低高密度脂蛋白 3 降低了男性在 53 年随访中活到 85 岁的几率。
Low high-density lipoprotein 3 reduces the odds of men surviving to age 85 during 53-year follow-up.
机构信息
Lawrence Berkeley Laboratory, Berkeley, California 94720, USA.
出版信息
J Am Geriatr Soc. 2012 Mar;60(3):430-6. doi: 10.1111/j.1532-5415.2011.03851.x. Epub 2012 Feb 13.
OBJECTIVES
To identify high-density lipoprotein (HDL) subfractions associated with longevity in men.
DESIGN
Fifty-three-year prospective follow-up of Gofman's Livermore Cohort between 1954 and 2008.
SETTING
Lawrence Livermore National Laboratory.
PARTICIPANTS
One thousand one hundred forty-four men who consented to the study, had analytic ultracentrifuge measurements of lipoprotein subfractions at baseline, and were old enough at baseline to have survived to age 85 during follow-up.
MEASUREMENTS
Survival was determined according to participant contact, Social Security Death Index, and National Death Index.
RESULTS
Three hundred ninety men survived to 85 years old (34.1%). Survivors were less likely than nonsurvivors to be in the lowest HDL3 (% (standard error) 18.5% (2.0%) vs 27.3% (1.6%), P < .001) and HDL2 (22.1% (2.1%) vs 27.7% (1.6%), P = .04) quartiles. Logistic regression analyses showed that the lowest HDL3 quartile significantly predicted shorter longevity (P = .002), whereas the linear increases per mg/dL of HDL3 did not (P = .38), suggesting a risk threshold proximal to the 25th percentile. Men who were above the 25th HDL3 percentile had 70% greater odds of surviving until age 85 than those below this level, which persisted when adjusted for HDL2, very low-density lipoprotein (LDL), and standard risk factors. Proportional hazard analyses of survival before age 85 showed that being in the lowest HDL3 quartile increased age-adjusted cancer risk by 39% (P = .05) and noncancer risk by 23% (P = .04) when adjusted for other risk factors. Survivors also smoked less (mean ± SD 0.31 ± 0.48 vs 0.57 ± 0.56 packs/d, P < .001), had lower systolic (118.36 ± 11.08 vs 122.81 ± 13.55 mmHg, P < .001) and diastolic (70.61 ± 8.59 vs 73.14 ± 9.22 mmHg, P < .001) blood pressures and lower LDL mass (359.55 ± 80.42 vs 374.37 ± 86.10 mg/dL, P = .009) and total cholesterol concentrations (229.51 ± 43.21 vs 235.89 ± 45.40 mg/dL, P = .04) than nonsurvivors.
CONCLUSION
Low HDL3 reduces the odds of extended survival in men, independent of HDL2, other lipoproteins, and standard risk factors.
目的
确定与男性长寿相关的高密度脂蛋白（HDL）亚群。
设计
1954 年至 2008 年期间，对 Gofman 的 Livermore 队列进行了 53 年的前瞻性随访。
地点
劳伦斯利弗莫尔国家实验室。
参与者
1144 名同意参加研究的男性，在基线时有脂蛋白亚组分的分析超速离心测量值，并且在基线时年龄足够大，可以在随访中活到 85 岁。
测量
根据参与者的联系、社会保障死亡指数和国家死亡指数确定生存情况。
结果
390 名男性活到 85 岁（34.1%）。与非幸存者相比，幸存者更不可能处于最低 HDL3（%（标准误差）18.5%（2.0%）与 27.3%（1.6%），P<.001）和 HDL2（22.1%（2.1%）与 27.7%（1.6%），P=.04）四分位数。逻辑回归分析表明，最低 HDL3 四分位数显著预测寿命较短（P=.002），而每毫克/分升 HDL3 的线性增加并没有（P=.38），表明接近 25%分位数的风险阈值。高于 HDL3 第 25 百分位的男性比低于此水平的男性存活至 85 岁的可能性高 70%，当调整 HDL2、极低密度脂蛋白（LDL）和标准风险因素时，这种情况仍然存在。在 85 岁之前的生存比例风险分析表明，处于最低 HDL3 四分位数时，癌症风险增加 39%（P=.05），非癌症风险增加 23%（P=.04），当调整其他风险因素时。幸存者吸烟也较少（平均±标准差 0.31±0.48 与 0.57±0.56 包/天，P<.001），收缩压（118.36±11.08 与 122.81±13.55 mmHg，P<.001）和舒张压（70.61±8.59 与 73.14±9.22 mmHg，P<.001）较低，LDL 质量（359.55±80.42 与 374.37±86.10 mg/dL，P=.009）和总胆固醇浓度（229.51±43.21 与 235.89±45.40 mg/dL，P=.04）也较低。
结论
在男性中，低 HDL3 降低了长寿的几率，独立于 HDL2、其他脂蛋白和标准风险因素。
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