Health: Elevated HDL levels may predict reduced lung function
YOUR DOSE OF MEDICINE By Charles C. Chante, MD
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Having an elevated level of high-density lipoprotein cholesterol is associated with an increased rate of lung function decline over time, according to results from a cohort analysis of more than 30,000 adults presented at the annual congress of the European Respiratory Society.
For forced expiratory volume in 1 second (FEV1), “there was a high statiscally significant inverse association for HDL-C for both cross-sectional and longitudinal measures of lung function,” reported by Columbia University Medical Center, New York. Those in the top quartile for HDL-C, on average, had a 9-mL greater decline in FEV1, compared with patients in lowest quartile. To put this in the lowest quartile said this decline is comparable “to a 10-year increment in pack-years of smoking.”
The study, which pooled size population-based cohorts in the United States, included 31,843 adults for whom there were baselines HDL-C levels and at least two longitudinally collected spirometry readings. According to quality control criteria were rigorously applied. For example, spirometry measures were obtained according to contemporary standards issued by the American Thoracic Society.
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The average age of the study patients was 57 years, and 45 percent were classified as never smokers. The mean FEV1 decline over a median follow-up of 5 years was 37 mL per year. Approximately 15 percent of individuals had airflow limitation at baseline. There were more than 300,000 total person -years of observation in the pooled data.
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In a fully adjusted cross-sectional analysis, each 1-mmol/L increase in HDL-C was associated with a 9-mL lower FEV1. The list of adjusted variable included age, gender, pack-years of smoking, weight and height.
Results were consistent across age groups, presence or absence of smoking history, body mass index, and the presence or absence of airflow limitations at baseline.
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HDL-C’s inverse correlation with the lung function has been shown in other studies, such as the MESA Lung Study, another population-based analysis. In that study there was a 0.4 percent increase in HDL -C.
In this study, being in the highest quartile for HDL at baseline was associated with an odd ratio of 1.2 for incident airflow limitation relative to being in the lowest quartile.
The risk of a decline in airway function from an elevated HDL-C, if confirmed, should be considered in the context of the well-known protective effect exerted by HDL against cardiovascular events. However, these data suggest that “having an excessively low HDL may incur risk. There may be a limitation to the good of the good cholesterol.
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Courtesy: The Philippine Star) | Updated November 19, 2017 – 12:00am
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