Inverse association of serum cholesterol with plasma insulin in the elderly. Cross-sectional and prospective analyses.
Cross-sectional studies have suggested that high plasma insulin is associated with relatively low levels of low density lipoprotein (LDL)-cholesterol. The present study was aimed at re-testing this association in a 70-year-old age cohort (N = 1023), and testing whether it could be caused by excessive mortality of hyperinsulinemic subjects with high LDL-cholesterol. A reverse U-shaped association between LDL-cholesterol and fasting plasma insulin was confirmed. LDL-cholesterol, HDL-cholesterol and total cholesterol were lowest in the highest insulin quarter. These associations remained after adjustment for diabetes, obesity and general health status. The combination of high LDL-cholesterol (> 4.25 mmol/L, 75th percentile) and high insulin (> 10 IU/L, 50th percentile) was not associated with excess 5-year mortality in this age cohort. Nor was it associated with excess mortality in four other elderly age cohorts (N = 1188), in which similar associations of cholesterol and insulin have been demonstrated. Thus, the inverse association of LDL-cholesterol with fasting insulin in the elderly is not caused by selective over mortality.
Lindberg
O
O
Department of Medicine, University of Helsinki, Turku.
Tilvis
R S
RS
Strandberg
T E
TE
Lehtonen
A
A
Ehnholm
C
C
Tuomilehto
J
J
D000368:Aged; D000369:Aged, 80 and over; D000375:Aging / Q000097:blood*; D002318:Cardiovascular Diseases / Q000097:blood / Q000453:epidemiology / Q000401:mortality; D002784:Cholesterol / Q000097:blood*; D008076:Cholesterol, HDL / Q000097:blood; D008078:Cholesterol, LDL / Q000097:blood; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D005260:Female; D005387:Finland / Q000453:epidemiology; D006801:Humans; D007328:Insulin / Q000097:blood*; D008297:Male; D011446:Prospective Studies; D012307:Risk Factors
D008076:Cholesterol, HDL; D008078:Cholesterol, LDL; D007328:Insulin; D002784:Cholesterol