Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, PR China; Beijing Municipal Key Laboratory of Clinical Epidemiology, Capital Medical University, Beijing, PR China.
Neuroscience Department, Washington University in Saint Louis, MO 63110, USA.
Arch Gerontol Geriatr. 2024 Oct;125:105503. doi: 10.1016/j.archger.2024.105503. Epub 2024 May 31.
Previous studies into relationship between high-density lipoprotein cholesterol (HDL-C) and cognitive decline were constrained to a single measurement, leaving the association between HDL-C variability and risk of cognitive decline unclear.
We identified 5930 participants from the China Health and Retirement Longitudinal Study (CHARLS) who were devoid for stroke, dementia, and memory-related diseases at baseline and underwent a minimum of 2 sequential health examinations during 2011-2015. Variability in HDL-C was defined as (1) variability independent of the mean (VIM), (2) average real variability (ARV), and (3) standard deviation (SD) of HDL-C change from baseline and follow-up visits. Cognitive function was evaluated in 2018 by Mini-mental state examination (MMSE) in the Chinese version. Logistic regression was employed to explore the association between HDL-C variability and cognitive decline. Odd ratios (OR) and 95 % confidence intervals (CI) were reported.
The study included participants from CHARLS, mean age of 57.84±8.44 years and 44 % male. After adjustment for covariates, the highest quartile of VIM was associated with an increased risk of cognitive decline [OR:1.049, 95 %CI: 1.014-1.086] compared to the lowest quartile. For each SD increment of VIM, the OR was 1.015 (95 %CI:1.003-1.027). Strong dose-response relationships were identified (P for trend: 0.005). Consistent results were obtained for other measures of HDL-C variability (ARV and SD). Similar patterns were identified in different dimensions of cognition.
Elevated HDL-C variability was associated with increased cognitive decline risk. Strategies to reducing HDL-C variability may lower the risks of cognitive decline among the general population.
先前关于高密度脂蛋白胆固醇（HDL-C）与认知能力下降之间关系的研究仅限于单次测量，因此 HDL-C 变异性与认知能力下降风险之间的关联尚不清楚。
我们从中国健康与养老追踪调查（CHARLS）中确定了 5930 名参与者，这些参与者在基线时没有中风、痴呆和与记忆相关的疾病，并在 2011-2015 年期间至少进行了 2 次连续的健康检查。HDL-C 的变异性定义为：（1）与平均值无关的变异性（VIM）；（2）平均真实变异性（ARV）；（3）从基线和随访访视中 HDL-C 变化的标准差（SD）。2018 年，使用中文版简易精神状态检查（MMSE）评估认知功能。采用 logistic 回归模型来探讨 HDL-C 变异性与认知能力下降之间的关系。报告比值比（OR）及其 95%置信区间（CI）。
该研究纳入了来自 CHARLS 的参与者，平均年龄为 57.84±8.44 岁，44%为男性。在调整了混杂因素后，与最低四分位组相比，VIM 的最高四分位组与认知能力下降的风险增加相关[OR：1.049，95%CI：1.014-1.086]。VIM 每增加一个 SD，OR 为 1.015（95%CI：1.003-1.027）。趋势检验具有统计学意义（P 值：0.005）。其他 HDL-C 变异性指标（ARV 和 SD）也得到了一致的结果。在不同的认知维度中也发现了相似的模式。
升高的 HDL-C 变异性与认知能力下降风险增加相关。降低 HDL-C 变异性的策略可能会降低普通人群认知能力下降的风险。
