Department of Epidemiology and Biostatistics, School of Public Health, Peking University, 38 Xueyuan Road, Haidian District, Beijing, 100191, China.
Department of Endocrinology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, 324 Jing 5 road, Huaiyin District, Jinan, 250021, China.
Alzheimers Res Ther. 2020 Dec 7;12(1):164. doi: 10.1186/s13195-020-00731-1.
Studies regarding the lipid-cognition relationship have increasingly gained popularity but have generated much mixed results. To date, few studies have focused on the difference between sexes.
This study included 6792 Chinese adults aged over 45 years (women, 48.56%; mean age, 57.28 years), who were free of severe conditions known to affect cognitive function at the baseline (2011). Blood concentrations of total cholesterol (TC), high-density lipoprotein cholesterol (HDL-c), low-density lipoprotein cholesterol (LDL-c), and triglycerides (TG) were assessed at baseline, and both continuous and categorical values were used in final analyses. Global cognitive functions were assessed by the word recall test and the mental status test in 2011, 2013, and 2015, respectively. We graded participants into three groups according to the cognitive change slopes: no decline (≥ 0), moderate decline (median to 0), and severe decline (< median). Sex-specific associations between blood lipids and cognitive decline were analyzed using ordinal logistic models, adjusting for sociodemographic information, lifestyle behaviors, and health status.
Higher baseline TC and LDL-C concentrations exhibited no significant association with 5-year cognitive decline in men but were significantly associated with greater 5-year cognitive decline in women [odds ratio (OR) 1.026, 95% confidence interval (CI) 1.003, 1.050; OR 1.026, CI 1.002, 1.051, respectively]. For higher serum HDL-c levels, a significantly protective effect on cognition was observed in men, but a slightly adverse effect was found in women (not significant after Bonferroni correction). TG presented almost no effect on later cognition in either sex.
Different associations between sexes were observed for the lipid-cognition relationship, and maintaining serum cholesterol levels at an appropriate range may have a positive effect on cognitive health.
关于血脂与认知关系的研究越来越受到关注，但结果却大相径庭。迄今为止，很少有研究关注性别差异。
本研究纳入了 6792 名年龄在 45 岁以上的中国成年人（女性占 48.56%，平均年龄为 57.28 岁），他们在基线时没有严重影响认知功能的疾病（2011 年）。在基线时评估了总胆固醇（TC）、高密度脂蛋白胆固醇（HDL-c）、低密度脂蛋白胆固醇（LDL-c）和甘油三酯（TG）的血浓度，并在最终分析中使用了连续和分类值。在 2011 年、2013 年和 2015 年，通过单词回忆测试和精神状态测试评估了整体认知功能。我们根据认知变化斜率将参与者分为三组：无下降（≥0）、中度下降（中位数至 0）和严重下降（<中位数）。使用有序逻辑模型分析了血脂与认知下降之间的性别特异性关联，并调整了社会人口统计学信息、生活方式行为和健康状况。
较高的基线 TC 和 LDL-C 浓度与男性 5 年认知下降无关，但与女性 5 年认知下降显著相关[比值比（OR）1.026，95%置信区间（CI）1.003，1.050；OR 1.026，CI 1.002，1.051]。对于较高的血清 HDL-c 水平，男性认知功能有明显的保护作用，但女性则有轻微的不利影响（经 Bonferroni 校正后无统计学意义）。TG 对两性的后期认知几乎没有影响。
性别之间观察到了血脂与认知关系的不同关联，保持血清胆固醇水平在适当范围内可能对认知健康有积极影响。
