Dyslipidemia is considered an independent health risk factor of cardiovascular disease (CVD), a leading cause of mortality in older adults. Despite its importance, there have been few reports on the association between lipoprotein cholesterol and future CVD and cardiovascular (CV) mortality among elderly Asians aged ≥ 65 years. This study investigated the association between lipoprotein cholesterol and future CVD and CV mortality in an elderly Korean population using a large nationwide sample. From the cohort database of the Korean National Health Insurance Service, 62,604 adults aged ≥ 65 years (32,584 men and 30,020 women) were included. High-density lipoprotein cholesterol (HDL-C) and low-density lipoprotein cholesterol (LDL-C) levels were categorized by quartiles. Cox proportional hazard models and linear regression analyses were used to assess the association between the quartiles of lipoprotein cholesterol and future CV events or mortality. The mean follow-up period was 3.3 years. The incidence rates of ischemic heart disease and ischemic brain disease were 0.97 and 0.61 per 1,000 person-years, respectively, and the mortality rates from these diseases were 0.22 and 0.34 per 1,000 person-years, respectively. In a completely adjusted model, high HDL-C and LDL-C levels were not associated with total CV events and CVD mortality. However, high LDL-C levels were significantly associated with a lower incidence of ischemic brain disease. Furthermore, diabetic patients with high LDL-C levels were more likely to have higher CV mortality, whereas non-smokers with high LDL-C levels were less likely to be at risk of CV events. Neither high LDL-C nor HDL-C levels were significantly associated with future CV mortality in older adults aged ≥ 65 years. High LDL-C levels do not seem to be a risk factor for CVD in elderly individuals, and further studies are required.

中文翻译：

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脂蛋白胆固醇与老年人未来心血管疾病和死亡率的关系：韩国全国纵向研究

血脂异常被认为是心血管疾病 (CVD) 的独立健康危险因素，心血管疾病是老年人死亡的主要原因。尽管它很重要，但很少有关于脂蛋白胆固醇与 65 岁以上亚洲老年人未来 CVD 和心血管 (CV) 死亡率之间关联的报告。本研究使用大型全国样本调查了韩国老年人群中脂蛋白胆固醇与未来 CVD 和 CV 死亡率之间的关联。从韩国国民健康保险服务的队列数据库中，包括 62,604 名≥ 65 岁的成年人（32,584 名男性和 30,020 名女性）。高密度脂蛋白胆固醇 (HDL-C) 和低密度脂蛋白胆固醇 (LDL-C) 水平按四分位数进行分类。Cox 比例风险模型和线性回归分析用于评估脂蛋白胆固醇四分位数与未来心血管事件或死亡率之间的关联。平均随访时间为 3.3 年。缺血性心脏病和缺血性脑病的发病率分别为0.97和0.61/1000人年，死亡率分别为0.22和0.34/1000人年。在完全调整的模型中，高 HDL-C 和 LDL-C 水平与总 CV 事件和 CVD 死亡率无关。然而，高 LDL-C 水平与较低的缺血性脑病发病率显着相关。此外，具有高 LDL-C 水平的糖尿病患者更有可能具有更高的心血管死亡率，而具有高 LDL-C 水平的非吸烟者发生心血管事件的风险较小。在≥ 65 岁的老年人中，高 LDL-C 和 HDL-C 水平与未来的心血管死亡率均无显着相关性。高 LDL-C 水平似乎不是老年人 CVD 的危险因素，需要进一步研究。