Wang Shengshu, Jia Wangping, Yang Shanshan, Han Ke, Cao Wenzhe, Ren Xueling, Li Jing, Tai Penggang, Kou Fuyin, Liu Miao, He Yao
Institute of Geriatrics, Beijing Key Laboratory of Aging and Geriatrics, National Clinical Research Center for Geriatrics Diseases, Second Medical Center of Chinese PLA General Hospital, Beijing, China.
Department of Disease Prevention and Control, The 1st Medical Center, Chinese PLA General Hospital, Beijing, China.
Front Med (Lausanne). 2021 Feb 16;8:608941. doi: 10.3389/fmed.2021.608941. eCollection 2021.
Lower serum lipid metabolism might be associated with the decline of activity of daily living in the extreme longevity group. However, studies on models and possible paths of this correlation between total cholesterol (TC) and disability in centenarians are scarce. The aim of this study was to verify this correlation and explore the mediating effect of BMI and blood pressure on this relationship in Hainan centenarians. We conducted a cross-sectional analysis of 1002 centenarians from the China Hainan Centenarians Cohort Study (CHCCS). Data on demographics, anthropometry data, lifestyle, and TC levels were collected through interviews, physical examinations, and laboratory tests. The Barthel index and Lawton index, measuring the disability status, were used to estimate the activity of daily living (ADL) and instrumental activity of daily living (IADL). A multivariable logistic regression model was used to explore the correlation between disability and TC levels. Mediation analyses were used to explore the both direct and indirect effects of TC level on disability. After adjusting for covariates, with 1 mmol/L increment in TC, the adjusted odds ratios (ORs) of ADL severe disability and ADL moderate & severe disability were 0.789(95%CI: 0.650-0.959) and 0.822(95%CI: 0. 0.699-0.966), respectively. There was a significant declining trend in the prevalence of different types of disability with increment in TC. The correlation was more pronounced among Hainan female centenarians. In the analysis of mediating effect among the female population, BMI significantly mediated the effect of TC levels on different types of disability. BMI and SBP, as chain mediators, multiply and chain mediated the effect of TC levels on IADL. Low TC levels might be correlated with a higher frequency of disability in female centenarians, and this correlation might be mediated by BMI and blood pressure.
血清脂质代谢水平较低可能与极端长寿人群日常生活活动能力的下降有关。然而，关于百岁老人总胆固醇（TC）与残疾之间这种相关性的模型和可能路径的研究却很少。本研究的目的是验证这种相关性，并探讨体重指数（BMI）和血压在海南百岁老人中对这种关系的中介作用。我们对来自中国海南百岁老人队列研究（CHCCS）的1002名百岁老人进行了横断面分析。通过访谈、体格检查和实验室检测收集了人口统计学数据、人体测量数据、生活方式和TC水平的数据。使用巴氏指数和Lawton指数来衡量残疾状况，以评估日常生活活动能力（ADL）和工具性日常生活活动能力（IADL）。采用多变量逻辑回归模型探讨残疾与TC水平之间的相关性。中介分析用于探讨TC水平对残疾的直接和间接影响。在调整协变量后，TC每增加1 mmol/L，ADL重度残疾和ADL中度及重度残疾的调整比值比（OR）分别为0.789（95%CI：0.650 - 0.959）和0.822（95%CI：0.699 - 0.966）。随着TC的增加，不同类型残疾的患病率呈显著下降趋势。这种相关性在海南女性百岁老人中更为明显。在女性人群的中介效应分析中，BMI显著介导了TC水平对不同类型残疾的影响。BMI和收缩压（SBP）作为链式中介，多重链式介导了TC水平对IADL的影响。低TC水平可能与女性百岁老人较高的残疾发生率相关，这种相关性可能由BMI和血压介导。
