Longitudinal and nonlinear relations of dietary and Serum cholesterol in midlife with cognitive decline: results from EMCOA study

被引：64

作者：

An, Yu ^{[1
]}

Zhang, Xiaona ^{[1
]}

Wang, Ying ^{[1
]}

Wang, Yushan ^{[1
]}

Liu, Wen ^{[1
]}

Wang, Tao ^{[1
]}

Qin, Zhongsheng ^{[2
]}

Xiao, Rong ^{[1
]}

机构：

[1] Capital Med Univ, Sch Publ Hlth, 10 Xitoutiao, Beijing 100069, Peoples R China

[2] Jincheng Peoples Hosp, Jincheng, Peoples R China

来源：

MOLECULAR NEURODEGENERATION | 2019年 / 14卷 / 01期

基金：

中国国家自然科学基金;

关键词：

Cholesterol; Cognitive decline; Nonlinear; DENSITY LIPOPROTEIN CHOLESTEROL; LATE-LIFE; HDL CHOLESTEROL; CHINESE ADULTS; ASSOCIATION; IMPAIRMENT; RISK; PERFORMANCE; DEMENTIA; DISEASE;

D O I：

10.1186/s13024-019-0353-1

中图分类号：

Q189 [神经科学];

学科分类号：

071006 ;

摘要：

Background Previous studies regarding the cholesterol-cognition relationship in midlife have generated conflicting results. We thus investigated whether dietary and blood cholesterol were associated with cognitive decline. Methods Participants were drawn from a large cohort study entitled the Effects and Mechanism Investigation of Cholesterol and Oxysterol on Alzheimer's disease (EMCOA) study. We included 2514 participants who completed a selection of comprehensive cognitive tests and were followed for an average of 2.3 years. Blood concentrations of total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C) and triglycerides (TG) were assessed and dietary intakes were investigated by food frequency questionnaire (FFQ) at baseline. Apolipoprotein E (APOE) was genotyped by Kompetitive Allele Specific PCR (KASP) sequencing. Non-high-density lipoprotein cholesterol (Non-HDL-C) and LDL-C/HDL-C ratio were calculated. The longitudinal effects of dietary and blood cholesterol on risk of global cognitive decline (decrease in Montreal Cognitive Assessment (MoCA) > 2 points) were examined using Cox proportional hazards models. The nonlinear associations with global and domain-specific cognitive decline was evaluated with mixed effect linear models. Results In Cox proportional hazards models, neither cholesterol nor egg intake was associated with a higher risk of accelerated global cognitive decline. In contrast, the higher serum concentrations of TC, LDL-C, non-HDL-C and LDL-C/HDL-C ratio were positively associated with accelerated global cognitive decline regardless of being evaluated continuously or categorically while higher HDL-C was positively associated with accelerated global cognitive decline only when being evaluated categorically (all P < 0.05). In mixed effect linear models, quadratic and longitudinal relations of dietary cholesterol and egg intakes to global cognition, processing speed and executive function were observed. Moreover, there were inverted U-shaped relations of HDL-C, with processing speed and executive function but U-shaped relations of HDL-C and LDL-C/HDL-C ratio with verbal memory. Adverse linear associations of higher LDL-C and LDL-C/HDL-C ratio with multiple cognitive comes were also revealed. Additionally adjusting for APOE genotype did not modify cholesterol-cognition associations. Dietary and serum cholesterol had variable associations with global and domain-specific cognitive decline across educational groups. Conclusion Differential associations between dietary/serum cholesterol and cognitive decline across different domains of function were observed in a particular population of middle-aged and elderly Chinese. Interventions to improve cognitive reserve regarding dietary instruction and lipid management should be tailored according to specific target.

引用

页数：19