High-density lipoprotein cholesterol and objective measures of lower extremity performance in older nondisabled persons: The InChianti study

Department of Clinical and Experimental Medicine, Section of Internal Medicine and Geriatrics, University of Ferrara, Ferrara, Italy.
Journal of the American Geriatrics Society (Impact Factor: 4.57). 05/2008; 56(4):621-9. DOI: 10.1111/j.1532-5415.2007.01608.x
Source: PubMed


To evaluate the independent association between high-density lipoprotein cholesterol (HDL-C) levels and objective measures of lower extremity performance.
Cross-sectional cohort study.
Eight hundred thirty-six nondisabled women and men aged 65 and older enrolled in the Invecchiare in Chianti study.
Lower extremity performance was assessed using 4-m walking speed at fast pace, 400-m walking speed, and knee extension torque. Fasting HDL-C levels were determined using commercial enzymatic tests.
The mean age of participants was 73.7 (65-92), and 55.6% were women. After adjusting for potential confounders (sociodemographic factors, smoking, physical activity, body composition, and clinical conditions including cardiovascular and cerebrovascular disease, inflammatory markers, and serum testosterone) HDL-C levels were significantly associated with knee extension torque in men and women and with 4-m and 400-m walking speed in men. Men in the highest tertile of the HDL-C distribution (>55 mg/dL) had, on average, a three times greater probability of belonging to the best tertile of all indexes of lower extremity performance, including 4-m fast walking speed (odds ratio (OR)=2.57, 95%=confidence interval (CI)=1.07-6.17), 400-m walking speed (OR=3.74, 95% CI=1.20-11.7), and knee extension torque (OR=3.63, 95%=CI 1.41-9.33). Path analysis suggested a direct relationship between HDL-C and knee extension torque.
In older nondisabled persons, HDL-C levels are highly correlated with knee extension torque and walking speed. Further research should focus on the biological mechanism of this association.

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    • "Our findings show that high vascular risk is associated with poorer motor function. This is in agreement with previous studies, mainly based on walking speed, that reported associations of worse motor function with individual vascular risk factors (hypertension [5;24], diabetes [6], homocysteine [25] [26] [27], low HDL-cholesterol [28]) or markers of vascular ageing (increased common carotid artery intima-media thickness [7;8], arterial stiffness [9]). Most prior studies were cross-sectional or based on a single measure of vascular risk, while we assessed cardiovascular risk four times over many years, thus minimizing the risk of measurement error and reverse causation. "
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    ABSTRACT: Background Vascular risk factors are associated with increased risk of cognitive impairment and dementia, but their association with motor function, another key feature of ageing, has received little research attention. We examined the association between trajectories of the Framingham general cardiovascular disease risk score (FRS) over midlife and motor function later in life. Methods A total of 5376 participants of the Whitehall II cohort study (29% women) who had up to four repeat measures of FRS between 1991–1993 (mean age = 48.6 years) and 2007–2009 (mean age = 65.4 years) and without history of stroke or coronary heart disease in 2007–2009 were included. Motor function was assessed in 2007–2009 through objective tests (walking speed, chair rises, balance, finger tapping, grip strength). We used age- and sex-adjusted linear mixed models. Results Participants with poorer performances for walking speed, chair rises, and balance in 2007–2009 had higher FRS concurrently and also in 1991–1993, on average 16 years earlier. These associations were robust to adjustment for cognition, socio-economic status, height, and BMI, and not explained by incident mobility limitation prior to motor assessment. No association was found with finger tapping and grip strength. Conclusions Cardiovascular risk early in midlife is associated with poor motor performances later in life. Vascular risk factors play an important and under-recognized role in motor function, independently of their impact on cognition, and suggest that better control of vascular risk factors in midlife may prevent physical impairment and disability in the elderly.
    International journal of cardiology 01/2013; 172(1). DOI:10.1016/j.ijcard.2013.12.051 · 4.04 Impact Factor
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    • "Dietary and exercise modifications can lead to improvement of HDL-c concentrations, which may be associated with greater antioxidative role of HDL-c [6] [7] [8] [9]. It has been demonstrated that HDL-c concentrations are positively associated with physical function in older adults [10]. "
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    ABSTRACT: The level of high-density lipoprotein is thought to be critical in inhibiting lesion formation as well as reducing the lipid load of preexisting atherosclerotic lesions. With the aim of determining the main determinants of plasma HDL-cholesterol (HDL-c) in free-living adults, 997 individuals (52.3 ± 10 years, 67% females) were selected for a descriptive cross-sectional study. The used data corresponded to the baseline obtained from participants clinically selected for a lifestyle modification program. Covariables of clinical, anthropometry, food intake, aerobic fitness, and plasma biochemistry were analyzed against plasma HDL-c either as continuous or categorized variables. After adjustments for age, gender, and BMI the excess of abdominal fat along with high carbohydrate-energy intake and altered plasma triglycerides were the stronger predictors of reduced plasma HDL-c. In conclusion lifestyle interventions aiming to normalize abdominal fatness and plasma triglycerides are recommended to restore normal levels of HDL-c in these free-living adults.
    Cholesterol 01/2011; 2011:851750. DOI:10.1155/2011/851750
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    ABSTRACT: We investigated social inequalities in walking speed in early old age. Walking speed was measured by timed 8-ft (2.44 m) test in 6,345 individuals, with mean age of 61.1 (SD 6.0) years. Current or last known civil service employment grade defined socioeconomic position. Mean walking speed was 1.36 (SD 0.29) m/s in men and 1.21 (SD 0.30) in women. Average age- and ethnicity-adjusted walking speed was approximately 13% higher in the highest employment grade compared with the lowest. Based on the relative index of inequality (RII), the difference in walking speed across the social hierarchy was 0.15 m/s (95% confidence interval [CI] 0.12-0.18) in men and 0.17 m/s (0.12-0.22) in women, corresponding to an age-related difference of 18.7 (13.6-23.8) years in men and 14.9 (9.9-19.9) years in women. The RII for slow walking speed (logistic model for lowest sex-specific quartile vs others) adjusted for age, sex, and ethnicity was 3.40 (2.64-4.36). Explanatory factors for the social gradient in walking speed included Short-Form 36 physical functioning, labor market status, financial insecurity, height, and body mass index. Demographic, psychosocial, behavioral, biologic, and health factors in combination accounted for 40% of social inequality in walking speed. Social inequality in walking speed is substantial in early old age and reflects many factors beyond the direct effects of physical health.
    The Journals of Gerontology Series A Biological Sciences and Medical Sciences 07/2009; 64(10):1082-9. DOI:10.1093/gerona/glp078 · 5.42 Impact Factor
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