Optimal serum total cholesterol level for life expectancy and for active-life expectancy in the Japanese elderly

在日本老年人中，研究了血清总胆固醇浓度(TC)与全因死亡率和功能能力下降的关系。在基线年龄在65岁及以上的454名男性和632名女性中，使用比例风险模型计算了6年随访期间TC的死亡风险，并根据地区、年龄、血清白蛋白、稳态血压、体重指数和吸烟进行了调整。在1086名受试者中，23人服用了治疗高脂血症的药物，13人在一年内死亡，这些人被排除在分析之外。在6年的随访中，22.4%的男性和12.1%的沃伦死亡。青壮年(66~74岁)TC与男女死亡率呈U型关系。对于青壮年，低TC(男性最低四分位数，&lt；4.0 mm o l/L(相对危险度RH=3.3)，女性4.7 mm ol/L(RH=2.3))是显著的死亡风险，高TC(男性最高四分位数，&gt；5.4 mm o l/L(RH=3.3))也是男性显著的死亡风险。青壮年相对危险度最低的是TC，女性为4.0~4.7 mm ol/L，女性为4.7~5.3 mm ol/L。而对于老年人(75岁及以上)，TC与男性的死亡率无关，此外，在女性中，TC与死亡率呈显著负相关。老年妇女的相对危险度最低的是TC6.0 mmol/L及以上(最高四分位数)。老年组和青壮年组的最佳TC似乎不同。TC与功能能力下降无关。

The association of serum total cholesterol concentration (TC) with all-cause mortality and with decline in functional capacity was investigated in the Japanese elderly. In 454 men and 632 women aged 65 years and over at baseline who were ambulatory, TC was measured Mortality risk during 6 years of follow-up was calculated using a proportional hazards model, adjusted for region, age, serum albumin, sistolic blood pressure, body mass index, and smoking. Of 1086 subjects, 23 who took a medicine for hyperlipidemia, and 13 who died within a year were excluded from the analysis. During the 6-year follow-up, 22.4% of men and 12.1% of warren died. TC for the young-old (66-74 years) elderly had a U-shaped relationship with mortality in both sexes. For the young-old, low TC (lowest quartile, <4.0 mmol/L for men (relative hazard (RH)=3.3), <4.7 mmol/L for women (RH=2.3)) was significant mortality risk, and high TC (highest quartile, >5.4 mmol/L for men (RH=3.3)) was also significant mortality risk for men. Lowest relative hazard in the young-old was at TC between 4.0 and 4.7 mmol/L for women, and between 4.7 and 5.3 mmol/L for women. While for the old-old (75 years and over) elderly, TC was not associated with mortality for men, furthermore, among women, a significant inverse association was found. Lowest relative hazard in the old-old women was at TC 6.0 mmol/L and over (highest quartile). The optimal TC for the old-old elderly appears to be different from that for the young-old elderly. TC was not associated with decline in functional capacity.