Fracture Risk Up With Higher Levels of HDL-C in Healthy Seniors

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Similar results seen when analyses stratified by sex; non-HDL-C levels not associated with fractures

By Elana Gotkine HealthDay Reporter

THURSDAY, Jan. 19, 2023 (HealthDay News) — For older adults, higher levels of high-density lipoprotein cholesterol (HDL-C) are associated with increased fracture risk, according to a study published online Jan. 18 in JAMA Cardiology.

Sultana Monira Hussain, M.B.B.S., Ph.D., from Monash University in Melbourne, Australia, and colleagues examined whether higher HDL-C levels are predictive of increased fracture risk in older adults in a post hoc analysis of data from the Aspirin in Reducing Events in the Elderly (ASPREE) clinical trial and the ASPREE-Fracture substudy.

Overall, 1,659 of the 16,262 participants with a plasma HDL-C measurement at baseline experienced at least one fracture during a median of 4.0 years. The researchers found that each 1 standard deviation increment in HDL-C level was associated with an increased risk for fracture in a fully adjusted model (hazard ratio, 1.14). When analyses were stratified by sex, the results were similar. These associations persisted when the analyses included only minimal trauma fractures; participants not taking osteoporosis medications; participants who were never smokers and did not drink alcohol; participants who walked outside for less than 30 minutes per day and did not participate in moderate/vigorous physical activity; and only statin use. Non-HDL-C levels were not associated with fractures.

“These findings highlight another potential concern with high HDL-C levels and another likely adverse effect of the drugs that substantially increases plasma HDL-C levels,” the authors write. “Further research is needed to determine the pathophysiological explanation for these findings.”

Two authors disclosed financial ties to the pharmaceutical industry.

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