Higher Normal Levels of Triglyceride and Low and High-Density Lipoprotein Cholesterol Might Have a Protective Effect Against Activities of Daily Living Disability Within Chinese Female Centenarians: A Cross-Sectional, Complete Sample Study

Figures & data

Table 1 General Characteristics of Low-Density Lipoprotein Cholesterol Among Hainan Female Centenarians

Variables	Total	Quintile of LDL-C					P
		Q1 (n=166)	Q2 (n=165)	Q3 (n=165)	Q4 (n=164)	Q5 (n=162)
Nationality							0.648
Han	727(88.4)	142(19.5)	145(19.9)	146(20.1)	147(20.2)	147(20.2)
Ethnic minority	95(11.6)	24(25.3)	20(21.1)	19(20.0)	17(17.9)	15(15.8)
Educational level^a							0.860
Illiteracy	794(96.6)	161(20.3)	157(19.8)	160(20.2)	159(20.0)	157(19.8)
Primary school and above	28(3.4)	5(17.9)	8(28.6)	5(17.9)	5(17.9)	5(17.9)
Marital status							0.834
Married	59(7.2)	12(20.3)	9(15.3)	11(18.6)	13(22.0)	14(23.7)
Widowed/divorced/unmarried	763(92.8)	154(20.2)	156(20.4)	154(20.2)	151(19.8)	148(19.4)
Residential type							0.469
Living with family	718(87.3)	150(20.9)	141(19.6)	141(19.6)	147(20.5)	139(19.4)
Living alone/nursing home	104(12.7)	16(15.4)	24(23.1)	24(23.1)	17(16.3)	23(22.1)
Smoking^a							0.207
Yes	10(1.2)	3(30.0)	0(0.0)	2(20.0)	1(10.0)	4(40.0)
No	812(98.8)	163(20.1)	165(20.3)	163(20.1)	163(20.1)	158(19.5)
Drinking							0.429
Yes	64(7.8)	13(20.3)	17(26.6)	9(14.1)	10(15.6)	15(23.4)
No	758(92.2)	153(20.2)	148(19.5)	156(20.6)	154(20.3)	147(19.4)
Infrequent physical activity							0.915
Yes	728(88.6)	146(20.1)	149(20.5)	146(20.1)	146(20.1)	141(19.4)
No	94(11.4)	20(21.3)	16(17.0)	19(20.2)	18(19.1)	21(22.3)
ADL							<0.001
Non-disability	578(70.3)	98(17.0)	109(18.9)	116(20.1)	126(21.8)	129(22.3)
Disability	244(29.7)	71(29.1)	53(21.7)	49(20.1)	39(16.0)	32(13.1)
Age, median (IQR), y	102(101–104)	102(101–104)	102(101–104)	102(101–105)	102(101–104)	102(101–104)	0.749
ADL scores, median (IQR)	85(55–95)	75(40–90)	85(60–95)	85(55–90)	85(60–95)	85(65–95)	<0.001
BMI, median (IQR), kg/m^Citation2	17.76(16.01–19.72)	16.88(15.41–18.79)	17.78(15.79–19.74)	17.59(16.04–19.60)	18.42(16.67–20.23)	17.86(16.04–20.12)	<0.001
FPG(IQR), mmol/L	4.92(4.25–5.60)	4.77(4.10–5.77)	5.00(4.35–5.71)	5.14(4.39–5.34)	4.72(4.18–5.32)	4.82(4.28–5.66)	<0.001
SBP, median (IQR), mmHg	152(138–168)	148 (138–163)	152(132–167)	152 (139–171)	152 (138–170)	152 (141–168)	0.298
DBP, median (IQR), mmHg	76(68–82)	74(65–80)	74.5(66–80)	76(70–83)	76(69–82)	76(70–83)	0.015

Notes: ^aFisher’s exact test. LDL-C levels were calculated by quintile variables and ranked as Q1-Q5 from low to high. The differences between the quintile of LDL-C were evaluated by Kruskal–Wallis test for continuous data and Chi-square test for categorical data.

Abbreviations: ADL, activities of daily living; IQR, interquartile range; BMI, body mass index; SBP, Systolic blood pressure; DBP, diastolic blood pressure; LDL-C, low-density lipoprotein cholesterol; FPG, fasting plasma glucose.

Table 2 General Characteristics of Triglyceride Among Hainan Female Centenarians

Variables	All	Quintile of TG					P
		Q1 (n=175)	Q2 (n=154)	Q3 (n=180)	Q4 (n=150)	Q5 (n=163)
Nationality							0.267
Han	727(88.4)	150(20.6)	141(19.4)	154(21.2)	134(18.4)	148(20.4)
Ethnic minority	95(11.6)	25(26.3)	13(13.7)	26(27.4)	16(16.8)	15(15.8)
Educational level							0.922
Illiteracy	794(96.6)	170(21.4)	148(18.6)	174(21.9)	146(18.4)	156(19.6)
Primary school and above	28(3.4)	5(17.9)	6(21.4)	6(21.4)	4(14.3)	7(25.0)
Marital status							0.232
Married	59(7.2)	19(32.2)	8(13.6)	10(16.9)	12(20.3)	10(16.9)
Widowed/divorced/unmarried	763(92.8)	156(20.4)	146(19.1)	170(22.3)	138(18.1)	153(20.1)
Residential type							0.348
Living with family	718(87.3)	158(22.0)	135(18.8)	150(20.9)	130(18.1)	145(20.2)
Living alone/nursing home	104(12.7)	17(16.3)	19(18.3)	30(28.8)	20(19.2)	18(17.3)
Smoking^a							0.811
Yes	10(1.2)	3(30.0)	1(10.0)	3(30.0)	2(20.0)	1(10)
No	812(98.8)	172(21.2)	153(18.8)	177(21.8)	148(18.2)	162(20)
Drinking							0.961
Yes	64(7.8)	13(20.3)	10(15.6)	15(23.4)	12(18.8)	14(21.9)
No	758(92.2)	162(21.4)	144(19)	165(21.8)	138(18.2)	149(19.7)
Infrequent physical activity							0.713
Yes	728(88.6)	151(20.7)	139(19.1)	162(22.3)	134(18.4)	142(19.5)
No	94(11.4)	24(25.5)	15(16.0)	18(19.1)	16(17.0)	21(22.3)
ADL							0.007
Non-disability	578(70.3)	117(20.2)	108(18.7)	112(19.4)	112(19.4)	129(22.3)
Disability	244(29.7)	58(23.8)	46(18.9)	68(27.9)	38(15.6)	34(13.9)
Age, median (IQR), y	102(101–104)	102(101–104)	102(101–104)	102(101–104)	103(101–105)	102(101–104)	0.573
ADL scores, median (IQR)	85(55–95)	85(55–95)	85(60–90)	80(45–90)	85(60–95)	90(65–95)	0.007
BMI, median (IQR), kg/m^2	17.76(16.01–19.72)	17.11(15.35–18.80)	17.44(15.64–19.57)	17.65(15.88–19.23)	17.90(16.18–19.82)	18.96(17.17–20.72)	<0.001
FPG(IQR), mmol/L	4.92(4.25–5.60)	4.82(4.14–5.63)	4.74(4.15–5.43)	5.14(4.62–5.60)	4.72(4.19–5.61)	4.92(4.25–5.74)	0.01
SBP, median (IQR), mmHg	152 (138–168)	151(138–162)	152(137–166)	152(137–169)	152(141–173)	152(140–171)	0.19
DBP, median (IQR), mmHg	76(68–82)	75(66–79)	76(70–83)	76(67–80)	76(70–82)	76(70–85)	0.062

Notes: ^aFisher’s exact test. TG levels were calculated by quintile variables and ranked as Q1-Q5 from low to high. The differences between the quintile of TG were evaluated by Kruskal–Wallis test for continuous data and Chi-square test for categorical data.

Abbreviations: ADL, activities of daily living; IQR, interquartile range; BMI, body mass index; SBP, Systolic blood pressure; DBP, diastolic blood pressure; LDL-C, low-density lipoprotein cholesterol; FPG, fasting plasma glucose.

Table 3 General Characteristics of High-Density Lipoprotein Cholesterol Among Hainan Female Centenarians

Variable	All	Quintile of HDL-C					P
		Q1 (n=169)	Q2 (n=162)	Q3 (n=165)	Q4 (n=165)	Q5 (n=161)
Nationality							0.814
Han	727(88.4)	154(21.2)	142(19.5)	144(19.8)	145(19.9)	142(19.5)
Ethnic minority	95(11.6)	15(15.8)	20(21.1)	21(22.1)	20(21.1)	19(20.0)
Educational level							0.884
Illiteracy	794(96.6)	162(20.4)	157(19.8)	158(19.9)	160(20.2)	157(19.8)
Primary school and above	28(3.4)	7(25.0)	5(17.9)	7(25.0)	5(17.9)	4(14.3)
Marital status							0.112
Married	59(7.2)	6(10.2)	9(15.3)	12(20.3)	17(28.8)	15(25.4)
Widowed/divorced/unmarried	763(92.8)	163(21.4)	153(20.1)	153(20.1)	148(19.4)	146(19.1)
Residential type							0.866
Living with family	718(87.3)	148(20.6)	143(19.9)	147(20.5)	141(19.6)	139(19.4)
Living alone/nursing home	104(12.7)	21(20.2)	19(18.3)	18(17.3)	24(23.1)	22(21.2)
Smoking^a							0.719
Yes	10(1.2)	1(10.0)	1(10.0)	2(20.0)	3(30.0)	3(30.0)
No	812(98.8)	168(20.7)	161(19.8)	163(20.1)	162(20)	158(19.5)
Drinking							0.053
Yes	64(7.8)	12(18.8)	14(21.9)	7(10.9)	21(32.8)	10(15.6)
No	758(92.2)	157(20.7)	148(19.5)	158(20.8)	144(19)	151(19.9)
Infrequent physical activity							0.022
Yes	728(88.6)	159(21.8)	146(20.1)	148(20.3)	140(19.2)	135(18.5)
No	94(11.4)	10(10.6)	16(17)	17(18.1)	25(26.6)	26(27.7)
ADL							0.005
Non-disability	578(70.3)	98(17.0)	121(20.9)	114(19.7)	121(20.9)	124(21.5)
Disability	244(29.7)	68(27.9)	44(18.0)	51(20.9)	43(17.6)	38(15.6)
Age, median (IQR), y	102(101–104)	102(101–104)	102(101–105)	102(100–104)	102(101–104)	102(101–105)	0.138
ADL scores, median (IQR)	85(55–95)	75(45–90)	80(55–95)	85(55–95)	85(65–95)	85(67.5–95)	0.001
BMI^b, median (IQR), kg/m^2	17.76(16.01–19.72)	18.42(16.71–20.29)	17.82(15.97–19.95)	17.65(16.04–19.38)	17.33(15.63–19.47)	17.36(15.71–19.23)	0.009
FPG(IQR), mmol/L	4.92(4.25–5.60)	4.93(4.25–5.78)	5.00(4.25–5.76)	5.06(4.33–5.27)	4.71(4.15–5.53)	4.84(4.22–5.53)	0.604
SBP, median (IQR), mmHg	152(138–168)	152(134–164)	152(139–170)	152(137–164)	152(137–169)	152(142–174)	0.242
DBP, median (IQR), mmHg	76(68–82)	76(67–82)	75(68–82)	76(66–82)	763(67–81)	76(71–84)	0.367

Notes: ^aFisher’s exact test. HDL-C levels were calculated by quintile variables and ranked as Q1-Q5 from low to high. The differences between the quintile of HDL-C were evaluated by Kruskal–Wallis test for continuous data and Chi-square test for categorical data. ^bCalculated as weight in kilograms divided by height in meters squared.

Abbreviations: ADL, activities of daily living; IQR, interquartile range; BMI, body mass index; SBP, Systolic blood pressure; DBP, diastolic blood pressure; LDL-C, low-density lipoprotein cholesterol; FPG, fasting plasma glucose.

Figure 1 With the aggravation of ADL disability, the levels of LDL-C, TG, HDL-C appear to have a significant downward trend in female centenarians.

Table 4 The Odds Ratios (ORs) for ADL Disability in Different Lipids Profiles Indicators

Lipids Profiles	Continuous Variable	Quintile Variables
		Q1 (n=166)	Q2 (n=165)	Q3 (n=165)	Q4 (n=164)	Q5 (n=162)	P for Trend
LDL-C
Crude Model	0.704(0.569–0.872)	1.00(Ref)	0.414(0.252–0.682)	0.665(0.418–1.058)	0.467(0.286–0.762)	0.440(0.268–0.723)	0.004
Model 1	0.706(0.569–0.876)	1.00(Ref)	0.420(0.254–0.694)	0.672(0.421–1.073)	0.465(0.284–0.761)	0.448(0.272–0.738)	0.005
Model 2	0.728(0.586–0.905)	1.00(Ref)	0.437(0.264–0.725)	0.693(0.433–1.110)	0.512(0.311–0.843)	0.467(0.283–0.773)	0.011
Model 3	0.736(0.592–0.915)	1.00(Ref)	0.436(0.263–0.723)	0.705(0.439–1.131)	0.524(0.318–0.864)	0.478(0.288–0.792)	0.015
		Q1 (n=175)	Q2 (n=154)	Q3 (n=180)	Q4 (n=150)	Q5 (n=163)
TG
Crude Model	0.711(0.532–0.950)	1.00(Ref)	0.859(0.539–1.371)	1.225(0.792–1.894)	0.684(0.422–1.111)	0.532(0.325–0.869)	0.011
Model 1	0.711(0.530–0.952)	1.00(Ref)	0.873(0.546–1.396)	1.288(0.830–2.000)	0.699(0.430–1.136)	0.534(0.326–0.874)	0.012
Model 2	0.756(0.564–1.000)	1.00(Ref)	0.873(0.546–1.396)	1.288(0.830–2.000)	0.699(0.430–1.136)	0.534(0.326–0.874)	0.012
Model 3	0.702(0.521–0.948)	1.00(Ref)	0.809(0.500–1.310)	1.229(0.781–1.936)	0.651(0.395–1.072)	0.514(0.310–0.852)	0.009
		Q1 (n=169)	Q2 (n=162)	Q3 (n=165)	Q4 (n=165)	Q5 (n=161)
HDL-C
Crude Model	0.392(0.258–0.596)	1.00(Ref)	0.671(0.429–1.051)	0.583(0.371–0.917)	0.427(0.267–0.685)	0.342(0.209–0.561)	<0.001
Model 1	0.393(0.258–0.599)	1.00(Ref)	0.665(0.424–1.044)	0.574(0.364–0.905)	0.429(0.267–0.690)	0.342(0.208–0.561)	<0.001
Model 2	0.356(0.232–0.548)	1.00(Ref)	0.616(0.390–0.973)	0.531(0.335–0.842)	0.388(0.240–0.628)	0.310(0.187–0.512)	<0.001
Model 3	0.395(0.257–0.610)	1.00(Ref)	0.640(0.401–1.020)	0.558(0.349–0.893)	0.427(0.260–0.699)	0.346(0.207–0.578)	<0.001

Notes: Model 1: Adjusted for ages, nationality, marital status, educational level and residential type. Model 2: Adjusted for ages, nationality, marital status, educational level, residential type, BMI, Glucose and DBP. Model 3: Adjusted for ages, nationality, marital status, educational level, residential type, BMI, Glucose and DBP, smoking, drinking, physical activity.

Table 5 Association Between LDL-C, TG and HDL-C and ADL Disability in Hainan Female Centenarians

Variables of Lipid Profile	No. of Female Centenarians	Adjusted Odds Ratios (95% CI)	P value
All Female Centenarians
LDL-C	822	0.736(0.592–0.915)	0.001
TG	822	0.702(0.521–0.948)	0.021
HDL-C	822	0.395(0.257–0.610)	<0.001
Female Centenarians*
LDL-C	736	0.681(0.521–0.891)	0.002
TG	736	0.653(0.446–0.955)	0.028
HDL-C	736	0.449(0.276–0.729)	0.001

Notes: Adjusted for ages, nationality, marital status, educational level, residential type, BMI, FPG and DBP, smoking, drinking, physical activity. *Excluding 112 participants with hyperlipidemia, previous hyperlipidemia, cardiovascular disease, and taking lipid-lowering drugs and cardiovascular disease drugs.

Table 6 Association Between LDL-C, TG and HDL-C and ADL Disability in Hainan Female Centenarians in Different Models

Variables of Lipid Profile	No. of Female Centenarians	Adjusted Odds Ratios (95% CI)
		Model 1	Model 2	Model 3
LDL-C
Q1	166	1.00(Ref)	1.00(Ref)	1.00(Ref)
Q2	165	0.544(0.337–0.879)	0.486(0.301–0.782)	0.524(0.330–0.833)
Q3	165	0.702(0.441–1.117)	0.620(0.388–0.990)	0.645(0.410–1.014)
Q4	164	0.504(0.311–0.818)	0.483(0.299–0.781)	0.512(0.322–0.816)
Q5	162	0.443(0.270–0.725)	0.426(0.261–0.697)	0.442(0.274–0.712)
P for trend		0.002	0.002	0.004
TG
Q1	175	1.00(Ref)	1.00(Ref)	1.00(Ref)
Q2	154	0.916(0.566–1.482)	0.799(0.494–1.291)	0.859(0.539–1.371)
Q3	180	1.438(0.911–2.268)	1.164(0.742–1.826)	1.225(0.792–1.894)
Q4	150	0.759(0.460–1.252)	0.639(0.389–1.051)	0.684(0.422–1.111)
Q5	163	0.537(0.322–0.894)	0.508(0.307–0.841)	0.532(0.325–0.869)
P for trend		0.019	0.008	0.011
HDL-C
Q1	169	1.00(Ref)	1.00(Ref)	1.00(Ref)
Q2	162	0.637(0.400–1.015)	0.704(0.445–1.113)	0.620(0.393–0.977)
Q3	165	0.609(0.382–0.972)	0.612(0.386–0.971)	0.539(0.341–0.852)
Q4	165	0.442(0.272–0.719)	0.475(0.294–0.770)	0.385(0.238–0.622)
Q5	161	0.337(0.203–0.560)	0.383(0.231–0.633)	0.308(0.187–0.509)
P for trend		<0.001	<0.001	<0.001

Notes: Model 1: adjusted for ages, nationality, marital status, educational level, residential type. Model 2: adjusted for smoking, drinking, physical activity. Model 3: adjusted for BMI, Glucose and DBP.

Figure 2 Restrictive cubic splines are used to visualize and analyze the correlation between ADL disability and LDL-C, TG and HDL-C levels.

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