甘油三酯、高密度脂蛋白和中老年人的认知功能：一项横断面分析

IF 4.4 4区医学 Q1 GERIATRICS & GERONTOLOGY

Biogerontology Pub Date : 2025-03-22 DOI:10.1007/s10522-025-10201-6

Lanying Xie, Huanhuan Luo, Yajie Zhao, Yuqing Hao, Jie Gao, Chao Sun, Huixiu Hu

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引用次数: 0

摘要

随着中国人口持续老龄化，解决与老龄化相关的认知能力下降问题变得越来越重要。同时，经济的快速发展也引起了人们对脂质代谢紊乱的关注，尤其是与血脂有关的疾病。早期识别可改变的危险因素对于增强老年人的认知功能至关重要。因此，本研究的重点是甘油三酯（TG）、高密度脂蛋白（HDL）和认知能力之间的关系，以探讨潜在的机制。使用2015年中国健康与退休纵向研究（CHARLS）调查的数据进行横断面研究。认知功能通过三个领域进行评估：整体认知、情景记忆和精神状态。分析空腹血液样本的甘油三酯和高密度脂蛋白（HDL）水平。使用限制三次样条（RCS）分析、多元线性回归和中介分析来检验甘油三酯、HDL和认知功能之间的关系。分析发现，甘油三酯与整体认知和情景记忆之间存在非线性、反u型关系，整体认知的甘油三酯（TG）水平为202.65，情景记忆的甘油三酯（TG）水平为115.04。高密度脂蛋白（HDL）与认知结局（包括整体认知、情景记忆或精神状态）之间无非线性关系（p < 0.05）。线性混合模型表明HDL与情景记忆呈正相关，如HDLQ1 (B = 0.0033, 95% CI: 0,0.569), HDLQ2 （B = 0.039, 95% CI: 0.051, 0.594）和HDLQ3 （B = 0.033, 95% CI: 0.004, 0.556）与HDLQ4相比。TG和HDL对情景记忆的联合分析进一步表明，“高TG-低HDL”组（B = 0.036, 95% CI: 0.043, 0.578）与“高HDL-低TG”组相比具有显著的积极作用。中介分析显示，身体质量指数（BMI）间接中介hdl -情景记忆的关系，中介效应量为22.2%。总之，本研究探讨了中国中老年人甘油三酯水平、高密度脂蛋白胆固醇（HDL-C）水平与认知功能之间的相互作用。研究结果揭示了甘油三酯浓度与认知能力之间呈u型负相关，强调了维持最佳甘油三酯水平对认知健康的必要性。此外，与较高的HDL水平（HDLQ4）相比，较低的HDL水平（HDLQ1-Q3）被发现对认知功能有积极影响，特别是在整体认知和情景记忆方面。重要的是，身体质量指数（BMI）介导了HDL对情景记忆的影响，效应量为22.2%。

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Triglycerides, high-density lipoprotein and cognitive function in middle-aged and older adults: a cross-sectional analysis.

As China's population continues to age, addressing cognitive decline related to aging has become increasingly important. Simultaneously, rapid economic development has led to rising concerns about lipid metabolism disorders, particularly those involving blood lipids. Identifying modifiable risk factors early is critical to enhancing cognitive function in older adults. Thus, this study focuses on the relationship between triglycerides (TG), high-density lipoprotein (HDL), and cognitive performance to investigate potential mechanisms. A cross-sectional study was conducted using data from the 2015 China Health and Retirement Longitudinal Study (CHARLS) survey. Cognitive function was assessed across three domains: global cognition, episodic memory, and mental status. Fasting blood samples were analyzed for triglycerides and high-density lipoprotein (HDL) levels. The relationship between triglycerides, HDL, and cognitive function was examined using restricted cubic spline (RCS) analysis, multivariate linear regression, and mediation analysis. The analysis identifies a non-linear, inverse U-shaped relationship between triglycerides and both global cognition and episodic memory, with significant inflection points at a triglyceride (TG) level of 202.65 for global cognition and 115.04 for episodic memory. No non-linear relationship was observed between High-Density Lipoprotein (HDL) and cognitive outcomes, including global cognition, episodic memory, or mental status (p > 0.05). Linear mixed models indicate that HDL has a positive association with episodic memory, as shown by HDLQ1 (B = 0.0033, 95% CI: 0, 0.569), HDLQ2 (B = 0.039, 95% CI: 0.051, 0.594), and HDLQ3 (B = 0.033, 95% CI: 0.004, 0.556) compared to HDLQ4. A combined analysis of TG and HDL on episodic memory further demonstrated that the ''High-TG-low-HDL'' group (B = 0.036, 95% CI: 0.043, 0.578) had a significantly positive effect compared to the "High-HDL-low-TG" group. Mediation analysis revealed that Body Mass Index (BMI) indirectly mediated the HDL-episodic memory relationship, with a mediation effect size of 22.2%. In conclusion, this study explored the interplay between triglyceride levels, high-density lipoprotein cholesterol (HDL-C) levels, and cognitive function among middle-aged and elderly individuals in China. The findings reveal a U-shaped inverse relationship between triglyceride concentrations and cognitive ability, underscoring the need to maintain optimal triglyceride levels for cognitive health. Additionally, lower HDL levels (HDLQ1-Q3) were found to positively affect cognitive function, particularly in overall cognition and episodic memory, compared to higher HDL levels (HDLQ4). Importantly, body mass index (BMI) mediated the influence of HDL on episodic memory, with an effect size of 22.2%.

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来源期刊

Biogerontology 医学-老年医学

CiteScore

8.00

自引率

4.40%

发文量

审稿时长

>12 weeks

期刊介绍： The journal Biogerontology offers a platform for research which aims primarily at achieving healthy old age accompanied by improved longevity. The focus is on efforts to understand, prevent, cure or minimize age-related impairments. Biogerontology provides a peer-reviewed forum for publishing original research data, new ideas and discussions on modulating the aging process by physical, chemical and biological means, including transgenic and knockout organisms; cell culture systems to develop new approaches and health care products for maintaining or recovering the lost biochemical functions; immunology, autoimmunity and infection in aging; vertebrates, invertebrates, micro-organisms and plants for experimental studies on genetic determinants of aging and longevity; biodemography and theoretical models linking aging and survival kinetics.