Abstract
Reduced pulmonary function and elevated serum cholesterol levels are recognized risk factors for cardiovascular disease. Currently, there is some controversy concerning relationships between cholesterol, LDL-cholesterol, HDL-cholesterol, serum triglycerides and lung function. However, most previous studies compared patients suffering from chronic obstructive pulmonary disease (COPD) with healthy controls, and only a small number examined this relationship in population-based cohorts. Moreover, lipoprotein a [Lp(a)], another lipid parameter independently associated with cardiovascular diseases, appears not to have been addressed at all in studies of lung function at the population level. Here, we determined relationships between lung function and several lipid parameters including Lp(a) in 606 older community-dwelling participants (55.1% women, 68±4 years old) from the Berlin Aging Study II (BASE-II). We found a significantly lower forced expiration volume in 1 second (FEV1) in men with low Lp(a) concentrations (t-test). This finding was further substantiated by linear regression models adjusting for known covariates, showing that these associations are statistically significant in both men and women. According to the highest adjusted model, men and women with Lp(a) levels below the 20th percentile had 217.3ml and 124.2ml less FEV1 and 239.0ml and 135.2ml less FVC, respectively, compared to participants with higher Lp(a) levels. The adjusted models also suggest that the known strong correlation between pro-inflammatory parameters and lung function has only a marginal impact on the Lp(a)-pulmonary function association. Our results do not support the hypothesis that higher Lp(a) levels are responsible for the increased CVD risk in people with reduced lung function, at least not in the group of community-dwelling older people studied here.
Highlights
Reduced lung function has been associated with cardiovascular disease (CVD) and risk of mortality; parameters of lung function have been identified as predictors of cardiovascular events, independently of age, gender or smoking habits [1,2,3,4,5,6,7,8,9,10]
Lp(a) values were significantly higher in women, which is in accordance with the fact that Lp(a) levels increase after menopause. Another known factor influencing the Lp(a) serum concentration is the glomerular filtration rate (GFR), which is lower in BASE-II women and thereby might explain the observed Lp(a) sex difference, as indicated by our analysis excluding subjects with GFR < 60 ml/min [38]
Partial correlation analysis adjusting for age, BMI and smoking status revealed positive associations of total cholesterol with forced expiratory volume in 1 second (FEV1)/forced vital capacity (FVC), LDL-cholesterol with FEV1 and LDL-cholesterol with FEV1/FVC which were only seen in women
Summary
Reduced lung function has been associated with cardiovascular disease (CVD) and risk of mortality; parameters of lung function have been identified as predictors of cardiovascular events, independently of age, gender or smoking habits [1,2,3,4,5,6,7,8,9,10]. Total cholesterol and its subfractions high-density lipoprotein (HDLcholesterol) and low-density lipoprotein (LDL-cholesterol), have been studied intensively in relation to their association with pulmonary function, mostly in the context of COPD [17,18,19]. The results of these studies on non-clinical cohorts, are somewhat contradictory. Gunell and colleagues analyzed data from 2,338 study participants with a mean age of about 45 years and showed an inverse association between the forced expiratory volume in 1 second (FEV1) and total cholesterol in men and women [20]
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