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Aging and disease
Orginal Article |
Trends in LDL-C and Non-HDL-C Levels with Age
Peng Zhang1, Qian Su1, Xiaomiao Ye1, Ping Guan1, Chengjun Chen1, Yanwen Hang1, Jian Dong1, Zhongjie Xu2,*, Wei Hu1,*
1Department of Cardiology, Minhang Hospital, Fudan University, Shanghai, China
2Shanghai Minhang District Medical Emergency Center, Shanghai, China
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Understanding how blood lipid levels change with age in the general population is a precondition to defining dyslipidemia. To explore age-related trends in LDL-C and non-HDL-C levels in the general population, a large-scale cross-sectional study with 49,201 males and 35,084 females was adopted. Trends of non-HDL-C and LDL-C levels were plotted against each age (18 to 85 years old, one-year increments); the trends, as well as the influence of confounding factors on the trends, were validated and adjusted by linear regression modeling. The trajectory of LDL-C and non-HDL-C levels by age displayed a nonlinear correlation trend. Further multivariate linear regression modeling that incorporated sex-specific age phases showed that age was positively associated with LDL-C and non-HDL-C levels, with coefficients of 0.018 and 0.031, respectively, in females aged ≥18 to ≤56 years and negatively associated with LDL-C and non-HDL-C levels, with coefficients of -0·013 and -0.015, respectively, in females aged ≥57 years. The LDL-C and non-HDL-C levels increased with age in males ≥18 to ≤33 years of age, with coefficients of 0.025 and 0.053, respectively; the lipid levels plateaued at ≥34 to ≤56 years of age and subsequently decreased in those ≥57 years of age, with coefficients of -0.008 and -0.018, respectively. In contrast, pooled analyses without age stratification concealed these details. In conclusion, fluctuating increasing and decreasing lipid levels occurred with phases of aging in both sexes. Well-grounded age stratification is necessary to improve lipid-related pathophysiological studies.

Keywords low-density lipoprotein cholesterol (LDL-C)      non-high-density lipoprotein cholesterol (non-HDL-C)      age     
Corresponding Authors: Zhongjie Xu,Wei Hu   
Just Accepted Date: 19 November 2019  
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Peng Zhang
Qian Su
Xiaomiao Ye
Ping Guan
Chengjun Chen
Yanwen Hang
Jian Dong
Zhongjie Xu
Wei Hu
Cite this article:   
Peng Zhang,Qian Su,Xiaomiao Ye, et al. Trends in LDL-C and Non-HDL-C Levels with Age[J]. Aging and disease, 10.14336/AD.2019.1025
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Figure 1.  Flow chart of the participants. A total of 92,687 subjects (54,322 males and 38,365 females) attended annual physical examinations, of whom 84,285 subjects (49,201 males and 35,084 females) with 168,570 person times data were included in the statistical analyses.
Number of subjects49,20135,084/
Age, years44.3 ± 13.242.4 ± 12.5<0.001
Current smoker17,221 (35.0%)726 (2.1%)<0.001
Moderate drinker10,993 (22.3%)1,022 (2.9%)<0.001
Inactive lifestyle8,856 (18.0%)5,101 (14.8%)<0.001
BMI (kg/m2)24.4 ± 3.122.3 ± 3.1<0.001
Systolic BP132.4 ± 17.7125.0 ± 19.0<0.001
Diastolic BP81.8 ± 11.375.1 ± 11.2<0.001
TC (mmol/L)4.76 ± 0.914.59 ± 0.87<0.001
TG (mmol/L)1.73 (1.20, 2.56)1.17 (0.84, 1.68)<0.001
HDL-C (mmol/L)1.29 ± 0.381.49 ± 0.32<0.001
LDL-C (mmol/L)2.59 ± 0.822.46 ± 0.73<0.001
Non-HDL-C (mmol/L)3.48 ± 0.963.10 ± 0.85<0.001
Glucose (mmol/L)5.52 ± 1.45.23 ± 1.0<0.001
Table 1  General distribution characteristics of the parameters by sex.
Figure 2.  Lifetime trends of the LDL-C and non-HDL-C levels. Means with 95% CIs for LDL-C and non-HDL-C levels (left ordinate) are plotted against each age by sex; the shadow indicates the number of subjects at each age (right ordinate).
VariableCoef.95% CIPVariableCoef.95% CIP
Systolic BP///Systolic BP///
Diastolic BP0.0070.003~0.012<0.001Diastolic BP0.0050.002~0.009<0.001
Glucose (mmol/L)0.0910.023~0.132<0.001Glucose (mmol/L)0.0820.045~0.1240.003
BMI (kg/m2)0.0310.022~0.0440.001BMI (kg/m2)0.0410.032~0.056<0.001
Inactive lifestyle0.0230.019~0.0380.002Inactive lifestyle0.0310.019~0.0440.003
Moderate drinking///Moderate drinking0.0440.032~0.0560.003
Age phase I: 18 ≤ age ≤ 56 (N = 61,420)Age phase I: 18 ≤ age ≤ 33 (N = 22,942)
Systolic BP///Systolic BP///
Diastolic BP0.0040.001~0.008<0.001Diastolic BP///
Glucose (mmol/L)0.1140.098~0.1430.002Glucose (mmol/L)0.1540.137~0.1760.001
BMI (kg/m2)0.0390.028~0.0510.003BMI (kg/m2)0.0630.048~0.079<0.001
Inactive lifestyle0.0480.039~0.066<0.001Inactive lifestyle0.0230.019~0.0330.004
Moderate drinking///Moderate drinking0.0320.023~0.054<0.001
Age phase II: 34 ≤ age ≤ 56 (N = 59,807)
Systolic BP///
Diastolic BP0.0080.004~0.0110.002
Glucose (mmol/L)0.0320.021~0.039<0.001
BMI (kg/m2)0.0290.019~0.0450.002
Inactive lifestyle0.0160.012~0.0230.002
Moderate drinking0.0560.043~0.077<0.001
Age phase II: age ≥ 57 (N = 8,748)Age phase III: age ≥ 57 (N = 15,653)
Age-0.013-0.010 ~ -0.007<0.001Age-0.008-0.010 ~ -0.007<0.001
Systolic BP///Systolic BP///
Diastolic BP0.0130.009~0.017<0.001Diastolic BP0.0040.001~0.0080.027
Glucose (mmol/L)0.0490.032~0.076<0.001Glucose (mmol/L)0.0290.021~0.0430.003
BMI (kg/m2)0.0170.012~0.032<0.001BMI (kg/m2)0.0190.011~0.044<0.001
Inactive lifestyle0.0180.012~0.0330.003Inactive lifestyle0.0230.014~0.033<0.001
Moderate drinking///Moderate drinking0.0210.014~0.034<0.001
Table 2  Associations with LDL-C level evaluated by univariate linear regression analyses.
VariableCoef.95% CIPVariableCoef.95% CIP
Systolic BP///Systolic BP///
Diastolic BP0.0210.017~0.0330.003Diastolic BP0.0050.003~0.0170.005
Glucose (mmol/L)0.0150.011~0.0210.004Glucose (mmol/L)0.2110.139~0.3410.004
BMI (kg/m2)0.0540.039~0.061<0.001BMI (kg/m2)0.0790.067~0.087<0.001
Inactive lifestyle0.0310.022~0.0410.003Inactive lifestyle0.0540.034~0.0690.003
Moderate drinking///Moderate drinking0.0490.041~0.051<0.001
Age phase I: 18 ≤ age ≤ 56 (N = 61,420)Age phase I: 18 ≤ age ≤ 33 (N = 22,942)
Age0.0330.033~0.034<0.001Age0.0520.049~0.055 <0.001
Systolic BP///Systolic BP0.0050.002~0.0230.027
Diastolic BP0.0290.021~0.031<0.001Diastolic BP///
Glucose (mmol/L)0.2010.178~0.231<0.001Glucose (mmol/L)0.3120.201~0.4020.004
BMI (kg/m2)0.0580.048~0.068<0.001BMI (kg/m2)0.0790.056~0.087<0.001
Inactive lifestyle0.0280.021~0.039<0.001Inactive lifestyle0.0360.026~0.0570.004
Moderate drinking///Moderate drinking0.0340.023~0.045<0.001
Age phase II: 34 ≤ age ≤ 56 (N = 59,807)
Systolic BP///
Diastolic BP0.0070.005~0.0110.006
Glucose (mmol/L)0.1920.136~0.203<0.001
BMI (kg/m2)0.0610.053~0.072<0.001
Inactive lifestyle0.1010.079~0.2090.002
Moderate drinking0.0630.045~0.0760.008
Age phase II: age ≥ 57 (N = 8,748)Age phase III: age ≥ 57 (N = 15,653)
Systolic BP///Systolic BP///
Diastolic BP0.0090.005~0.0130.004Diastolic BP0.0060.003~0.0230.034
Glucose (mmol/L)0.0650.054~0.1050.003Glucose (mmol/L)0.1140.098~0.2310.006
BMI (kg/m2)0.0410.038~0.059<0.001BMI (kg/m2)0.0420.037~0.053<0.001
Inactive lifestyle0.0310.022~0.044<0.001Inactive lifestyle0.0410.029~0.0570.005
Moderate drinking///Moderate drinking0.0410.036~0.0550.003
Table 3  Associations with non-HDL-C level evaluated by univariate linear regression analyses.
Independent variableCoef.95% CIPIndependent variableCoef.95% CIP
Age phase I: 18 ≤ age ≤ 56 Age phase I: 18 ≤ age ≤ 33
Systolic BP///Systolic BP///
Diastolic BP0.0040.002~0.007<0.001Diastolic BP///
Glucose (mmol/L)0.1150.105~0.125<0.001Glucose (mmol/L)0.1690.153~0.186<0.001
BMI (kg/m2)0.0410.032~0.050<0.001BMI (kg/m2)0.0710.055~0.087<0.001
Inactive lifestyle0.0430.032~0.089 <0.001Inactive lifestyle0.0210.011~0.067<0.001
Moderate drinking///Moderate drinking0.0310.012~0.071<0.001
Age phase II: 34 ≤ age ≤ 56
Systolic BP///
Diastolic BP0.0070.003~0.010<0.001
Glucose (mmol/L)0.0300.022~0.037 <0.001
BMI (kg/m2)0.0350.023~0.048<0.001
Inactive lifestyle0.0230.013~0.0370.004
Moderate drinking0.0610.054~0.2010.003
Age phase II: age ≥ 57Age phase III: age ≥ 57
Systolic BP///Systolic BP///
Diastolic BP0.0120.007~0.018<0.001Diastolic BP0.0040.001~0.0070.002
Glucose (mmol/L)0.0510.019~0.083)<0.001Glucose (mmol/L)0.0380.026~0.050<0.001
BMI (kg/m2)0.0240.010~0.0380.002BMI (kg/m2)0.0250.010~0.040<0.001
Inactive lifestyle0.0210.016~0.0370.007Inactive lifestyle0.0340.020~0.0430.004
Moderate drinking///Moderate drinking0.0430.032~0.0770.009
Table 4  Age associations with the LDL-C levels in each age phase adjusted for confounding factors.
Independent variableCoef.95% CIPIndependent variableCoef.95% CIP
Age phase I: 18 ≤ age ≤ 56Age phase I: 18 ≤ age ≤ 33
Systolic BP///Systolic BP0.0040.001~0.008<0.001
Diastolic BP0.0300.023~0.039<0.001Diastolic BP///
Glucose (mmol/L)0.1910.179~0.202<0.001Glucose (mmol/L)0.3190.299~0.339<0.001
BMI (kg/m2)0.0560.044~0.064<0.001BMI (kg/m2)0.0850.067~0.103<0.001
Inactive lifestyle0.0290.019~0.045 <0.001Inactive lifestyle0.0340.027~0.0430.008
Moderate drinking///Moderate drinking0.0370.023~0.058<0.001
Age phase II: 34 ≤ age ≤ 56
Systolic BP///
Diastolic BP0.0080.004~0.011<0.001
Glucose (mmol/L)0.1810.172~0.188<0.001
BMI (kg/m2)0.0640.049~0.078<0.001
Inactive lifestyle0.0870.081~0.092<0.001
Moderate drinking0.0310.029~0.0430.009
Age phase II: age ≥ 57Age phase III: age ≥ 57
Systolic BP///Systolic BP///
Diastolic BP0.0120.006~0.018<0.001Diastolic BP0.0050.001~0.0060.004
Glucose (mmol/L)0.0730.036~0.110<0.001Glucose (mmol/L)0.1170.103~0.131<0.001
BMI (kg/m2)0.0390.023~0.055<0.001BMI (kg/m2)0.0430.027~0.060<0.001
Inactive lifestyle0.0280.017~0.0330.007Inactive lifestyle0.0320.021~0.0680.008
Moderate drinking///Moderate drinking0.0210.018~0.0340.001
Table 5  Age associations with the non-HDL-C level in each age phase adjusted for confounding factors.
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