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Professori Schwabin käsitys on se, että nälkä vain tulee ja menee täysin riippumatta siitä, mitä ihminen on syönyt ja juonut.

It seems that, in the matter of diet, public health experts cannot be relied on to investigate the possibility that they have made a mistake. They control the narrative so that a (questionable) historical change in cholesterol within a 5-year period is considered evidence that a lifetime intervention is valuable, yet a nation-wide worsening of hard endpoints after that intervention can be ignored. Certainly the diabetes disaster in Mauritius can have had many causes, but the possibility that the soya bean oil intervention was one of them has not even registered in the medical literature over a 30 year period, let alone been tested.

Korkea LDL-kolesterolin pitoisuus lisää sydän- ja verisuonisairauksien sairastumisriskiä myös yli 70-vuotiailla. Tämä ilmenee kahdesta tutkimuksesta, jotka on julkaistu Lancet-lehdessä marraskuussa.

Suuri LDL-pitoisuus on tiedetty sydäninfarktin ja aivohalvauksen riskitekijäksi ennenkin, mutta sen yhteyttä yli 70-vuotiaiden sairastumiseen on tätä ennen tutkittu vain vähän.

Toisessa Lancetin julkaisemassa tutkimuksessa seurattiin yli 90 000 tanskalaista 20–100 -vuotiasta henkilöä keskimäärin kahdeksan vuoden ajan. Tutkimuksen alkaessa heillä ei ollut sydän- ja verisuonitauteja tai diabetesta, eivätkä he olleet statiinilääkityksellä.

Tulokset osoittivat suuren veren LDL-pitoisuuden liittyvän suurempaan sydäninfarktin ja ateroskleroottisen sydän- ja verisuonitaudin riskiin, oli ikäryhmä mikä tahansa.

Varsinkin 70–100-vuotiailla riskit vain suurenivat LDL-pitoisuudenkin kasvaessa.

Lääkitys vähensi ikääntyneiden oireita
Toinen tutkimus tehtiin Yhdysvalloissa ja valtaosa sen tekijöistä tuli Harvardin yliopistosta. Siinä tarkasteltiin kolesterolilääkitysten vaikutuksia yhdistämällä ja analysoimalla kuuden satunnaistetun tutkimuksen sekä 21 000 yli 75-vuotiaan potilaan tietoja.

Analyysin mukaan LDL-kolesterolin vähentäminen statiineilla tai muilla kolesterolilääkkeillä vähentää myös yli 75-vuotiaiden sydänoireita.

Tutkimuksista uutisoineen uutispalvelu Duodecimin mukaan ne vahvistavat yhdessä näyttöä siitä, että LDL-kolesteroli on yhteydessä myös iäkkäiden sydän- ja verisuonisairauksiin.

Lisäksi tutkimukset osoittavat, että kolesterolilääkityksestä on hyötyä, oli lääkkeiden käyttäjä sitten minkä ikäinen tahansa.

Parhaiten kolesterolilääkitys kuitenkin tehoaa, jos se aloitetaan varhain...

Mikä on jäännöskolesteroli?

Dear Editor

In their study of the general population in Copenhagen, Johannesen et al. concluded that high levels of LDL-C were associated with an increased risk of all-cause mortality. They claim that “no previous study has examined the concentration of LDL-C associated with the lowest risk of all-cause mortality in a general population cohort.” [1] The fact is that the association between LDL-C and longevity in community-dwelling people has been examined in Spain, [2] Italy, [3,4] the USA, [5] Finland, [6] Korea [7] and China. [8] In two of these studies, the association between LDL-C and mortality was inverse; [2,3] in four of the others [4-7] it was nonsignificant. In an Iranian study, only CVD mortality was reported, and it was inversely associated with LDL-C. [9]

In the Chinese study, [8] which included more than five million statin-naïve young people, high LDL-C was associated with mortality, but those with the highest LDL-C who died, included only 0.076 percent of the population. Most likely they may have had familial hypercholesterolemia (FH), but that does not mean that the cause of death was high LDL-C. There is much evidence that premature mortality among subjects with FH is increased coagulation factors which a few of them have inherited as well. [10]

As the authors mention, several studies of elderly people with high cholesterol have shown that after the age of retirement, they live just as long or longer than elderly people with normal or low cholesterol. These studies are rejected by Johannesen et al. because they consider them conflicting and historical. However, they are in accord with the result of a review of 19 follow-up studies of elderly people, [11] and at least seven other studies from all over the world published during the last four years. [3-6,12-14] In the review, [11] CVD mortality was reported as well in seven of the 19 studies, and it was unassociated with LDL-C in six of them. Furthermore, eight more follow-up studies including young and middle-aged people or patients have found that high LDL-C is unassociated or inversely associate with mortality. [15-22]

In their review, Johannesen et al. claim that a recent study of young Korean people without statin-treatment has shown a U-shaped association between LDL-C and mortality. [25] This study of two cohorts included 347,971 and 182,943 individuals, respectively. In the first cohort, the association was U-shaped, but it was only statistically significant for the association between low LDL-C and mortality. In the other cohort, the association was also U-shaped, but not with statistical significance.

Johannesen et al. suggest that the association between low levels of LDL-C and an increased risk of all-cause mortality is explained by reverse causation. However, there is much evidence that low cholesterol predisposes both to infectious diseases [23] and to cancer. [24]

As CVD is the most common cause of death in most countries, these follow-up studies contradict the idea that high LDL-C causes CVD; an idea which is contradicted by many other types of studies as well. [25]