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高血脂症发病年龄与随后痴呆风险的相关性研究。

Association between Age at Diagnosis of Hyperlipidemia and Subsequent Risk of Dementia.

机构信息

School of Nursing, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.

Peking University Clinical Research Institute, Peking University First Hospital, Beijing, China.

出版信息

J Am Med Dir Assoc. 2024 Jul;25(7):104960. doi: 10.1016/j.jamda.2024.01.029. Epub 2024 Mar 4.

Abstract

OBJECTIVES

The relationship between age at diagnosis of hyperlipidemia and dementia remains unclear. We examined whether younger age at diagnosis of hyperlipidemia is associated with higher risk of subsequent dementia.

DESIGN

A longitudinal population-based study with a median follow-up of 12.8 years.

SETTING AND PARTICIPANTS

We analyzed data on a sample of 489,642 participants in the United Kingdom.

METHODS

This study was based on the UK Biobank. Information on hyperlipidemia and dementia diagnoses was collected at baseline (2006-2010) and follow-up [median = 12.8 years, interquartile range (IQR): 12.1-13.6 years]. Propensity score matching method and Cox proportional hazards models were used to assess the association between age at diagnosis of hyperlipidemia and dementia.

RESULTS

Among 489,642 participants (mean age: 56.9 ± 8.1 years; female: 54.7%), 114,112 (23.3%) were diagnosed with hyperlipidemia. Younger age at diagnosis of hyperlipidemia (per 10-year decrease) was significantly associated with higher risks of all-cause dementia [hazard ratio (HR), 1.12; 95% CI, 1.07-1.18; P < .001], Alzheimer's disease (AD) (HR, 1.22; 95% CI, 1.14-1.31; P < .001), and vascular dementia (VD) (HR, 1.16; 95% CI, 1.05-1.27; P < .001). After propensity score matching, patients with hyperlipidemia diagnosed before 50 years had the highest HR for all-cause dementia (HR, 1.46; 95% CI, 1.15-1.86; P = .002), followed by patients diagnosed between 50 and 69 years (HR, 1.21; 95% CI, 1.12-1.31; P < .001) and then patients diagnosed aged 70 years and older (HR, 0.94; 95% CI, 0.84-1.06; P = .302). Similar results were observed for AD and VD.

CONCLUSIONS AND IMPLICATIONS

A dose-response relationship between age at hyperlipidemia diagnosis and risk of dementia was found in the longitudinal cohort study, with younger age at diagnosis of hyperlipidemia being associated with higher subsequent risk.

摘要

目的

高脂血症发病年龄与痴呆之间的关系仍不清楚。我们研究了高脂血症的发病年龄是否与随后痴呆的风险增加有关。

设计

一项具有中位随访时间为 12.8 年的基于人群的纵向研究。

地点和参与者

我们分析了英国生物银行的 489642 名参与者的数据。

方法

本研究基于英国生物库。在基线(2006-2010 年)和随访时(中位随访时间为 12.8 年,四分位间距 [IQR]:12.1-13.6 年)收集了高脂血症和痴呆诊断的信息。采用倾向评分匹配法和 Cox 比例风险模型评估高脂血症发病年龄与痴呆之间的关系。

结果

在 489642 名参与者(平均年龄:56.9 ± 8.1 岁;女性:54.7%)中,有 114112 人(23.3%)被诊断患有高脂血症。高脂血症的发病年龄越年轻(每减少 10 岁),全因痴呆的风险越高[风险比(HR),1.12;95%置信区间(CI),1.07-1.18;P<0.001]、阿尔茨海默病(AD)(HR,1.22;95%CI,1.14-1.31;P<0.001)和血管性痴呆(VD)(HR,1.16;95%CI,1.05-1.27;P<0.001)。在进行倾向评分匹配后,50 岁之前被诊断为高脂血症的患者发生全因痴呆的风险最高(HR,1.46;95%CI,1.15-1.86;P=0.002),其次是 50-69 岁之间被诊断为高脂血症的患者(HR,1.21;95%CI,1.12-1.31;P<0.001),然后是 70 岁及以上被诊断为高脂血症的患者(HR,0.94;95%CI,0.84-1.06;P=0.302)。AD 和 VD 也观察到了类似的结果。

结论和意义

在这项纵向队列研究中,发现高脂血症发病年龄与痴呆风险之间存在剂量-反应关系,发病年龄越小,随后的风险越高。

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