연령에 따른 저밀도지단백-콜레스테롤과 죽상경화성 심혈관계질환의 연관성 연구

Abstract

Background: It remains undetermined if the relationship between LDL cholesterol (LDL-C) and atherosclerotic cardiovascular disease (ASCVD) changes with age. Thus, this study aimed to investigate whether the association of LDL-C and ASCVD may be affected by the subject’s age.

Methods: Data from the Korean National Health Insurance Service-National Health Screening Cohort were analyzed. Individuals previously diagnosed with cardiovascular disease (CVD) or taking lipid-lowering drugs were excluded. Age-specific association between LDL-C and ASCVD was calculated using adjusted Cox proportional hazards models.

Results: During a median follow-up of 6.44 years, ASCVD developed in 8,996 (3.2%) among 285,119 Korean adults. All age groups showed positive associations between LDL-C and ASCVD risk with a statistical significance from LDL-C of ≥ 160 mg/dL. The risk of ASCVD did not significantly differ between the age groups (P for interaction = 0.62). With a reference to the ASCVD risk in the group of LDL-C 70-99 mg/dL, the ASCVD risk in the group of highest LDL-C (≥190 mg/dL) was similar between the subjects of age <50 and those of age 70 years (adjusted hazard ratio [aHR], 1.90 [95% confidence interval (CI), 1.52-2.38] vs. 1.86 [95% CI, 1.30-2.68]). Consistently, the subgroup analysis in subjects with type 2 diabetes exhibited no difference in the association of LDL-C and ASCVD between different age groups (P for interaction = 0.31).

Conclusions: A nationwide population-based cohort study of individuals who had no prior CVD history and were not on lipid-lowering drugs, demonstrated that elderly Korean subjects (>70 years of age) still presented increased ASCVD risk if they had higher LDL-C at baseline. Thus, the association of LDL-C and ASCVD in elderly Korean population did not significantly differ from that in the younger groups. These findings support the importance of managing LDL-C for the purpose of primary prevention of ASCVD in the elderly population.