Yoo Byunghun, Jung Sun Ho, Bae Soo Han, Kim Young Sam, Lee Chanho
Department of Biomedical Sciences, Yonsei University College of Medicine, Seoul, South Korea.
Yonsei University College of Medicine, Seoul, South Korea.
Lung. 2025 Mar 27;203(1):54. doi: 10.1007/s00408-025-00809-3.
Cholesterol regulation is essential to maintain pulmonary homeostasis. Studies suggest that increased high-density lipoprotein cholesterol (HDL-C) levels correlate with better lung function. However, the longitudinal association of HDL-C with lung function remains unknown. We aimed to analyze the long-term correlation of HDL-C with lung function decline in a population-based cohort study.
We included 7,652 participants from a prospective community-based cohort study in South Korea. Participants were categorized into five trajectory groups based on repeated HDL-C measurements. Generalized linear mixed models with random intercepts and slopes were used to examine the longitudinal relationship between HDL-C levels and lung function decline within these groups.
In the five HDL-C trajectory group analyses, the very low HDL-C trajectory group (Group 1) showed faster declines in forced vital capacity (FVC) (-3.1 mL/year) and forced expiratory volume in one second (FEV) (-3.1 mL/year) than the middle HDL-C group (Group 3, the reference group) did. The low HDL-C trajectory group (Group 2) also exhibited faster FVC (-1.5 mL/year) and FEV (-1.7 mL/year) declines than the middle HDL-C group; however, the estimated difference was smaller than that in Group 1. Faster lung function decline in the low HDL-C trajectory group was consistently observed even when the population was analyzed using three- or four-HDL-C trajectory groups instead of five.
Participants in the low HDL-C trajectory groups experienced a more rapid lung function decline over time than the reference groups, suggesting a negative longitudinal association between HDL-C and lung function decline.
胆固醇调节对于维持肺部稳态至关重要。研究表明，高密度脂蛋白胆固醇（HDL-C）水平升高与更好的肺功能相关。然而，HDL-C与肺功能的纵向关联仍不清楚。我们旨在通过一项基于人群的队列研究分析HDL-C与肺功能下降的长期相关性。
我们纳入了韩国一项基于社区的前瞻性队列研究中的7652名参与者。根据重复的HDL-C测量结果，将参与者分为五个轨迹组。使用具有随机截距和斜率的广义线性混合模型来检验这些组内HDL-C水平与肺功能下降之间的纵向关系。
在五个HDL-C轨迹组分析中，极低HDL-C轨迹组（第1组）的用力肺活量（FVC）（-3.1 mL/年）和一秒用力呼气量（FEV）（-3.1 mL/年）下降速度比中等HDL-C组（第3组，参照组）更快。低HDL-C轨迹组（第2组）的FVC（-1.5 mL/年）和FEV（-1.7 mL/年）下降速度也比中等HDL-C组更快；然而，估计差异小于第1组。即使使用三个或四个HDL-C轨迹组而非五个轨迹组对人群进行分析，低HDL-C轨迹组中肺功能下降更快的情况仍持续存在。
低HDL-C轨迹组的参与者随着时间推移肺功能下降比参照组更快，表明HDL-C与肺功能下降之间存在负向纵向关联。
