What is the clinical evidence from this study?

Study design: Cohort. Population: Community-dwelling older adults (n=3239). Intervention: Lowest quintile of LDL-C (<2.61 mmol/L) vs. Highest quintile of LDL-C (≥4.10 mmol/L). Primary outcome: All-cause mortality (HR 1.67, 95% CI 1.26-2.21, p=<0.001).

March 8, 2022Frontiers in MedicineOpen Access

Low and High-Density Lipoprotein Cholesterol and 10-Year Mortality in Community-Dwelling Older Adults: The Shanghai Aging Study

Q: What are the key findings of this study?

The lowest quintile of LDL-C (<2.61 mmol/L) was associated with a significantly higher risk of all-cause mortality (HR 1.67) compared to the highest quintile (≥4.10 mmol/L) in older adults.

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Key result

Lowest LDL-C quintile linked to ~67% higher all-cause mortality risk versus highest quintile in older adults.

HR 1.67
95% CI 1.26-2.21
P<0.001
n=3,239

Why the study?

The relationship between serum cholesterol and mortality remains disputed.

Does the level of LDL-C and HDL-C affect all-cause mortality in community-dwelling older adults?

Population

3,239 community-dwelling older adults free of lipid-lowering agents in the Shanghai Aging Study

Comparison

Different levels (quintiles) of LDL-C and HDL-C

Design

Cohort study

Follow-up

Median of 10 years

Authors

WWWanqing WuEast China University of Science and Technology ZXZhenxu XiaoFudan University XLXiaoniu LiangHuashan Hospital

Discussion

Member takes

Implication

Low LDL-C should not yet change lipid management in older adults; leaves open reverse causation versus true risk.

Study Design

Type

Cohort (n=3,239)

Multicenter

Structured PICO

Does the level of LDL-C and HDL-C affect all-cause mortality in community-dwelling older adults?

Population

3,239 community-dwelling older Chinese adults free of lipid-lowering agents from the Shanghai Aging Study

Intervention

Low and high-density lipoprotein cholesterol (LDL-C and HDL-C) levels

Comparator

Highest quintile of LDL-C (≥4.10 mmol/L) and third quintile of HDL-C (1.21-1.39 mmol/L)

Outcome

All-cause mortality at median 10 years follow-uphard clinical

Main Result

Effect estimate: HR 1.67 (95% CI 1.26-2.21)

Absolute Event Rate: 26.36% vs 11.71%

p-value: p=<0.001

In older Chinese adults not on lipid-lowering therapy, low LDL-C and both low and high HDL-C levels were associated with increased long-term all-cause mortality.

Limitations

Relied on a single measurement of LDL-C and HDL-C at baseline
Potential reverse causality due to underlying chronic diseases
Possibility of residual confounding from unmeasured variables such as diets, occupation history, and air pollution
Focused only on all-cause mortality due to relatively small number of events limiting cause-specific mortality analysis
Post-hoc analysis where sample size was not calculated according to mortality rate
Findings may not be generalized to other populations in China with different demographic characteristics

Cite This Study

Wu et al. (2022) conducted a cohort in Community-dwelling older adults (n=3,239). Lowest quintile of LDL-C (<2.61 mmol/L) vs. Highest quintile of LDL-C (≥4.10 mmol/L) was evaluated on All-cause mortality (HR 1.67, 95% CI 1.26-2.21, p=<0.001). The lowest quintile of LDL-C (<2.61 mmol/L) was associated with a significantly higher risk of all-cause mortality (HR 1.67) compared to the highest quintile (≥4.10 mmol/L) in older adults.

synapsesocial.com/papers/6a100c8296ccf432805fe965 https://doi.org/10.3389/fmed.2022.783618

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March 8, 2022Frontiers in MedicineOpen Access

Low and High-Density Lipoprotein Cholesterol and 10-Year Mortality in Community-Dwelling Older Adults: The Shanghai Aging Study

View Full Paper

Ask AI

Bookmark

Key result

Lowest LDL-C quintile linked to ~67% higher all-cause mortality risk versus highest quintile in older adults.

HR 1.67
95% CI 1.26-2.21
P<0.001
n=3,239

Why the study?

The relationship between serum cholesterol and mortality remains disputed.

Does the level of LDL-C and HDL-C affect all-cause mortality in community-dwelling older adults?

Population

3,239 community-dwelling older adults free of lipid-lowering agents in the Shanghai Aging Study

Comparison

Different levels (quintiles) of LDL-C and HDL-C

Design

Cohort study

Follow-up

Median of 10 years

Authors

WWWanqing WuEast China University of Science and Technology ZXZhenxu XiaoFudan University XLXiaoniu LiangHuashan Hospital

Discussion

Member takes

Implication

Low LDL-C should not yet change lipid management in older adults; leaves open reverse causation versus true risk.

Study Design

Type

Cohort (n=3,239)

Multicenter

Structured PICO

Does the level of LDL-C and HDL-C affect all-cause mortality in community-dwelling older adults?

Population

3,239 community-dwelling older Chinese adults free of lipid-lowering agents from the Shanghai Aging Study

Intervention

Low and high-density lipoprotein cholesterol (LDL-C and HDL-C) levels

Comparator

Highest quintile of LDL-C (≥4.10 mmol/L) and third quintile of HDL-C (1.21-1.39 mmol/L)

Outcome

All-cause mortality at median 10 years follow-uphard clinical

Main Result

Effect estimate: HR 1.67 (95% CI 1.26-2.21)

Absolute Event Rate: 26.36% vs 11.71%

p-value: p=<0.001

In older Chinese adults not on lipid-lowering therapy, low LDL-C and both low and high HDL-C levels were associated with increased long-term all-cause mortality.

Limitations

Relied on a single measurement of LDL-C and HDL-C at baseline
Potential reverse causality due to underlying chronic diseases
Possibility of residual confounding from unmeasured variables such as diets, occupation history, and air pollution
Focused only on all-cause mortality due to relatively small number of events limiting cause-specific mortality analysis
Post-hoc analysis where sample size was not calculated according to mortality rate
Findings may not be generalized to other populations in China with different demographic characteristics

Cite This Study

synapsesocial.com/papers/6a100c8296ccf432805fe965 https://doi.org/10.3389/fmed.2022.783618

Also Consider

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