Zhou Zhike, Liang Yifan, Zhang Xiaoqian, Xu Junjie, Lin Jueying, Zhang Rongwei, Kang Kexin, Liu Chang, Zhao Chuansheng, Zhao Mei
Department of Geriatrics, The First Affiliated Hospital, China Medical University, Shenyang, China.
Department of Neurology, The First Affiliated Hospital, China Medical University, Shenyang, China.
Front Aging Neurosci. 2020 Jan 30;12:5. doi: 10.3389/fnagi.2020.00005. eCollection 2020.
To assess the association between low-density lipoprotein cholesterol (LDL-c) and risk of Alzheimer's disease (AD). Embase, Pubmed, and Web of Science were searched until June 2019. Standard mean difference (SMD) with 95% confidence intervals (CI) was estimated using random-effects models. Our meta-analysis of 26 studies revealed higher levels of LDL-c in AD than that of non-dementia controls (SMD = 0.35, 95% CI 0.12-0.58, < 0.01). The meta-regression analysis on confounders showed that age ( < 0.01, Adj -squared = 92.41%) and cardiovascular disease ( = 0.01, Adj -squared = 85.21%), but not the body mass index, education, smoking, hypertension and diabetes mellitus, exerted an impact on the relationship between LDL-c and risk of ICH. Further subgroup analysis of age showed LDL-c levels in AD patients aged 60-70 were higher than that of non-dementia (60 ≤ age < 70: SMD = 0.80, 95% CI 0.23-1.37, < 0.01); but no association between the SMD of AD in LDL-c and age over 70 was noted across the studies (70 ≤ age < 77: SMD = -0.02, 95% CI -0.390.34, = 9.0; 77 ≤ age < 80: SMD = 0.15, 95% CI -0.170.47, = 0.35; ≥80: SMD = 0.53, 95% CI -0.041.11, = 0.07). The concentrations of LDL-c during the quintile interval of 34 were positively associated with AD (121 ≤ concentration < 137: SMD = 0.98, 95% CI 0.131.82, = 0.02; ≥137: SMD = 0.62, 95% CI 0.181.06, < 0.01); whereas there was no correlation between AD and LDL-c within the quintile interval of 12 (103.9 ≤ concentration < 112: SMD = 0.08, 95% CI -0.200.35, = 0.59; 112 ≤ concentration < 121: SMD = -0.26, 95% CI -0.58~0.06, = 0.11). Elevated concentration of LDL-c (>121 mg/dl) may be a potential risk factor for AD. This association is strong in patients aged 60-70 years, but vanishes with advancing age.
评估低密度脂蛋白胆固醇（LDL-c）与阿尔茨海默病（AD）风险之间的关联。检索了截至2019年6月的Embase、Pubmed和Web of Science数据库。使用随机效应模型估计了具有95%置信区间（CI）的标准平均差（SMD）。我们对26项研究的荟萃分析显示，AD患者的LDL-c水平高于非痴呆对照组（SMD = 0.35，95%CI 0.12 - 0.58，P < 0.01）。对混杂因素的元回归分析表明，年龄（P < 0.01，调整后R平方 = 92.41%）和心血管疾病（P = 0.01，调整后R平方 = 85.21%），而非体重指数、教育程度、吸烟、高血压和糖尿病，对LDL-c与脑出血风险之间的关系产生影响。年龄的进一步亚组分析显示，60 - 70岁AD患者的LDL-c水平高于非痴呆患者（60≤年龄<70：SMD = 0.80，95%CI 0.23 - 1.37，P < 0.01）；但在各项研究中，未发现70岁以上AD患者LDL-c的SMD与年龄之间存在关联（70≤年龄<77：SMD = -0.02，95%CI -0.390.34，P = 9.0；77≤年龄<80：SMD = 0.15，95%CI -0.170.47，P = 0.35；≥80：SMD = 0.53，95%CI -0.041.11，P = 0.07）。在3至4五分位数区间内的LDL-c浓度与AD呈正相关（121≤浓度<137：SMD = 0.98，95%CI 0.131.82，P = 0.02；≥137：SMD = 0.62，95%CI 0.181.06，P < 0.01）；而在1至2五分位数区间内，AD与LDL-c之间无相关性（103.9≤浓度<112：SMD = 0.08，95%CI -0.200.35，P = 0.59；112≤浓度<
