title: Low-density lipoprotein cholesterol was inversely associated with 3-year all-cause mortality among Chinese oldest old: data from the Chinese Longitudinal Healthy Longevity Survey.
abstract: OBJECTIVE
  Low-density lipoprotein cholesterol (LDL-C) is a risk factor for survival in middle-aged individuals, but conflicting evidence exists on the relationship between LDL-C and all-cause mortality among the elderly. The goal of this study was to assess the relationship between LDL-C and all-cause mortality among Chinese oldest old (aged 80 and older) in a prospective cohort study.
  
  
  METHODS
  LDL-C concentration was measured at baseline and all-cause mortality was calculated over a 3-year period. Multiple statistical models were used to adjust for demographic and biological covariates.
  
  
  RESULTS
  During three years of follow-up, 447 of 935 participants died, and the overall all-cause mortality was 49.8%. Each 1 mmol/L increase of LDL-C concentration corresponded to a 19% decrease in 3-year all-cause mortality (hazard ratio [HR] 0.81, 95% confidence interval [CI] 0.71-0.92). The crude HR for abnormally higher LDL-C concentration (≥3.37 mmol/L) was 0.65 (0.41-1.03); and the adjusted HR was statistically significant around 0.60 (0.37-0.95) when adjusted for different sets of confounding factors. Results of sensitivity analysis also showed a significant association between higher LDL-C and lower mortality risk.
  
  
  CONCLUSIONS
  Among the Chinese oldest old, higher LDL-C level was associated with lower risk of all-cause mortality. Our findings suggested the necessity of re-evaluating the optimal level of LDL-C among the oldest old.
authors.affiliation: Division of Non-Communicable Disease Control and Community Health, Chinese Center for Disease Control and Prevention, Beijing, China.
authors.forename: Yue-Bin
authors.initials: YB
authors.lastname: Lv
authors.affiliation: Division of Non-Communicable Disease Control and Community Health, Chinese Center for Disease Control and Prevention, Beijing, China.
authors.forename: Zhao-Xue
authors.initials: ZX
authors.lastname: Yin
authors.affiliation: Health Services and Systems Research, Duke-NUS Graduate Medical School Singapore, Singapore.
authors.forename: Choy-Lye
authors.initials: CL
authors.lastname: Chei
authors.affiliation: Vanderbilt Institute for Global Health, Division of Epidemiology, Department of Medicine, Vanderbilt University, Nashville, TN, USA.
authors.forename: Han-Zhu
authors.initials: HZ
authors.lastname: Qian
authors.affiliation: Duke Molecular Physiology Institute, Department of Medicine, Duke University School of Medicine, Durham, NC, USA.
authors.forename: Virginia Byers
authors.initials: VB
authors.lastname: Kraus
authors.affiliation: Division of Non-Communicable Disease Control and Community Health, Chinese Center for Disease Control and Prevention, Beijing, China.
authors.forename: Juan
authors.initials: J
authors.lastname: Zhang
authors.affiliation: Department of Sociology and Anthropology, Department of Human Development and Family Studies, University of Rhode Island, Kingston, RI, USA.
authors.forename: Melanie Sereny
authors.initials: MS
authors.lastname: Brasher
authors.affiliation: Division of Non-Communicable Disease Control and Community Health, Chinese Center for Disease Control and Prevention, Beijing, China. Electronic address: shixm@chinacdc.cn.
authors.forename: Xiao-Ming
authors.initials: XM
authors.lastname: Shi
authors.affiliation: Health Services and Systems Research, Duke-NUS Graduate Medical School Singapore, Singapore; Center for Clinical Health Policy Research and Department of Medicine, Duke University School of Medicine, Durham, NC, USA. Electronic address: david.matchar@duke-nus.edu.sg.
authors.forename: David Bruce
authors.initials: DB
authors.lastname: Matchar
authors.affiliation: Center for the Study of Aging and Human Development and the Geriatric Division of School of Medicine, Duke University, Durham, NC, USA; Center for Study of Healthy Aging and Development Studies, Peking University, Beijing, China. Electronic address: zengyi68@gmail.com.
authors.forename: Yi
authors.initials: Y
authors.lastname: Zeng
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000097:blood*; D002681:China; D008078:Cholesterol, LDL / Q000097:blood*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008136:Longevity; D008137:Longitudinal Studies; D008297:Male; D009026:Mortality; D011446:Prospective Studies; D012307:Risk Factors; D012680:Sensitivity and Specificity; D016896:Treatment Outcome
chemical_list: D015415:Biomarkers; D008078:Cholesterol, LDL
keywords: China; Epidemiology; LDL-C; Mortality; Oldest old