Department of Family Medicine, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro 43 gil, Songpa-gu, 05505, Seoul, Republic of Korea.
Lipids Health Dis. 2021 Jan 6;20(1):3. doi: 10.1186/s12944-020-01426-0.
Dyslipidemia is considered an independent health risk factor of cardiovascular disease (CVD), a leading cause of mortality in older adults. Despite its importance, there have been few reports on the association between lipoprotein cholesterol and future CVD and cardiovascular (CV) mortality among elderly Asians aged ≥ 65 years. This study investigated the association between lipoprotein cholesterol and future CVD and CV mortality in an elderly Korean population using a large nationwide sample.
From the cohort database of the Korean National Health Insurance Service, 62,604 adults aged ≥ 65 years (32,584 men and 30,020 women) were included. High-density lipoprotein cholesterol (HDL-C) and low-density lipoprotein cholesterol (LDL-C) levels were categorized by quartiles. Cox proportional hazard models and linear regression analyses were used to assess the association between the quartiles of lipoprotein cholesterol and future CV events or mortality.
The mean follow-up period was 3.3 years. The incidence rates of ischemic heart disease and ischemic brain disease were 0.97 and 0.61 per 1,000 person-years, respectively, and the mortality rates from these diseases were 0.22 and 0.34 per 1,000 person-years, respectively. In a completely adjusted model, high HDL-C and LDL-C levels were not associated with total CV events and CVD mortality. However, high LDL-C levels were significantly associated with a lower incidence of ischemic brain disease. Furthermore, diabetic patients with high LDL-C levels were more likely to have higher CV mortality, whereas non-smokers with high LDL-C levels were less likely to be at risk of CV events.
Neither high LDL-C nor HDL-C levels were significantly associated with future CV mortality in older adults aged ≥ 65 years. High LDL-C levels do not seem to be a risk factor for CVD in elderly individuals, and further studies are required.
血脂异常被认为是心血管疾病（CVD）的独立健康风险因素，也是老年人死亡的主要原因。尽管血脂异常很重要，但关于脂蛋白胆固醇与老年亚洲人未来 CVD 和心血管（CV）死亡率之间的关系的报告很少。本研究使用大型全国样本调查了脂蛋白胆固醇与老年韩国人群未来 CVD 和 CV 死亡率之间的关系。
从韩国国家健康保险服务的队列数据库中纳入 62604 名年龄≥65 岁的成年人（32584 名男性和 30020 名女性）。高密度脂蛋白胆固醇（HDL-C）和低密度脂蛋白胆固醇（LDL-C）水平按四分位区间分类。使用 Cox 比例风险模型和线性回归分析评估脂蛋白胆固醇四分位区间与未来 CV 事件或死亡率之间的关系。
平均随访时间为 3.3 年。缺血性心脏病和缺血性脑病的发生率分别为 0.97 和 0.61/1000 人年，这些疾病的死亡率分别为 0.22 和 0.34/1000 人年。在完全调整模型中，高 HDL-C 和 LDL-C 水平与总 CV 事件和 CVD 死亡率无关。然而，高 LDL-C 水平与较低的缺血性脑病发生率显著相关。此外，高 LDL-C 水平的糖尿病患者 CV 死亡率较高，而高 LDL-C 水平的不吸烟者发生 CV 事件的风险较低。
在年龄≥65 岁的老年人中，高 LDL-C 或 HDL-C 水平与未来 CV 死亡率均无显著相关性。高 LDL-C 水平似乎不是老年人群 CVD 的危险因素，需要进一步研究。
