Choi Hansol, Kim Hyeon Chang, Stefani Katherine M, Lee Ju-Mi, Yoon Young Mi, Lee Eun Young, Kim Kyoung Min, Rhee Yumie, Youm Yoosik, Kim Chang Oh
Department of Public Health, Yonsei University Graduate School, Seoul, Republic of Korea.
Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea; Cardiovascular and Metabolic Disease Etiology Research Center, Yonsei University College of Medicine, Seoul, Republic of Korea.
Arch Gerontol Geriatr. 2017 Jul;71:115-121. doi: 10.1016/j.archger.2017.04.002. Epub 2017 Apr 7.
Functional state and cholesterol metabolism are important for older adults; however, this association has not been fully investigated among community-dwelling older adults. Thus, we investigated the association of HDL cholesterol with multiple functional state measures in an elderly Korean population.
This cross-sectional analysis included 3514 participants, aged 65 years or older, who participated in baseline health assessment for the Korean Urban Rural Elderly cohort study from 2012 to 2015. HDL cholesterol concentration was analyzed using both continuous and categorical variables. Functional state was assessed by the mini-mental state examination (MMSE), activities of daily living (ADL) scale, instrumental activities of daily living (IADL) scale, timed up-and go (TUG) test, and chair-rise test (CRT). Multiple logistic regression models were used to investigate independent association between HDL cholesterol and functional state, after adjusting for sex, age, body mass index, systolic blood pressure, fasting glucose, lipid-lowering drug, history of cancer and cardiovascular disease, and health behaviors.
HDL cholesterol concentration was significantly associated with MMSE, ADL, IADL, TUG, and CRT in the unadjusted model. After adjustment for covariates, the association remained significant for MMSE (standardized β=0.059, p=0.001), ADL (standardized β=-0.053, p=0.004), and CRT (standardized β=-0.037, p=0.037). In fully-adjusted model, Participants who had a lower HDL concentration (<40mg/dL) showed significantly increased odds for having MMSE decline (OR 1.451, 95% CI 1.119-1.883) and ADL dependency (OR 2.251, 95% CI 1.119-4.526), compared reference group (≥60mg/dL).
Higher HDL cholesterol concentration was associated with better functional state among Korean older adults.
功能状态和胆固醇代谢对老年人很重要；然而，在社区居住的老年人中，这种关联尚未得到充分研究。因此，我们在韩国老年人群中研究了高密度脂蛋白胆固醇与多种功能状态指标之间的关联。
这项横断面分析纳入了3514名年龄在65岁及以上的参与者，他们参加了2012年至2015年韩国城乡老年人队列研究的基线健康评估。使用连续变量和分类变量分析高密度脂蛋白胆固醇浓度。通过简易精神状态检查表（MMSE）、日常生活活动（ADL）量表、工具性日常生活活动（IADL）量表、计时起立行走（TUG）测试和椅子起立测试（CRT）评估功能状态。在调整了性别、年龄、体重指数、收缩压、空腹血糖、降脂药物、癌症和心血管疾病史以及健康行为后，使用多个逻辑回归模型研究高密度脂蛋白胆固醇与功能状态之间的独立关联。
在未调整的模型中，高密度脂蛋白胆固醇浓度与MMSE、ADL、IADL、TUG和CRT显著相关。在调整协变量后，MMSE（标准化β=0.059，p=0.001）、ADL（标准化β=-0.053，p=0.004）和CRT（标准化β=-0.037，p=0.037）的关联仍然显著。在完全调整的模型中，与参考组（≥60mg/dL）相比，高密度脂蛋白浓度较低（<40mg/dL）的参与者出现MMSE下降（OR 1.451，95%CI 1.119-1.883）和ADL依赖（OR 2.251，95%CI 1.119-4.526）的几率显著增加。
在韩国老年人中，较高的高密度脂蛋白胆固醇浓度与较好的功能状态相关。
