High HDL Levels Linked to Lung Function Decline

An observational study demonstrates a connection between higher levels of high-density lipoprotein (HDL) cholesterol and a deterioration of lung function over time.

Presented at the European Respiratory Society International Congress 2016, held September 3-7 in London, the study expanded on existing research by examining the hypothesis that a correlation would be found between higher HDL cholesterol and increased decline in lung function in the general population.

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A team led by Columbia University researchers examined findings from the National Heart, Lung, and Blood Institute's Pooled Cohorts Study, which included 6 large studies with data on HDL cholesterol levels as well as spirometry readings.

The authors followed the cases of 32,350 adult patients for up to 25 years, finding that higher baseline protein HDL cholesterol showed a direct link to more rapid decline in lung function. Over a median follow-up period of 7 years, patients in the higher HDL cholesterol quartile showed a 9 mL greater decline in forced expiratory volume in the first second of expiration (FEV1) compared with those in the lowest quartile.

The investigators repeatedly measured prebronchodilator spirometry, finding that participants had, on average, between 2 and 5 measures of spirometry over an interval of 4 to 24 years. The team measured HDL cholesterol with enzymatic methods and mixed models, adjusting for factors such as baseline age, sex, race/ethnicity, smoking status, and hypertension.

The researchers also developed several mixed models to assess the cross-sectional associations between baseline HDL cholesterol and baseline lung function, and the longitudinal association between baseline HDL and 10-year decline in lung function. In adjusted models, the researchers found that higher HDL cholesterol was associated with a greater rate of decline in FEV1 and FEV1/forced vital capacity. In stratified analyses, findings were similar in men and women, in never smokers, in nonobese study participants, and in those without airflow limitations.

—Mark McGraw


Oelsner E, Balte P, Schwartz JE, et al. High density lipoprotein cholesterol (HDL-C) and longitudinal lung function in six United States (US) cohorts. Abstract presented at: European Respiratory Society International Congress 2016. September 5, 2016. London, UK. http://www.ers-education.org/Media/Media.aspx?idMedia=295816. Accessed September 8, 2016.