Zhou Yi, Xu Hao-Ling, Lin Xiao-Ling, Chen Zhi-Ting, Ye Qin-Yong, Zhao Zhen-Hua
Shengli Clinical Medical College of Fujian Medical University, Fuzhou, China.
Department of Neurology, Shengli Clinical Medical College of Fujian Medical University, Fuzhou University Affiliated Provincial Hospital, Fujian Provincial Hospital, Fuzhou, China.
Front Nutr. 2025 Mar 5;12:1525348. doi: 10.3389/fnut.2025.1525348. eCollection 2025.
Cholesterol is a critical component of the human body, particularly within the brain, where it plays an essential role in maintaining cellular structure and function. In addition, the blood lipid profile has been recognized as a significant factor influencing cognitive performance. However, the association between the ratio of total cholesterol (TC) to high-density lipoprotein cholesterol (HDL-C) and cognitive function remains unclear.
This community-based, cross-sectional study was conducted using data from middle-aged and older adults (aged ≥45 years) participating in the China Health and Retirement Longitudinal Study (CHARLS). The primary exposure of interest was the ratio of TC to HDL-C, while the main outcome was cognitive function, assessed using cognition scores. The association between the TC-HDL-C ratio and cognitive performance was examined using multiple linear regression analyses and restricted cubic spline modeling to assess potential nonlinear relationships.
A total of 8,914 participants were included in the analysis. Within a certain range, a higher TC-HDL-C ratio was significantly associated with improved cognitive scores ( < 0.05) among middle-aged and older adults. This relationship remained significant even after adjusting for sociodemographic and health-related factors. Moreover, restricted cubic spline analyses revealed a significant nonlinear association (p for nonlinearity <0.05) between the TC-HDL-C ratio and cognition scores. Subgroup analyses further highlighted differential effects of the TC-HDL-C ratio across specific population subgroups. Sensitivity analyses consistently supported the robustness of the observed relationship between the TC-HDL-C ratio and cognitive function.
Our findings confirm a significant nonlinear relationship between the TC-HDL-C ratio and cognitive performance in middle-aged and elderly individuals, even after adjusting for sociodemographic factors. These results underscore the potential importance of maintaining an appropriate TC-HDL-C ratio to support cognitive health in aging populations.
胆固醇是人体的重要组成部分，尤其是在大脑中，它在维持细胞结构和功能方面起着至关重要的作用。此外，血脂谱已被认为是影响认知能力的一个重要因素。然而，总胆固醇（TC）与高密度脂蛋白胆固醇（HDL-C）的比值与认知功能之间的关联仍不明确。
本基于社区的横断面研究使用了参与中国健康与养老追踪调查（CHARLS）的中年及老年人（年龄≥45岁）的数据。主要关注的暴露因素是TC与HDL-C的比值，而主要结局是认知功能，通过认知得分进行评估。使用多元线性回归分析和受限立方样条模型来检验TC-HDL-C比值与认知表现之间的关联，以评估潜在的非线性关系。
共有8914名参与者纳入分析。在一定范围内，中年及老年人中较高的TC-HDL-C比值与认知得分的改善显著相关（<0.05）。即使在调整了社会人口学和健康相关因素后，这种关系仍然显著。此外，受限立方样条分析显示TC-HDL-C比值与认知得分之间存在显著的非线性关联（非线性p<0.05）。亚组分析进一步突出了TC-HDL-C比值在特定人群亚组中的不同影响。敏感性分析一致支持了观察到的TC-HDL-C比值与认知功能之间关系的稳健性。
我们的研究结果证实，即使在调整了社会人口学因素后，中年及老年个体中TC-HDL-C比值与认知表现之间仍存在显著的非线性关系。这些结果强调了维持适当的TC-HDL-C比值对支持老年人群认知健康的潜在重要性。
