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

Volpato S, Ble A, Metter EJ, Lauretani F, Bandinelli S, Zuliani G, Fellin R, Ferrucci L, Guralnik JM

Department of Clinical and Experimental Medicine, Section of Internal Medicine and Geriatrics, University of Ferrara, Ferrara, Italy. vlt@unife.it

OBJECTIVES: To evaluate the independent association between high-density lipoprotein cholesterol (HDL-C) levels and objective measures of lower extremity performance. DESIGN: Cross-sectional cohort study. SETTING: Community-based. PARTICIPANTS: Eight hundred thirty-six nondisabled women and men aged 65 and older enrolled in the Invecchiare in Chianti study. MEASUREMENTS: 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. RESULTS: 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. CONCLUSION: 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.

Published 2 April 2008 in J Am Geriatr Soc, 56(4): 621-9.
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