Low HDL-C and greater HDL-C variability associated with a higher risk of Parkinson’s disease

Older people with low levels of high density lipoprotein cholesterol (HDL-C) and increased variability in HDL-C levels over time may have a higher risk of Parkinson’s disease (PD), according to study results published in Neurology.

This population-based cohort study used data from a database of the Korean National Health Insurance System (NHIS) and the registry of rare hard-to-treat diseases. In total, the study researchers included 382,391 people aged 65 and over who underwent three or more health examinations carried out by the Korean NHIS from 2008 to 2013.

All participants were followed up until 2017. The researchers assessed the HDL-C variability and the association between HDL-C and PD incidence.

At the start of the study, the mean HDL-C value of the participants in the entire study cohort was 53.1 (standard deviation ± 13.0) mg / dl, while the mean HDL-C variability was 7.6, measured with a variability independent of the mean (VIM). . A total of 2,733 of 380,404 participants in the study developed Parkinson’s disease during a median follow-up of 5 years. 62% of the study participants were men.

An increased incidence of PD was associated with the lowest quartile group (Q1) of the HDL-C baseline (adjusted hazard ratio) [aHR]1.20; 95% CI, 1.08-1.34) and mean HDL-C (aHR, 1.16; 95% CI, 1.04-1.30) compared to the population with the highest quartile (Q4). Compared to patients in the first quarter, patients in the fourth quarter with a VIM of HDL-C had an increased risk of PD (aHR, 1.19; 95% CI, 1.06-1.33). The highest incidence of PD was observed in patients in the first quarter of HDL-C baseline and fourth quarter of HDL-C variability (aHR 1.6; 95% CI 1.31-1.96).

Limitations of this study included the lack of information about the genetics of the participants, as well as the lack of consensus about measurements of intra-individual HDL-C variability.

Although this study suggests that HDL-C variability is associated with a higher risk of PD, the study’s researchers wrote that additional “studies are needed to determine the exact mechanism of this association between HDL-C variability and PD and to clarify the modulation effect of HDL-C PD. ”


Park JH, Lee CW, Nam MJ et al. Association of high density lipoprotein cholesterol variability and risk of developing Parkinson’s disease. Neurology. 2021; 96 (10): e1391-e1401. doi: 10.1212 / WNL.0000000000011553

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