Longevity--the ultimate genetic limitation
A link to longevity: Cholesterol-bearing molecules
Mary Duenwald/NYTIMES
Wednesday, October 15, 2003
Scientists trying to figure out why only one person in 10,000 lives to be 100 have found an important clue in the blood.
Centenarians, a new study shows, tend to have larger than average cholesterol-carrying molecules.
The study, published Wednesday in The Journal of the American Medical Association, adds to an emerging collection of evidence suggesting that the size of lipoproteins, both good and bad, may play a significant role in heart disease and diabetes and consequently in longevity.
"Large particle size seems to give people an extra 20 years of life, with very little disability to go along with it," said Dr. Nir Barzilai, who directed the study at Albert Einstein College of Medicine in New York.
Barzilai also traced large lipoproteins to a specific gene that influences lipoprotein size.
The study looked at the health characteristics of 213 centenarians and 216 of their offspring, as well as a control group of 256 people in their 60's and 70's whose parents did not live to 100.
The three groups were similar in their average total cholesterol; in their bad cholesterol, or low density lipoproteins; and in their body mass indexes, which are based on a ratio of height and weight and are used to gauge whether people are overweight. The centenarians and offspring, as would be expected, had higher levels of the good cholesterol.
But when the researchers looked at lipoprotein size, the centenarians stood out. Eighty percent of them were found to have an unusually high proportion of large particles.
Nearly half of their children also had the large particles, suggesting an even chance of inheriting the quality, Barzilai said.
Only 8 percent of the control group had the larger lipoproteins.
The researchers also found that subjects with cardiovascular problems were less likely to have large lipoproteins.
"It's no surprise that centenarians would be specially protected against cardiovascular disease," said Dr. Thomas Perls, a geriatrician at Boston Medical Center who directs a separate study of centenarians. "It's the No. 1 killer among old people, and centenarians must have some protection against it."
Another researcher, Dr. James Vaupel, director of the Max Planck Institute for Demographic Research, in Rostock, Germany, cautioned against overinterpreting the new study.
Smaller lipoprotein size "looks to be a risk factor for cardiovascular disease," Vaupel said.
"But there are many other risk factors - high blood pressure, smoking, eating a fatty diet, not getting enough exercise," he added.
In the past five years, other researchers have also found a connection between small molecules of the bad cholesterol, or LDL, and the perilous buildup of plaques in the arteries.
Small LDL particles are better at digging into blood vessel walls and creating the conditions for plaques to form, said Dr. W. Timothy Garvey, chairman of nutrition sciences at the University of Alabama at Birmingham School of Medicine, who has done some of this research. "All LDL particles are bad," Garvey said, "but the smaller ones are worse than the bigger ones."
When people who have been sedentary start getting regular exercise, their LDL particles grow bigger, Dr. William Kraus, a cardiologist at Duke University Medical Center, and his colleagues showed a year ago in a study of people 40 to 65.
"For years, scientists had known that exercise helped prevent heart disease, but we didn't know how it could be beneficial because it didn't affect cholesterol levels," Kraus said. "Now we know that exercise makes small, dense LDL particles larger and fluffier."
How size affects the operation of the good cholesterol, or high density lipoproteins, is not known. HDL carries cholesterol out of the blood vessels and into the liver, and one possibility is that the larger HDL molecules simply carry a bigger load.
But, Barzilai said, "The situation may be more complex."
Barzilai traced the larger particles to a mutation in a gene that is responsible for creating a protein known as CETP, or cholesterol ester transfer protein, which helps regulate cholesterol particle size.
He found that nearly 25 percent of the centenarians in his study carried two copies of a particular variant of the gene, which suppresses CETP activity. In the control group, only 8 percent had the same variant.
The gene may be one reason why some of the centenarians in Barzilai's study have lived to 100, even though they were overweight or had poor nutritional habits, Barzilai said.
"I hate to say it, but I think it's true," he said. "If you have this gene, you can smoke and you can be fat and you can not exercise. This sounds to me terrible."
Barzilai suspects that perhaps four or five other genes also play a role in determining lipoprotein size. He said he had already begun to zero in on a second gene that appears to be as important as the CETP gene.