认知障碍和抑郁先于中年及以上中国成年人高密度脂蛋白胆固醇水平升高：交叉滞后面板分析。

Cognitive impairment and depression precede increased HDL-C levels in middle-aged and older Chinese adults: cross-lagged panel analyses.

机构信息

The Second School of Clinical Medicine, Southern Medical University, Guangzhou, China.

Guangdong Mental Health Center, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, Guangdong Province, 510180, China.

出版信息

Lipids Health Dis. 2024 Sep 9;23(1):288. doi: 10.1186/s12944-024-02285-9.

DOI:10.1186/s12944-024-02285-9

PMID:39252009

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11382475/

Abstract

BACKGROUND

High-density lipoprotein cholesterol (HDL-C) is widely recognized for its protective effects against cognitive decline. However, recent studies have presented conflicting results, with some suggesting no significant cognitive benefits or even an increased risk of dementia associated with high HDL-C levels. For those who suffer from depression, the cognitive benefits of HDL-C may be diminished or reversed. The purpose of this study is to investigate the associations between HDL-C, cognitive ability, and depressive symptoms in middle-aged and older Chinese adults.

METHODS

The datasets utilized were sourced from the China Health and Retirement Longitudinal Study (CHARLS) for the years 2011 and 2015, comprising 4,302 participants. Cross-lagged models were employed to explore the temporal sequence between cognitive performance and HDL-C levels, and to examine the interplay among depression, cognition, and HDL-C. Confounding factors such as sociodemographic characteristics, sleep conditions, and history of chronic diseases were controlled for.

RESULTS

The analysis revealed unidirectional effects of baseline impaired cognition and greater severity of depression on increased HDL-C levels at follow-up (β = - 0.036 and β = 0.028, respectively, P < 0.05). However, higher baseline HDL-C levels did not significantly predict cognitive performance or depression 4 years later (β = - 0.008 and β = 0.023, respectively, P > 0.05). Depressive symptoms and cognition were found to have a significant bidirectional association (β = - 0.026 and β = - 0.053, respectively, P < 0.05).

CONCLUSIONS

Cognitive impairment and depression are associated with higher HDL-C levels, whereas higher HDL-C levels do not appear to protect against cognitive decline or depressive symptoms. These findings underscore the importance of preserving cognitive and mental health, which may lower the likelihood of cardiovascular disease and dementia. Future studies should validate these findings and develop targeted interventions tailored to specific populations.

摘要

背景

高密度脂蛋白胆固醇（HDL-C）广泛被认为对认知能力下降具有保护作用。然而，最近的研究结果却存在矛盾，一些研究表明高 HDL-C 水平与认知益处无关，甚至增加痴呆风险。对于患有抑郁症的人来说，HDL-C 的认知益处可能会减弱或逆转。本研究旨在探讨中年和老年中国成年人中 HDL-C、认知能力和抑郁症状之间的关系。

方法

本研究使用了中国健康与退休纵向研究（CHARLS）2011 年和 2015 年的数据，共纳入 4302 名参与者。采用交叉滞后模型探讨认知表现和 HDL-C 水平之间的时间序列关系，并检验抑郁、认知和 HDL-C 之间的相互作用。控制了社会人口统计学特征、睡眠状况和慢性疾病史等混杂因素。

结果

分析结果显示，基线认知障碍和抑郁严重程度增加会导致随访时 HDL-C 水平升高，具有单向效应（β=−0.036 和β=0.028，P<0.05）。然而，较高的基线 HDL-C 水平在 4 年后对认知表现或抑郁没有显著预测作用（β=−0.008 和β=0.023，P>0.05）。抑郁症状和认知之间存在显著的双向关联（β=−0.026 和β=−0.053，P<0.05）。