Objective: To evaluate the association of serum cholesterol levels over time with the risk of Parkinson’s disease (PD); among statin-free individuals.

Background: High levels of serum cholesterol are well-established risk factors in developing coronary artery disease and stroke. Whether cholesterol levels play a similar role in PD remains elusive.

Methods:  A Population-based large-scale cohort study; based on medical data of Maccabi Healthcare Services, a large Israeli healthcare organization that serves 25% of the population. The cohort included statin-free individuals with repeated cholesterol profile measures during a 13-year period (1999-2012).  Mean annual levels for serum total, low and high density lipoprotein cholesterol (TC, LDL-C, and HDL-C, respectively) were included in a chronological order for each individual. PD incidence was assessed using a validated anti-Parkinsonian drugs (APD) tracing approach, considering APD purchase profiles, first purchase age, purchase  density and length of follow up period. Cox proportional hazard models with time dependent covariates were applied to estimate PD risk (HR) associated with cholesterol levels over time. Analysis was stratified by sex and age-groups at 1^st blood test.

Results: The cohort included 261,638 individuals (aged 40-79 at the first blood test, 42.7% men) with 2,093,104 repeated measures. During a mean follow up of 7.9 (±3.6) years, 764 (0.3% among 40-64 years; 3.3% among 65+ years) incident PD cases were detected. Among men, middle and upper tertiles of TC mg/dl (middle: 180-209; upper ≥ 210) and LDL-C (middle: 110-139; upper ≥140), as compared to the lowest tertiles, were significantly associated with a lower PD risk, in most age groups. Age pooled HRs (95%CIs) were 0.91 (0.83-1.04) and 0.86 (0.77-0.96) for TC and 0.90 (0.82-0.99) and 0.86 (0.76-0.97) for LDL-C, respectively. Among women, insignificant associations were found between TC or LDL-C levels and PD risk. For HDL-C, null results were found for PD risk among both sexes. 

Conclusions: Higher serum TC and LDL-C levels among men over time indicated a decreased PD risk. The potential role of serum cholesterol affecting PD etiology or as a marker of incipient PD warrants further investigation.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/serum-cholesterol-levels-over-time-and-risk-of-parkinsons-disease/