Axelsson Andrén Elin, Safi Dewa, Wallin Anders, Svensson Johan
Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Mölndal, Sweden.
Cereb Circ Cogn Behav. 2024 Jun 5;6:100229. doi: 10.1016/j.cccb.2024.100229. eCollection 2024.
There are conflicting results whether serum lipid pattern is related to the amount of white matter hyperintensities (WMHs) on magnetic resonance imaging. Little is known of the associations between lipid concentrations and the subsequent risk of the subcortical small vessel type of dementia (SSVD), in which WMHs are a prominent manifestation. Here, we determined whether lipid levels are associated with the risk of SSVD, Alzheimer's disease (AD), or mixed dementia (combined AD and SSVD).
This was a longitudinal, prospective study of 329 patients with subjective or objective mild cognitive impairment at baseline. The statistical analyses included Cox proportional hazards regression with adjustments for age, gender, education, body mass index, current smoking, hypertension, diabetes mellitus, and ε4 genotype.
During the follow-up (mean 4.1 years), 80 patients converted to dementia [SSVD, = 15 (5 %); AD, = 39 (12 %); and mixed dementia, = 26 (8 %)]. Serum high-density lipoprotein cholesterol (HDL, per SD increase) was inversely associated with the risk of SSVD, whereas triglycerides (TG), low-density lipoprotein cholesterol (LDL)/HDL ratio, and TG/HDL ratio were positively associated with SSVD risk. Furthermore, the lowest HDL tertile was associated with a sevenfold, and the highest tertile of TG/HDL ratio with a threefold, increase in SSVD risk. There were no associations with the risk of AD or mixed dementia after adjustment for covariates.
In a memory clinic population, low HDL and high TG/HDL ratio were independent risk factors of SSVD, but not of AD or mixed dementia.
关于血清脂质模式是否与磁共振成像上的白质高信号（WMHs）量相关，存在相互矛盾的结果。脂质浓度与皮质下小血管型痴呆（SSVD）的后续风险之间的关联知之甚少，其中WMHs是一个突出表现。在此，我们确定脂质水平是否与SSVD、阿尔茨海默病（AD）或混合性痴呆（AD和SSVD合并）的风险相关。
这是一项对329例基线时有主观或客观轻度认知障碍患者的纵向、前瞻性研究。统计分析包括Cox比例风险回归，并对年龄、性别、教育程度、体重指数、当前吸烟情况、高血压、糖尿病和ε4基因型进行了调整。
在随访期间（平均4.1年），80例患者转变为痴呆[SSVD，n = 15（5%）；AD，n = 39（12%）；混合性痴呆，n = 26（8%）]。血清高密度脂蛋白胆固醇（HDL，每增加1个标准差）与SSVD风险呈负相关，而甘油三酯（TG）、低密度脂蛋白胆固醇（LDL）/HDL比值和TG/HDL比值与SSVD风险呈正相关。此外，HDL三分位数最低者与SSVD风险增加7倍相关，TG/HDL比值三分位数最高者与SSVD风险增加3倍相关。在对协变量进行调整后，与AD或混合性痴呆的风险无关联。
在记忆门诊人群中，低HDL和高TG/HDL比值是SSVD的独立危险因素，但不是AD或混合性痴呆的独立危险因素。
