Cholesterol paradox in the community-living old adults:is higher better?
Sheng-Shu WANG1
Shan-Shan YANG2
Chun-Jiang PAN3
Jian-Hua WANG1
Hao-Wei LI1
Shi-Min CHEN1
Jun-Kai HAO4
Xue-Hang LI1
Rong-Rong LI1
Bo-Yan LI1
Jun-Han YANG1
Yue-Ting SHI1
Huai-Hao LI1
Ying-Hui BAO1
Wen-Chang WANG1
Sheng-Yan DU1
Yao HE5
Chun-Lin LI6
Miao LIU7
1.Institute of Geriatrics,Beijing Key Laboratory of Aging and Geriatrics,National Clinical Research Center for Geriatri-cs Diseases,the Second Medical Center,Chinese PLA General Hospital,Beijing,China2.Department of Disease Prevent-ion and Control,the First Medical Center,Chinese PLA General Hospital,Beijing,China3.Department of Disease Con-trol and Prevention,Chinese PLA Strategic Support Force Characteristic Medical Center,Beijing,China4.Department of Health Service,the Second Medical Center,Chinese PLA General Hospital,Beijing,China5.Institute of Geriatrics,Beijing Key Laboratory of Aging and Geriatrics,National Clinical Research Center for Geriatri-cs Diseases,the Second Medical Center,Chinese PLA General Hospital,Beijing,China;Department of Epidem-iology,State Key Laboratory of Kidney Diseases,Chinese PLA General Hospital,Beijing,China6.Institute of Endocri-nology,the Second Medical Center,Chinese PLA General Hospital,Beijing,China7.Department of anti-NBC Medic-ine,Chinese PLA Medical School,Chinese PLA General Hospital,Beijing,China
摘要：OBJECTIVE To evaluate the associations of lipid indicators and mortality in Beijing Elderly Comprehensive Health Cohort Study.
METHODS A prospective cohort was conducted based on Beijing Elderly Comprehensive Health Cohort Study with 4499 com-munity older adults.After the baseline survey,the last follow-up was March 31,2021 with an average 8.13 years of follow-up.Cox proportional hazard model was used to estimate the hazard ratios(HR)with 95%CI for cardiovascular disease(CVD)death and all-cause death in associations with baseline lipid indicators.
RESULTS A total of 4499 participants were recruited,and the mean levels of uric acid,body mass index,systolic blood pres-sure,diastolic blood pressure,fasting plasma glucose,total cholesterol(TC),triglyceride,and low-density lipoprotein cholesterol(LDL-C)showed an upward trend with the increasing remnant cholesterol(RC)quarters(Ptrend<0.05),while the downward tr-end was found in high-density lipoprotein cholesterol(HDL-C).During the total 36,596 person-years follow-up,the CVD mortal-ity and all-cause mortality during an average 8.13 years of follow-up was 3.87%(95%CI:3.30%-4.43%)and 14.83%(95%CI:13.79%-15.86%)with 174 CVD death participants and 667 all-cause death participants.After adjusting for confounders,the higher level of TC(HR = 0.854,95%CI:0.730-0.997),LDL-C(HR = 0.817,95%CI:0.680-0.982)and HDL-C(HR = 0.443,95%CI:0.271-0.724)were associated with lower risk of CVD death,and the higher level of HDL-C(HR = 0.637,95%CI:0.501-0.810)were associated with lower risk of all-cause death.The higher level of RC(HR = 1.276,95%CI:1.010-1.613)increase the risk of CVD death.Com-pared with the normal lipid group,TC≥6.20 mmol/L group and LDL-C≥4.10 mmol/L group were no longer associated with lower risk of CVD death,while RC≥0.80 mmol/L group was still associated with higher risk of CVD death.In normal lipid gr-oup,the higher levels of TC,LDL-C and HDL-C were related with lower CVD death.
CONCLUSIONS In community older adults,higher levels of TC and HDL-C were associated with lower CVD mortality in normal lipid reference range.Higher RC was associated with higher CVD mortality,which may be a better lipid indicator for es-timating the CVD death risk in older adults.
机标关键词：communityparadoxlivinghigheradultsbettercholesterol
论文发表日期：2023-12-28
在线出版日期：2025-08-15（本平台首次上网日期，不代表文献的发表时间）
页数：8( 837-844 )