03982nas a2200421 4500008004100000022001400041245012400055210006900179260001300248300001100261490000700272520282000279653000903099653001003108653002803118653004303146653002103189653002103210653002803231653001103259653001803270653001103288653001103299653001703310653000903327653002603336653001803362100001903380700001403399700001603413700001503429700001503444700001703459700001703476700001503493700001703508856003503525 1992 eng d a0009-732200aLipoprotein lipids in older people. Results from the Cardiovascular Health Study. The CHS Collaborative Research Group.0 aLipoprotein lipids in older people Results from the Cardiovascul c1992 Sep a858-690 v863 a

BACKGROUND: Cardiovascular disease is the leading cause of death and disability in older people. There is little information about the distributions of risk factors in older populations. This article describes the distribution and correlates of lipoprotein lipids in people greater than or equal to 65 years old.

METHODS AND RESULTS: Lipoprotein lipid concentrations were measured in 2,106 men (M) and 2,732 women (F) who were participants in the Cardiovascular Health Study, a population-based epidemiological study. Distributions of lipids by age and sex and bivariate and multivariate relations among lipids and other variables were determined in cross-sectional analyses. Mean concentrations of lipids were cholesterol: M, 5.20 +/- 0.93 mmol/l (201 +/- 36 mg/dl) and F, 5.81 +/- 0.98 mmol/l (225 +/- 38 mg/dl); triglyceride (TG): M, 1.58 +/- 0.85 mmol/l (140 +/- 75 mg/dl) and F, 1.57 +/- 0.78 mmol/l (139 +/- 69 mg/dl); high density lipoprotein cholesterol (HDL-C): M, 1.23 +/- 0.33 mmol/l (48 +/- 16 mg/dl), and F, 1.53 +/- 0.41 mmol/l (59 +/- 16 mg/dl); low density lipoprotein cholesterol (LDL-C): M, 3.27 +/- 0.85 mmol/l (127 +/- 33 mg/dl) and F, 3.57 +/- 0.93 mmol/l (138 +/- 36 mg/dl). The total cholesterol to HDL-C ratios were M, 4.49 +/- 1.29 and F, 4.05 +/- 1.22. TG, total cholesterol, and LDL-C concentrations were lower with increasing age, the last more evident in men than in women. TG concentration was positively associated with obesity (in women), central fat patterning, glucose intolerance, use of beta-blockers (in men), and use of estrogens (in women) and negatively associated with age, renal function, alcohol use, and socioeconomic status. In general, HDL-C had opposite relations with these variables, except that estrogen use was associated with higher HDL-C concentrations. LDL-C concentration was associated with far fewer variables than the other lipids but was negatively associated with age in men and women and positively correlated with obesity and central fat patterning and negatively correlated with renal function and estrogen use in women. There were no differences in total cholesterol and LDL-C concentrations among participants with and without prevalent coronary heart disease and stroke, but TG concentration was higher and HDL-C lower in men with both coronary heart disease and stroke and in women with coronary heart disease.

CONCLUSIONS: Cholesterol and cholesterol/HDL-C ratio were lower and HDL-C higher than previously reported values in older people, suggesting that lipid risk profiles may be improving in older Americans. TG and HDL-C concentrations, and to a lesser extent LDL-C, were associated with potentially important modifiable factors such as obesity, glucose intolerance, renal function, and medication use.

10aAged10aAging10aCardiovascular Diseases10aCardiovascular Physiological Phenomena10aCholesterol, HDL10aCholesterol, LDL10aCross-Sectional Studies10aFemale10aHealth Status10aHumans10aLipids10aLipoproteins10aMale10aMultivariate Analysis10aTriglycerides1 aEttinger, W, H1 aWahl, P W1 aKuller, L H1 aBush, T, L1 aTracy, R P1 aManolio, T A1 aBorhani, N O1 aWong, N, D1 aO'Leary, D H uhttps://chs-nhlbi.org/node/78103000nas a2200409 4500008004100000022001400041245008400055210006900139260001600208300001200224490000700236520195300243653001902196653000902215653001802224653002202242653002102264653002502285653001102310653001102321653001402332653001202346653000902358653002402367653000902391653001802400653001202418100001702430700001702447700001602464700001602480700001502496700001502511700001202526700001702538856003502555 1999 eng d a0027-887400aIncreased blood glucose and insulin, body size, and incident colorectal cancer.0 aIncreased blood glucose and insulin body size and incident color c1999 Jul 07 a1147-540 v913 a

BACKGROUND: Abdominal obesity--an elevated level of visceral adipose tissue--has been linked to colorectal cancer. Furthermore, elevated levels of visceral adipose tissue have been associated with hyperinsulinemia, and insulin is a growth factor in the colon. We assessed whether waist circumference, a surrogate measure of visceral adipose tissue, and metabolic parameters associated with visceral adipose tissue were related to colorectal cancer.

METHODS: In the Cardiovascular Health Study cohort, we examined the relationship of baseline measurements of body size, glucose, insulin, and lipoproteins to incident colorectal cancer. All P values are two-sided.

RESULTS: Among 5849 participants, 102 incident cases of colorectal cancer were identified. Individuals in the highest quartile of fasting glucose had a nearly twofold increased risk of colorectal cancer (relative risk [RR] = 1.8; 95% confidence interval [CI] = 1.0-3.1), and the linear trend RR (LT RR = 1.2; 95% CI = 1.0-1.5) for fasting glucose level was statistically significant (P =. 02). Glucose and insulin levels 2 hours after oral glucose challenge also exhibited statistically significant associations with colorectal cancer (2-hour glucose levels: RR = 2.4 [95% CI = 1.2-4. 7]/LT RR = 1.3 [95% CI = 1.0-1.6; P =.02]; 2-hour insulin levels: RR = 2.0 [95% CI = 1.0-3.8]/LT RR = 1.2 [95% CI = 1.0-1.5; P =.04]). Analysis of fasting insulin levels suggested a threshold effect, with values above the median associated with colorectal cancer (RR = 1.6; 95% CI = 1.1-2.4; P =.02). Higher levels of waist circumference were also statistically significantly associated with colorectal cancer (RR = 1.9; 95% CI = 1.1-3.3; P =.02).

CONCLUSIONS: These data provide, to our knowledge, the first direct evidence of an association between elevated visceral adipose tissue level, its associated metabolic effects, and colorectal cancer.

10aAdipose Tissue10aAged10aBlood Glucose10aBody Constitution10aCholesterol, HDL10aColorectal Neoplasms10aFemale10aHumans10aIncidence10aInsulin10aMale10aProspective Studies10aRisk10aTriglycerides10aViscera1 aSchoen, R, E1 aTangen, C, M1 aKuller, L H1 aBurke, G, L1 aCushman, M1 aTracy, R P1 aDobs, A1 aSavage, P, J uhttps://chs-nhlbi.org/node/594