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Original Article
- Age-related trajectories of blood lipids and lipoproteins by sex, region, and waist circumference changes in Korea: a longitudinal cohort study
- Mi Kyoung Son, Nam-Kyoo Lim, Joong-Yeon Lim, Hyun-Young Park
- Epidemiol Health. 2025;47:e2025066. Published online December 9, 2025
- DOI: https://doi.org/10.4178/epih.e2025066
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AbstractOBJECTIVES
This study aimed to evaluate the longitudinal trajectories of lipid and lipoprotein levels with aging according to sex and changes in waist circumference (ΔWC) from midlife to late life.METHODSWe included 4,345 male and 4,804 female participants aged 40-69 years at baseline from the Korean Genome and Epidemiology Study (2001-2018). The annual ΔWC was estimated using linear regression. Marginal models were fitted using mixed-effects regression.RESULTSThe trajectories of total cholesterol (TC), non-high-density lipoprotein cholesterol (non-HDL-C), and low-density lipoprotein cholesterol (LDL-C) levels displayed an increasing trend until the 60s age range in females (approximately 10-15 mg/dL) and the late 40s in males (approximately 3-5 mg/dL), with a subsequent decline. In females, HDL-C levels increased until the early 50s, declined thereafter, and rose again from the 70s onward, with a more pronounced rise in urban than in rural areas, while remaining relatively stable in males. Triglyceride (TG) levels decreased with advancing age in males, whereas in females they increased up to the age of 70 years, followed by a decrease. Females exhibited greater increases in TC, non-HDL-C, HDL-C, LDL-C, and TG across all ages compared with males. Both males and females with a decrease in waist circumference (WC) during follow-up showed improvements in lipid and lipoprotein profiles relative to those with stable or increased WC.CONCLUSIONSTrends in lipid and lipoprotein levels vary according to age and sex, and a decrease in WC significantly improves lipid and lipoprotein profiles. -
SummaryKorean summary
• 40세 이상 한국 성인을 대상으로 한 전향적 코호트에서 지질 및 지단백 궤적은 연령, 성별, 지역에 따라 상이한 양상을 보였으며, 총콜레스테롤, 저밀도 지단백 콜레스테롤, 비고밀도 지단백 콜레스테롤 수준은 농촌 지역에 비해 도시 지역에서 전반적으로 불리한 양상으로 나타났다. • 여성은 남성에 비해 5개 지질 및 지단백 지표 전반에서 더 큰 증가 폭을 보였으며, 여성의 고밀도 지단백 콜레스테롤은 폐경 이행기를 전후로 감소한 이후 다시 증가하였다. • 허리둘레의 지속적인 감소는 지질 및 지단백 프로파일의 개선과 관련되었으며, 이러한 결과는 복부비만 관리에 있어 연령과 성별을 고려한 맞춤형 접근의 중요성을 시사한다.Key Message
• In a prospective cohort analysis of Korean adults aged 40 years and older, lipid and lipoprotein trajectories varied by age, sex, and region, with total cholesterol, low- density llipoprotein cholesterol, and non-high-density lipoprotein cholesterol levels generally showing less favorable patterns in urban than rural areas. • Females exhibited greater increases across all five lipid and lipoprotein measures than males, while high-density cholesterol levels in females declined around the menopausal transition and increased again in later life. • A sustained decrease in waist circumference was associated with improvements in lipid and lipoprotein profiles, highlighting the importance of age- and sex-specific approaches to abdominal obesity management.
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