心血管疾病后的健康生活方式、炎症和代谢生物标志物与痴呆症风险：一项基于人群的纵向研究

IF 6.5 1区医学 Q1 NUTRITION & DIETETICS

American Journal of Clinical Nutrition Pub Date : 2025-03-01 DOI:10.1016/j.ajcnut.2024.09.012

Fei Tian , Yuhua Wang , Shengtao Wei , Chaoling Zhang , Gan Wu , Zilong Zhang , Baozhuo Ai , Xiaojie Wang , Chongjian Wang , Hualiang Lin

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Post-cardiovascular disease healthy lifestyle, inflammation and metabolic biomarkers, and risk of dementia: a population-based longitudinal study

Background

Cardiovascular disease (CVD) is associated with an increased risk of dementia, but the impact of healthy lifestyle on post-CVD dementia remains unclear.

Objectives

The aim of this study was to explore the association between post-CVD healthy lifestyle factors and risk of dementia. We further examined whether inflammation and metabolic biomarkers played a role in this association.

Methods

This prospective cohort study included 77,324 dementia-free participants with prevalent CVD from the UK Biobank. We constructed the lifestyle score based on no current smoking, moderate alcohol consumption, regular physical activity, healthy diet, adequate sleep duration, less sedentary behavior, and frequent social contact. Cox proportional hazard models were performed to examine the association of healthy lifestyle with risk of CVD-related dementia. Mediation models were fitted to investigate the underlying mechanisms driven by systemic inflammation, lipid profiles, liver/renal function, and blood pressure indices.

Results

Over a median follow-up of 12.43 y, 1605 all-cause dementia (ACD) cases were documented, including 646 Alzheimer’s dementia (AD) cases and 427 vascular dementia (VaD) cases. Healthy lifestyle scores were significantly associated with lower risk of dementia. The hazard ratios and 95% confidence intervals for the participants with 6–7 healthy lifestyle score were 0.50 (0.40, 0.62) for ACD, 0.80 (0.58, 1.10) for AD, and 0.30 (0.19, 0.48) for VaD, compared their counterpart with 0–1 score. Low-grade inflammatory markers and specific metabolic biomarkers were detected to significantly mediated the observed associations, explaining 1%∼11% of the associations of healthy lifestyle factors with dementia risk.

Conclusions

Adherence to healthy lifestyle behaviors is significantly associated with a lower risk of dementia in individuals with CVD. The observed associations may be partly explained by a reduction in systemic inflammation and the promotion of metabolic balance.

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来源期刊

American Journal of Clinical Nutrition 医学-营养学

CiteScore

12.40

自引率

4.20%

发文量

332

审稿时长

38 days

期刊介绍： American Journal of Clinical Nutrition is recognized as the most highly rated peer-reviewed, primary research journal in nutrition and dietetics.It focuses on publishing the latest research on various topics in nutrition, including but not limited to obesity, vitamins and minerals, nutrition and disease, and energy metabolism. Purpose: The purpose of AJCN is to: Publish original research studies relevant to human and clinical nutrition. Consider well-controlled clinical studies describing scientific mechanisms, efficacy, and safety of dietary interventions in the context of disease prevention or health benefits. Encourage public health and epidemiologic studies relevant to human nutrition. Promote innovative investigations of nutritional questions employing epigenetic, genomic, proteomic, and metabolomic approaches. Include solicited editorials, book reviews, solicited or unsolicited review articles, invited controversy position papers, and letters to the Editor related to prior AJCN articles. Peer Review Process: All submitted material with scientific content undergoes peer review by the Editors or their designees before acceptance for publication.