Zuliani G, Palmieri E, Volpato S, Bader G, Mezzetti A, Costantini F, Sforza G R, Imbastaro T, Romagnoni F, Fellin R
Department of Internal Medicine II, University of Ferrara, Italy.
Aging (Milano). 1997 Oct;9(5):335-41. doi: 10.1007/BF03339612.
Aging is frequently associated with a deterioration in health and functional status, which often induces important modifications in several biological parameters, including plasma lipids; as a consequence, the real "meaning" of lipoprotein parameters in old individuals is complex. A cross sectional study was carried out in order to investigate the lipoprotein profile in very old individuals with or without disability, and evaluate the possible influence of other biological variables on plasma lipids. One hundred selected healthy free-living (FL) and 62 disabled (DIS) subjects aged over 80 were enrolled; 91 healthy adults matched for origin were included as controls. Lipoprotein profile [total cholesterol, triglycerides, high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol, apoprotein A-I and B], anthropometric parameters, and ADL were measured. The FL octo-nonagenarians featured higher HDL-cholesterol levels than adult controls. DIS octo-nonagenarians showed lower total and HDL-C levels than FL. Discriminant analysis indicated that HDL-cholesterol and apoprotein A-I, but not total cholesterol, strongly discriminated between FL and DIS octo-nonagenarians. Multivariate analysis demonstrated that the waist/hip ratio, an index of visceral adiposity, was negatively associated with HDL-C levels in FL, but not in DIS elderly. We conclude that: 1) in very old individuals, the absence or presence of disability is strongly associated with high or low HDL-cholesterol values, respectively; 2) HDL-C and apo A-I are the parameters which better discriminate between FL and DIS octo-nonagenarians; and 3) the differences in HDL-C levels between FL and DIS are not due to modifications in anthropometric parameters. Prospective studies are needed to better understand the relationship between high-density lipoprotein levels, disability and aging.
衰老常常伴随着健康和功能状态的恶化，这通常会引起包括血脂在内的多个生物学参数的重要改变；因此，脂蛋白参数在老年人中的真正“意义”很复杂。开展了一项横断面研究，以调查有无残疾的高龄个体的脂蛋白谱，并评估其他生物学变量对血脂的可能影响。纳入了100名选定的健康自由生活（FL）且年龄超过80岁的个体以及62名残疾（DIS）个体；另外纳入91名年龄匹配的健康成年人作为对照。测量了脂蛋白谱[总胆固醇、甘油三酯、高密度脂蛋白胆固醇（HDL-C）、低密度脂蛋白胆固醇、载脂蛋白A-I和B]、人体测量参数和日常生活活动能力。FL组的八九十岁老人的HDL胆固醇水平高于成年对照组。DIS组的八九十岁老人的总胆固醇和HDL-C水平低于FL组。判别分析表明，HDL胆固醇和载脂蛋白A-I，而非总胆固醇，能很好地区分FL组和DIS组的八九十岁老人。多变量分析表明，内脏脂肪指数腰臀比与FL组老年人的HDL-C水平呈负相关，但与DIS组老年人无关。我们得出以下结论：1）在高龄个体中，有无残疾分别与HDL胆固醇值的高低密切相关；2）HDL-C和载脂蛋白A-I是能更好地区分FL组和DIS组八九十岁老人的参数；3）FL组和DIS组之间HDL-C水平的差异并非由于人体测量参数的改变。需要开展前瞻性研究以更好地理解高密度脂蛋白水平、残疾和衰老之间的关系。
