Epidemiology and Health

Original Articles

Blood lipid levels and all-cause mortality in older adults: the Chinese Longitudinal Healthy Longevity Survey 2008-2018: Rongxi Wang, Xiaoyue Yu, Zhiqiang Wang, Yujie Liu, Hui Chen, Shangbin Liu, Chen Xu, Yingjie Chen, Xin Ge, Danni Xia, Ruijie Chang, Gang Xu, Mi Xiang, Ying Wang, Tian Shen, Fan Hu, Yong Cai; Epidemiol Health. 2022;44:e2022054. Published online July 5, 2022; DOI: https://doi.org/10.4178/epih.e2022054

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Abstract Summary PDF Supplementary Material: Abstract
OBJECTIVES
Proper blood lipid levels are essential for survival in older adults, but inconsistent relationships have been reported between blood lipids and all-cause mortality in the elderly.
METHODS
This retrospective longitudinal study analyzed data from 1,067 Chinese older adults enrolled in the Chinese Longitudinal Healthy Longevity Survey collected in 2008 and followed up until death or December 31, 2018. The outcome was all-cause mortality. Multivariate Cox regression analyses were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) with stratification by age (60-80, 80-100, or ≥100 years) for further analysis. The survival probability according to lipid profile quartiles was calculated using Kaplan-Meier curves and the log-rank test.
RESULTS
The participants’ mean age was 84.84 years, and 57.0% were female. In total, 578 individuals died, and 277 were lost to follow-up. The mean total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), and low-density lipoprotein cholesterol (LDL-C) levels were higher among those who died than among those who survived. Participants in the second HDL-C quartile and the highest LDL-C and triglyceride (TG) quartiles had 28% higher, 23% lower, and 49% lower risks of all-cause mortality, respectively. After further adjustment, the associations remained except for HDL-C, and additional associations were observed between all-cause mortality and the third TC and LDL-C quartiles and the second TG quartile (HR, 1.44; 95% CI, 1.01 to 2.06; HR, 0.68; 95% CI, 0.49 to 0.94; HR, 0.79; 95% CI, 0.62 to 0.99, respectively).
CONCLUSIONS
Older adults should maintain an LDL-C level of 1.91-2.47 mmol/L and a TG level of no less than 1.66 mmol/L.; Summary

Key Message
The retrospective longitudinal study analyzed data from 1067 Chinese older adults enrolled in the Chinese Longitudinal Healthy Longevity Survey. 578 individuals died and 277 were lost to follow-up. Participants in the second HDL-C quartile and the highest LDL-C and TG quartiles had 28% higher, 23% lower, and 49% lower risks of all-cause mortality. After further adjustment, the associations remained except for HDL-C, and additional associations were observed between all-cause mortality and the third TC and LDL-C quartiles and the second TG quartile (HR, 1.44; 95% CI, 1.01 to 2.06; HR, 0.68; 95% CI, 0.49 to 0.94; HR, 0.79; 95% CI, 0.62 to 0.99).

Stressful life events and serum triglyceride levels: the Cardiovascular and Metabolic Diseases Etiology Research Center cohort in Korea: Naharin Sultana Anni, Sun Jae Jung, Jee-Seon Shim, Yong Woo Jeon, Ga Bin Lee, Hyeon Chang Kim; Epidemiol Health. 2021;43:e2021042. Published online June 9, 2021; DOI: https://doi.org/10.4178/epih.e2021042

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Abstract Summary PDF Supplementary Material

Abstract

OBJECTIVES
Elevated serum triglyceride levels are a risk factor for developing cardiovascular disease. A number of studies have demonstrated a positive association between psychological stress and serum triglyceride levels. However, there is limited evidence regarding the impact of stressful life events (SLEs) on serum triglyceride levels in the healthy population. Therefore, we evaluated the independent association between SLEs and serum triglyceride levels in a middle-aged Korean population.

METHODS

We analyzed a sample of 2,963 people (aged 30-64 years; 36% men) using baseline data from the Cardiovascular and Metabolic Diseases Etiology Research Center (CMERC) cohort study. The Korean version of the Life Experience Survey questionnaire was used to measure the presence and positive/negative impact of SLEs. Hypertriglyceridemia was defined as a fasting serum triglyceride level of ≥ 150 mg/dL.

RESULTS

Of the 2,963 participants, 33.1% reported at least 1 SLE over the past 6 months and 24.8% had hypertriglyceridemia. Even after adjusting for potential confounders, the serum triglyceride level was significantly associated with the total number of SLEs in men (3.333 mg/dL per event; p= 0.001), but not in women (0.451 mg/dL per event, p= 0.338). Hypertriglyceridemia was also associated with having 4 or more SLEs with positive effects (odds ratio [OR], 2.57; 95% CI, 1.02 to 6.46) and 4 or more SLEs with negative effects (OR, 1.99; 95% CI, 1.16 to 3.41) in men.

CONCLUSIONS

Our findings suggest that SLEs may increase the risk of hypertriglyceridemia in middle-aged men.

Summary

Korean summary
30-64세 중년 남성에서 스트레스성 생활 사건(stressful life events)를 많이 경험한 경우 혈청 중성지방 농도가 높은 경향이 관찰되었다. 스트레스성 질환의 적절한 관리가 이상지질혈증같은 만성대사질환 예방에 도움이 될 수 있음을 시사하는 결과이다.

Key Message
Stressful life events can be linked to hypertriglyceridemia among middle-aged men. This suggests that proper management of stressful events can help prevention of metabolic disorders such as abnormal blood lipids.

Citations

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The Effect of Anthropometric Change on Blood Lipids in Adolescents in Rural Area of Korea.: Kyeong Soo Cheon, Myoung Hee Kim, Kirang Kim, Mi Kyung Kim, Young Jeon Shin, Bo Youl Choi; Korean J Epidemiol. 2002;24(1):17-28.

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Abstract PDF: Abstract
Primary prevention of atherosclerosis is important for reducing morbidity and mortality from cardiovascular disease. As modifiable risk factors for atherosclerosis which appears and progresses in early life, obesity and hyperlipidemia are related with each other. Especially hyperlipidemia during adolescent period is closely related to cardiovascular morbidity and mortality in later life, but the association between anthropometric changes in growth period and lipids level in adolescence is not known yet. Therefore we investigated the effect of anthropometric changes in growth period on adolescent lipids level among 615 high school students in rural area of Korea. The study results were as the followings; In childhood, the weight and the height of boys didn't differ from those of girls, however, began to exceed them at 14 and 15 years old respectively. The body mass index(BMI) of both genders was appeared to increase with age. The BMI increase of girls was greater than that of boys from twelve years of age. The BMI slope (annual average increment of BMI; coefficient of regression line) of girls was greater than that of boys(t-test, p<0.01). The proportion of high obesity tracking group was 13.1%(82 persons). In multivariate analysis, total cholesterol and LDL-cholesterol were positively correlated with obesity tracking in boys; BMI slope and BMI at 7 years old in girls. The HDL-cholesterol didn't show any significant association with those factors. The triglyceride was related to BMI slope and obesity tracking in boy, but nothing in girls. In this study, the obesity at 7 years old, the BMI slope, and the obesity tracking are associated with adolescent serum lipid level. For primary prevention of cardiovascular disease, it is needed to develop more active prevention or health promotion program for children and adolesecents in Korea.; Summary

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