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Sex differences in the associations between lipid levels and incident dementia

机译：中消协血脂水平与痴呆症之间的性别差异

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Cholesterol is a risk factor for developing vascular pathologies, which is in turn an important risk factor for dementia. Previous studies linking lipids and dementia have yielded inconsistent results, which may be attributable to sex differences in the etiology of both vascular disease and dementia. The aim of this study was to evaluate the associations between lipids and incident dementia in 7053 community-dwelling elderly. Dementia was diagnosed at baseline, and 2, 4, and 7-year follow-up. Multivariate Cox models stratified by sex and history of vascular pathologies at baseline were adjusted for sociodemographic, mental and physical health variables and genetic vulnerability. In men without vascular pathologies, an increased incidence of all-cause dementia but not Alzheimer’s disease (AD) was associated with high triglyceride (TG) (HR=1.55, 95%CI=1.04–2.32, p=0.03) and low HDL-cholesterol levels (HR=1.49, 95%CI=0.99–2.23, p=0.05). In women without vascular pathologies, low TG levels were associated with a decreased risk of AD (HR=0.65, 95%CI=0.43–0.97, p=0.03). A decreased risk was also found with high TG levels which may depend on genetic vulnerability to dyslipidemia related to APOA5. For both sexes, no significant associations were found between total- or LDL-cholesterol and dementia or AD. Low HDL-cholesterol and high TG levels may be risk factors of dementia in elderly men whereas low TG is associated with decreased incident AD in women. This data suggests a complex sex-specific etiology of vascular dementia and AD.
机译：胆固醇是发展血管病变的危险因素，而胆固醇又是痴呆的重要危险因素。先前有关脂质和痴呆症的研究结果不一致，这可能归因于血管疾病和痴呆症病因的性别差异。这项研究的目的是评估7053个社区老年人中脂质与痴呆的关系。痴呆症在基线，2、4和7年的随访中被诊断出。基线时按性别和血管病史分层的多变量Cox模型针对社会人口统计学，心理和身体健康变量以及遗传易感性进行了调整。在无血管病变的男性中，全因痴呆的发生率增加，但阿尔茨海默氏病（AD）却与甘油三酸酯（TG）升高（HR = 1.55、95％CI = 1.04–2.32，p = 0.03）和HDL-低有关胆固醇水平（HR = 1.49，95％CI = 0.99–2.23，p = 0.05）。在无血管病变的女性中，低TG水平与AD风险降低相关（HR = 0.65，95％CI = 0.43–0.97，p = 0.03）。 TG水平高也可降低风险，这可能取决于与APOA5相关的血脂异常的遗传易感性。对于男女，总胆固醇或低密度脂蛋白胆固醇与痴呆或AD之间均未发现明显关联。低密度脂蛋白胆固醇和高甘油三酯水平可能是老年男性痴呆的危险因素，而低甘油三酸酯与女性AD事件减少有关。该数据表明血管性痴呆和AD的性别特异性病因复杂。

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