Liu Huamin, Zou Lianwu, Zhou Rui, Zhang Minyi, Gu Shanyuan, Zheng Jiazhen, Hukportie Daniel Nyarko, Wu Keyi, Huang Zhiwei, Yuan Zelin, Wu Xianbo
Department of Epidemiology, School of Public Health, Southern Medical University, Guangzhou, China.
Department of Psychiatry, Baiyun Psychiatric Rehabilitation Hospital, Guangzhou, China.
Front Aging Neurosci. 2021 Jun 17;13:691423. doi: 10.3389/fnagi.2021.691423. eCollection 2021.
Higher visit-to-visit cholesterol has been associated with cognitive decline. However, the association between long-term increase or decrease in cholesterol and cognitive decline remains unclear. A total of 4,915 participants aged ≥45 years with normal cognition in baseline were included. The participants were divided into four groups, namely low-low, low-high, high-low, and high-high, according to the diagnostic thresholds of total cholesterol (TC), non-high-density lipoprotein cholesterol (NHDL-C), low-density lipoprotein cholesterol, and high-density lipoprotein cholesterol (HDL-C) after 4 years of follow-up. Cognitive function was assessed by episodic memory and mental intactness. Binary logistic regression was used to analyse the association of cholesterol variation with cognitive decline. Among the participants, 979 (19.9%) experienced global cognitive decline. The odds ratio (OR) of global cognitive and memory function decline were remarkably lower in participants in the low-high NHDL-C group than those in the low-low group [OR and 95% confidence interval (CI): 0.50 [0.26-0.95] for global cognitive decline, 0.45 [0.25-0.82] for memory function decline]. The lower OR was also significant in females (OR [95% CI]: 0.38 [0.17-0.87] for global cognitive decline; 0.44 [0.19-0.97] for memory function decline) and participants without cardiovascular disease (OR [95% CI]: 0.31 [0.11-0.87] for global cognitive decline; 0.34 [0.14-0.83] for memory function decline). The increases in other cholesterol were also negatively associated with the risk of cognitive decline although not significantly. A longitudinal increase in NHDL-C may be protective for cognition in females or individuals without cardiovascular disease.
就诊时胆固醇水平较高与认知功能下降有关。然而,胆固醇水平的长期升高或降低与认知功能下降之间的关联仍不清楚。本研究共纳入4915名基线认知功能正常、年龄≥45岁的参与者。根据随访4年后总胆固醇(TC)、非高密度脂蛋白胆固醇(NHDL-C)、低密度脂蛋白胆固醇和高密度脂蛋白胆固醇(HDL-C)的诊断阈值,将参与者分为四组,即低-低、低-高、高-低和高-高组。通过情景记忆和精神完整性评估认知功能。采用二元逻辑回归分析胆固醇变化与认知功能下降的关联。在参与者中,979人(19.9%)出现了整体认知功能下降。低-高NHDL-C组参与者的整体认知和记忆功能下降的比值比(OR)显著低于低-低组[整体认知功能下降的OR及95%置信区间(CI):0.50[0.26-0.95];记忆功能下降的OR及95%CI:0.45[0.25-0.82]]。较低的OR在女性中也具有显著性(整体认知功能下降的OR[95%CI]:0.38[0.17-0.87];记忆功能下降的OR[95%CI]:0.44[0.19-0.97])以及无心血管疾病的参与者中也具有显著性(整体认知功能下降的OR[95%CI]:0.31[0.11-0.87];记忆功能下降的OR[95%CI]:0.34[0.14-0.83])。其他胆固醇水平的升高与认知功能下降风险也呈负相关,尽管不显著。NHDL-C的纵向升高可能对女性或无心血管疾病个体的认知具有保护作用。