Joo-Hyun Park1, Chung-Woo Lee2, Myung Ji Nam2, Hyunjin Kim1, Do-Young Kwon2, Ji Won Yoo2, Kyu Na Lee2, Kyungdo Han1, Jin-Hyung Jung2, Yong-Gyu Park1, Do-Hoon Kim1. 1. From the Departments of Family Medicine (J.-H.P., C.-w.L., M.J.N., H.K., D.-H.K.) and Neurology (D.-Y.K.), Korea University Ansan Hospital, Korea University College of Medicine, Ansan, Republic of Korea; Department of Internal Medicine (J.W.Y.), University of Nevada Las Vegas School of Medicine; Department of Statistics and Actuarial Science (K.N.L., K.H.), Soongsil University; and Department of Biostatistics (J.-H.J., Y.-G.P.), College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea. kmcfm@hanmail.net ygpark@catholic.ac.kr. 2. From the Departments of Family Medicine (J.-H.P., C.-w.L., M.J.N., H.K., D.-H.K.) and Neurology (D.-Y.K.), Korea University Ansan Hospital, Korea University College of Medicine, Ansan, Republic of Korea; Department of Internal Medicine (J.W.Y.), University of Nevada Las Vegas School of Medicine; Department of Statistics and Actuarial Science (K.N.L., K.H.), Soongsil University; and Department of Biostatistics (J.-H.J., Y.-G.P.), College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.
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.
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.