Gong Jessica, Harris Katie, Peters Sanne A E, Woodward Mark
The George Institute for Global Health, University of New South Wales, Level 5, 1 King St, Newtown, NSW 2042, Australia.
The George Institute for Global Health, Central Working - Fourth Floor, Translation and Innovation Hub, Imperial College London, 84 Wood Lane, London W12 0BZ, United Kingdom.
EClinicalMedicine. 2022 Oct 6;54:101695. doi: 10.1016/j.eclinm.2022.101695. eCollection 2022 Dec.
Serum lipid traits are associated with cardiovascular disease, but uncertainty remains regarding their associations with dementia.
From 2006 to 2010, 254,575 women and 214,891 men were included from the UK Biobank. Cox regression estimated overall and sex-specific hazard ratios (HRs) for apolipoprotein A (ApoA), apolipoprotein B (ApoB), HDL, LDL, total cholesterol, triglycerides, lipoprotein A, and various lipid ratios, by quarters and standard deviation (SD) higher, associated with all-cause dementia, Alzheimer's disease (AD) and vascular dementia (VaD). Subgroup analyses by age and social deprivation were conducted.
Over 11·8 years (median), 3734 all-cause dementia (1,716 women), 1231 AD and 929 VaD were recorded. Compared to respective lowest quarters, highest quarter of ApoA was associated with lower dementia risk (HR, [95% confidence interval (95% CI)]: 0·77 [0·69, 0·86]) while the highest quarter of ApoB was associated with greater risk (HR, 1·12 [1·01, 1·24]). Higher HDL/ApoA and ApoB/ApoA, were associated with greater risk of dementia (HR, 1·12 [1·00, 1·25], per standard deviation (SD), 1.23 [1·11, 1·37], per SD, respectively), LDL/ApoB was inversely associated (HR, 0·85 [0·76, 0·94], per SD. Higher triglycerides was associated with higher dementia risk in <60 years, but the inverse was observed for ≥60 years. Similar associations were observed for VaD and AD.
Apolipoproteins, and their ratios, were associated with the risk of dementia. It may be prudent to consider apolipoproteins, along with circulating cholesterol, when assessing dementia risk.
University of New South Wales, UK Medical Research Council, and the Australian National Health and Medical Research Council.
血清脂质特征与心血管疾病相关，但它们与痴呆症的关联仍存在不确定性。
2006年至2010年，英国生物银行纳入了254,575名女性和214,891名男性。Cox回归按四分位数和标准差升高估计了载脂蛋白A（ApoA）、载脂蛋白B（ApoB）、高密度脂蛋白（HDL）、低密度脂蛋白（LDL）、总胆固醇、甘油三酯、脂蛋白A以及各种脂质比率与全因痴呆、阿尔茨海默病（AD）和血管性痴呆（VaD）相关的总体和性别特异性风险比（HRs）。进行了按年龄和社会剥夺程度的亚组分析。
在11.8年（中位数）期间，记录了3734例全因痴呆（1716例女性）、1231例AD和929例VaD。与各自最低四分位数相比，ApoA最高四分位数与较低的痴呆风险相关（HR，[95%置信区间（95%CI）]：0.77[0.69，0.86]），而ApoB最高四分位数与较高风险相关（HR，1.12[1.01，1.24]）。较高的HDL/ApoA和ApoB/ApoA与较高的痴呆风险相关（HR，分别为每标准差（SD）1.12[1.00，1.25]和1.23[1.11，1.37]），LDL/ApoB呈负相关（HR，每SD 0.85[0.76，0.94]））。较高的甘油三酯在<60岁时与较高的痴呆风险相关，但在≥60岁时观察到相反情况。VaD和AD也观察到类似的关联。
载脂蛋白及其比率与痴呆风险相关。在评估痴呆风险时，除了循环胆固醇外，考虑载脂蛋白可能是谨慎的做法。
新南威尔士大学、英国医学研究理事会和澳大利亚国家卫生与医学研究理事会。
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