Unit of Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Nobelsväg 13, 17177, Stockholm, Sweden.
Upper Gastrointestinal Surgery, Department of Molecular Medicine and Surgery, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden.
Sci Rep. 2021 Dec 24;11(1):24440. doi: 10.1038/s41598-021-03959-5.
Midlife lipid levels are important predictors of cardiovascular diseases, yet their association with mortality in older adults is less clear. We aimed to (1) identify lipid profiles based on cholesterol, triglycerides, and apolipoproteins using cluster analysis, and (2) investigate how lipid profiles and lipid levels at different ages are associated with later-life all-cause and cardiovascular mortality. We used data from 98,270 individuals in the Swedish AMORIS cohort who had blood measurements between 1985-1996 and were followed until 2012. Over the follow-up (mean 18.0 years), 30,730 (31.3%) individuals died. Three lipid profiles were identified. Compared with reference profile, a high lipid profile (low ApoA-I and high total cholesterol (TC), triglycerides, ApoB, and ApoB/ApoA-I ratio) at ages 39-59 or 60-79 was associated with higher all-cause mortality. A high lipid profile at ≥ 80 years, however, did not confer higher mortality. For the specific markers, high TC (≥ 7.25 mmol/L) was associated with higher all-cause mortality in ages 39-59 but lower mortality in ages 60-79 and ≥ 80. Low ApoA-I (< 1.28 g/L) and high ApoB/ApoA-I ratio (≥ 1.18), on the other hand, were associated with higher cardiovascular mortality regardless of age at lipid measurement, highlighting their potential relevance for survival in both young and older individuals.
中年人血脂水平是心血管疾病的重要预测指标，但它们与老年人死亡率的关系尚不清楚。我们的目的是：（1）通过聚类分析，根据胆固醇、甘油三酯和载脂蛋白确定血脂谱；（2）研究不同年龄的血脂谱和血脂水平与晚年全因和心血管死亡率的关系。我们使用了瑞典 AMORIS 队列中 98270 名个体的数据，这些个体在 1985-1996 年之间进行了血液测量，并随访至 2012 年。在随访期间（平均 18.0 年），有 30730 名（31.3%）个体死亡。确定了三种血脂谱。与参考谱相比，39-59 岁或 60-79 岁时的高脂质谱（低 ApoA-I 和高总胆固醇（TC）、甘油三酯、ApoB 和 ApoB/ApoA-I 比值）与全因死亡率升高相关。然而，≥80 岁时的高脂质谱并没有导致更高的死亡率。对于特定的标志物，TC（≥7.25mmol/L）在 39-59 岁时与全因死亡率升高相关，但在 60-79 岁和≥80 岁时与死亡率降低相关。另一方面，低 ApoA-I（<1.28g/L）和高 ApoB/ApoA-I 比值（≥1.18）与无论血脂测量年龄如何，都与更高的心血管死亡率相关，这突显了它们在年轻和老年个体生存中的潜在相关性。
