Paul Saladino· MD
the associations with longevity that come with higher LDL levels in many cohorts?
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the associations with longevity that come with higher LDL levels in many cohorts?
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even just LDL naked by itself okay so yeah okay great yeah you you had lower all cause mortality the higher it was above age 50
I also further did it at ten years and at ten years and this actually I haven't revealed in any podcast or presentation of a bomb but even at ten years you had the greatest survival rate for those people with an LTL of 200 or higher when any by ten years you're excluding people who died within ten years in ten years of having their lipid panel taken so basically rate of death excluding everybody who died within ten years of having their lipids taken
so that's why I went a step further and also did some further and haynes analysis where i actually excluded everybody who had died within five years of when they had their lipid panel taken so you tried to get rid of people who might have been sick close to the time that their panel was too strong there's a large body of literature that suggests that in the elderly population a higher LDL is protective right that's correct and people have criticized that body of literature for this reason exactly saying that hey when you're getting older a lower LDL this is reverse causality they're the people with low LDL are dying more not because LDL is protective or LDL is not harmful but because the people with low LDL you're seeing cancers but many of the researchers in that space have gone and done the same sort of thing they've shown that the Association holds even when they remove people who may have died I think even within one or two years of the study data and this is in the light in light and birth cohort and a couple of other things that I know nadir he has talked about you're saying for years they excluded siobhan is saying for years they excluded people so it's interesting to see that this has been looked at and this criticism has been addressed and that at least in the elderly population it still holds true that the people with the highest LDL have the best outcomes but yeah the same thing in this because we're not even necessarily looking at elderly people here but you excluded people who died within five years correct but I have also looked specifically at elderly people right right yeah in fact one of the because I have the data in front of me right now one of the more fascinating ones that I saw was I excluded for five years we still saw a greater longevity with those people who had a high LDL relative to lower LDL so the patterns stayed the same when you exclude those people that might have died with in fact they died within five years
so you're saying when you excluded people who died within ten years the correlation still held the people what the highest LDL had the best all cause mortality yes the lowest all cause yeah the most favorable the lowest yes they were still kicking around they were still surfing right now
there are many many elderly studies in which people who are 80 85 Plus who have elevated LDL cholesterol tend to live the longest
looked at that I think it's just cohort and cohorts of people that are living a long amount of time that are just they they do see that the the the elevated level of LDL is often there and so there's the the the inference is there's some benefit there
in many of the most longli people there are elevated levels of LDL and so people have argued that okay there are these people with low LDL which is what happens when you get a cancer or something you know you get a Cancer and your LDL levels drop I've actually seen this clinically right before someone dies of a cancer sometimes the lipoproteins go very low and so they'd say oh that that data is skewed by the fact that low LDL and cancer and so then an elevated LDL might look good for longevity but there are many studies these are all associational because there's no Interventional studies in humans where we can actually give them lipids we never give someone LDL in today's world but it's very clear that in these longlived cohorts there are actually higher levels of LDL
If you want to live a long time, LDL cholesterol, the cholesterol you've been told is bad for you, is protective, provided that your glucose is low and that you are insulin sensitive.