Someone explain to me why so many centenarians from NHANES have FH? They should have died 70 years ago without a statinpic.twitter.com/n0ZmjSDTL8
Epidemiologist. Writer (Guardian, Observer etc). "Well known research trouble-maker". PhDing at @UoW Host of @senscipod Email gidmk.healthnerd@gmail.com he/him
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Someone explain to me why so many centenarians from NHANES have FH? They should have died 70 years ago without a statinpic.twitter.com/n0ZmjSDTL8
I'm curious what you'd say, @ethanjweiss. The "reverse causality" hypothesis doesn't really work in this case, as these are all very elevated LDL-C levels 16 years prior... and likely not a coincidence they match up with high HDL and low TG, no?
The obvious answer would be survivorship bias of some description. People who survive to 100 are weird in many ways!
... and yet, they are surprising near uniform in the triad thus far. I’m excited to see upcoming centenarians and how much/little we see this phenomenon continue.
I want to see how common the triad is in centenarians (High LDL, high HDL, low TG) when tested a decade and a half earlier.
But you'd still be seeing survivorship bias there. You're seeing the people who, for whatever reason, can be in that state and live for a long time. Doesn't say much about the rest of the population imo
Survivorship bias makes sense if we were testing these 100/101 year olds a year earlier. But I'm emphasizing these markers (high LDL, high HDL, low TG) were taken 15 years earlier when they were age 84/85. The other 118 of those 84/85 taken at that time are not centenarians.
Well, the sample size is still tiny. But even so, the case-control you're suggesting would definitely be open to survivorship bias, because you're selecting people who have lived a very long time. More appropriate to start at, say 50, and see how many make it to 100
You could do this with a retrospective cohort design rather than the case-control you're thinking of. This tells you how many people have the triad and die vs the number that survive to 100
Would love to. If you've followed me for a while, I know just how much I'd love to get ahold of more raw datasets to test this out directly. Obviously, Framingham Offspring would be especially useful given followups, etc.
Yeh we should all move to Scandinavia it's the mecca of long-term linked data. Would be amazing to work with the datasets they have in Sweden and Denmark
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