非高密度脂蛋白胆固醇与中国中老年人群认知障碍的 U 型关系：一项横断面研究。

U-shaped relationship between non-high-density lipoprotein cholesterol and cognitive impairment in Chinese middle-aged and elderly: a cross-sectional study.

机构信息

Clinical Laboratory, The First Affiliated Hospital of Wannan Medical College, No. 2, West Zheshan Road, Wuhu, Anhui, 241001, China.

Department of Kidney Medicine, The First Affiliated Hospital of Wannan Medical College, No. 2, West Zheshan Road, Wuhu, Anhui, 241001, China.

出版信息

BMC Public Health. 2024 Jun 18;24(1):1624. doi: 10.1186/s12889-024-19164-8.

DOI:10.1186/s12889-024-19164-8

PMID:38890653

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11186169/

Abstract

BACKGROUND

The relationship between blood lipids and cognitive function has long been a subject of interest, and the association between serum non-high-density lipoprotein cholesterol (non-HDL-C) levels and cognitive impairment remains contentious.

METHODS

We utilized data from the 2011 CHARLS national baseline survey, which after screening, included a final sample of 10,982 participants. Cognitive function was assessed using tests of episodic memory and cognitive intactness. We used multiple logistic regression models to estimate the relationship between non-HDL-C and cognitive impairment. Subsequently, utilizing regression analysis results from fully adjusted models, we explored the nonlinear relationship between non-HDL-C as well as cognitive impairment using smooth curve fitting and sought potential inflection points through saturation threshold effect analysis.

RESULTS

The results showed that each unit increase in non-HDL-C levels was associated with a 5.5% reduction in the odds of cognitive impairment (OR = 0.945, 95% CI: 0.897-0.996; p < 0.05). When non-HDL-C was used as a categorical variable, the results showed that or each unit increase in non-HDL-C levels, the odds of cognitive impairment were reduced by 14.2%, 20.9%, and 24% in the Q2, Q3, and Q4 groups, respectively, compared with Q1. In addition, in the fully adjusted model, analysis of the potential nonlinear relationship by smoothed curve fitting and saturation threshold effects revealed a U-shaped relationship between non-HDL-C and the risk of cognitive impairment, with an inflection point of 4.83. Before the inflection point, each unit increase in non-HDL-C levels was associated with a 12.3% decrease in the odds of cognitive impairment. After the tipping point, each unit increase in non-HDL-C levels was associated with an 18.8% increase in the odds of cognitive impairment (All p < 0.05).

CONCLUSION

There exists a U-shaped relationship between non-HDL-C and the risk of cognitive impairment in Chinese middle-aged and elderly individuals, with statistical significance on both sides of the turning points. This suggests that both lower and higher levels of serum non-high-density lipoprotein cholesterol increase the risk of cognitive impairment in middle-aged and elderly individuals.

摘要

背景

血脂与认知功能之间的关系一直是研究的热点，血清非高密度脂蛋白胆固醇（non-HDL-C）水平与认知障碍之间的关系仍存在争议。

方法

我们利用了 2011 年 CHARLS 全国基线调查的数据，经过筛选，最终纳入了 10982 名参与者。认知功能使用情景记忆和认知完整性测试进行评估。我们使用多因素逻辑回归模型来估计 non-HDL-C 与认知障碍之间的关系。随后，利用完全调整模型的回归分析结果，通过平滑曲线拟合来探索 non-HDL-C 与认知障碍之间的非线性关系，并通过饱和阈值效应分析寻找潜在的拐点。

结果

结果表明，non-HDL-C 水平每增加一个单位，认知障碍的几率就会降低 5.5%（OR=0.945，95%CI：0.897-0.996；p<0.05）。当 non-HDL-C 作为分类变量使用时，结果显示，与 Q1 相比，non-HDL-C 水平每增加一个单位，Q2、Q3 和 Q4 组认知障碍的几率分别降低 14.2%、20.9%和 24%。此外，在完全调整模型中，通过平滑曲线拟合和饱和阈值效应分析潜在的非线性关系，发现 non-HDL-C 与认知障碍风险之间存在 U 型关系，拐点为 4.83。在拐点之前，non-HDL-C 水平每增加一个单位，认知障碍的几率就会降低 12.3%。在拐点之后，non-HDL-C 水平每增加一个单位，认知障碍的几率就会增加 18.8%（均 p<0.05）。