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Abstract
Objective To investigate the longitudinal association among high-density lipoprotein cholesterol (HDL-C) level, HDL-C variability, and the risk of developing Parkinson disease (PD).
Methods We conducted a nationwide, population-based cohort study. We included 382,391 patients aged ≥65 years who underwent at least 3 health examinations provided by the Korean National Health Insurance System from 2008 to 2013 and followed up until 2017. Individuals with a history of PD and missing values were excluded (n = 1,987). We assessed HDL-C variability using 3 indices, including variability independent of the mean (VIM). A multivariate-adjusted Cox proportional hazards regression analysis was performed.
Results Among the 380,404 participants, 2,733 individuals were newly diagnosed with PD during a median follow-up period of 5 years. The lowest quartile (Q1) group of baseline HDL-C and mean HDL-C was associated with increased PD incidence as compared with the highest quartile (Q4) group (adjusted hazard ratio [aHR], 1.20; 95% confidence interval [CI], 1.08–1.34; and aHR, 1.16; 95% CI, 1.04–1.30, respectively). The Q4 group of HDL-C variability (VIM) was associated with increased PD incidence compared to the Q1 group (aHR, 1.19; 95% CI, 1.06–1.33). The group with the Q1 of baseline HDL-C and with the Q4 of HDL-C variability had the highest risk of PD incidence (aHR, 1.6; 95% CI, 1.31–1.96).
Conclusion Lower HDL-C level and greater HDL-C variability were associated with a higher incidence of PD.
Glossary
- BMI=
- body mass index;
- BP=
- blood pressure;
- CETP=
- cholesteryl ester transfer protein;
- CI=
- confidence interval;
- CKD=
- chronic kidney disease;
- CV=
- coefficient of variation;
- HDL-C=
- high-density lipoprotein cholesterol;
- HR=
- hazard ratio;
- ICD-10-CM=
- International Classification of Diseases, 10th revision, Clinical Modification;
- IRB=
- institutional review board;
- NHIS=
- National Health Insurance Service;
- PD=
- Parkinson disease;
- RID=
- rare intractable disease;
- VIM=
- variability independent of the mean
Footnotes
Go to Neurology.org/N for full disclosures. Funding information and disclosures deemed relevant by the authors, if any, are provided at the end of the article.
↵* These authors contributed equally to this work.
Editorial, page 465
- Received April 30, 2020.
- Accepted in final form November 9, 2020.
- © 2021 American Academy of Neurology
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