High-Density Lipoprotein Cholesterol Trajectories and Lung Function Decline: A Prospective Cohort Study

Abstract

Purpose: Cholesterol regulation is essential to maintain pulmonary homeostasis. Studies suggest that increased high-density lipoprotein cholesterol (HDL-C) levels correlate with better lung function. However, the longitudinal association of HDL-C with lung function remains unknown. We aimed to analyze the long-term correlation of HDL-C with lung function decline in a population-based cohort study.

Methods: We included 7,652 participants from a prospective community-based cohort study in South Korea. Participants were categorized into five trajectory groups based on repeated HDL-C measurements. Generalized linear mixed models with random intercepts and slopes were used to examine the longitudinal relationship between HDL-C levels and lung function decline within these groups.

Results: In the five HDL-C trajectory group analyses, the very low HDL-C trajectory group (Group 1) showed faster declines in forced vital capacity (FVC) (-3.1 mL/year) and forced expiratory volume in one second (FEV1) (-3.1 mL/year) than the middle HDL-C group (Group 3, the reference group) did. The low HDL-C trajectory group (Group 2) also exhibited faster FVC (-1.5 mL/year) and FEV1 (-1.7 mL/year) declines than the middle HDL-C group; however, the estimated difference was smaller than that in Group 1. Faster lung function decline in the low HDL-C trajectory group was consistently observed even when the population was analyzed using three- or four-HDL-C trajectory groups instead of five.

Conclusion: Participants in the low HDL-C trajectory groups experienced a more rapid lung function decline over time than the reference groups, suggesting a negative longitudinal association between HDL-C and lung function decline.