.28，P=0.02）和 LI（r=0.32，P=0.01）呈正相关，但与 MEC 无相关性（r=0.18，P=0.15）。基线时正常的 HDL-C 水平与较高的 BI 评分显著相关（P<0.006，比值比[OR]=1.03，95%置信区间[CI]：1.01-1.05），使用的处方药数量较少（P<0.04，OR=0.71，95%CI：0.49-0.99）。在 3 年随访期间死亡的非高龄组中，基线 HDL-C 水平显著降低（P=0.02）。然而，在校正潜在混杂因素后，HDL-C 与死亡率之间的关联失去了显著性。
非高龄人群中 HDL-C 水平较高与功能状态较好和使用处方药较少相关。然而，在该人群中，低 HDL-C 水平与长期死亡率之间的关系仍不清楚。
