Statins and serum cholesterol's associations with incident dementia and mild cognitive impairment.
Statins and serum cholesterol's associations with incident dementia and mild cognitive impairment.
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DOI：
10.1136/jech.2009.100826
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发表时间：
2011-11
影响因子：
6.3
通讯作者：
Zonderman AB
中科院分区：
文献类型：
--
作者：
Beydoun MA;Beason-Held LL;Kitner-Triolo MH;Beydoun HA;Ferrucci L;Resnick SM;Zonderman AB
他汀类药物的使用和血清胆固醇的降低已被提议作为预防痴呆和轻度认知障碍（MCI）。来自巴尔的摩老龄化纵向研究（BLSA）的1，604和1，345名合格参与者在50岁后被随访，中位时间约为25年，分别检查痴呆（n=259）和MCI（n=138）的发病率。他汀类药物使用（曾使用和时间依赖性使用）、总胆固醇水平（TC;首次访视和时间依赖性）、TC自首次访视的变化轨迹和高密度脂蛋白（HDL-C）：TC比值（首次访视和时间依赖性）是主要关注的暴露。采用考克斯比例风险模型。与没有痴呆和MCI的参与者相比，患有痴呆的参与者的首次就诊TC较高，而与从未使用过的参与者相比，他汀类药物使用者的首次就诊TC较高（未调整年龄的关联）。他汀类药物使用者发生痴呆的风险降低2 - 3倍（HR=0.41; 95%CI：0.18-0.92），但在考虑时间依赖性“他汀类药物使用”和倾向评分模型调整时，MCI的风险没有降低。这种关联仍然显着独立的血清胆固醇暴露。首次访视TC升高与MCI风险降低相关（上四分位数（Q4）vs. Q1：HR=0.51; 95% CI=0.29-0.90）。与最低四分位数（Q1：0.00-0.19）相比，HDL-C：TC（时间依赖性）（Q2：0.19-0.24）与MCI风险降低相关（HR=0.53; 95%CI：0.30-0.94）。仅在男性中，首次就诊后TC下降与痴呆风险增加显著相关（HR=4.21; 95%CI：1.28-13.85）。他汀类药物可能对痴呆症有多因素影响，但对MCI风险无影响。未来的干预措施可能是必要的，研究应集中在最佳血清TC，HDL-C：TC比值和TC变化轨迹。
Statin use and serum cholesterol reduction have been proposed as preventions for dementia and mild cognitive impairment (MCI). 1,604 and 1,345 eligible participants from the Baltimore Longitudinal Study of Aging (BLSA) were followed after age 50 for a median time of around 25 years, to examine incidence of dementia (n=259) and MCI (n=138), respectively. Statin use (ever-use and time-dependent use), total cholesterol levels (TC; first-visit and time-dependent), TC change trajectory from first-visit, and high-density lipoprotein (HDL-C):TC ratio (first-visit and time-dependent) were main exposures of interest. Cox proportional hazards models were used. Participants with incident dementia had higher first-visit TC compared to participants who remained free of dementia and MCI, while first-visit TC was higher among statin ever-users compared to never-users (age-unadjusted associations). Statin users had two to three-fold lower risk of developing dementia (HR=0.41; 95% CI: 0.18–0.92), but not MCI, when considering time-dependent “statin use” with propensity score model adjustment. This association remained significant independently of serum cholesterol exposures. An elevated first-visit TC was associated with reduced MCI risk (Upper quartile (Q4) vs. Q1: HR=0.51; 95% CI=0.29–0.90). Compared to the lowest quartile (Q1: 0.00–0.19), HDL-C:TC (time-dependent) in (Q2: 0.19–0.24) was associated with reduced MCI risk (HR=0.53; 95%CI: 0.30–0.94). Among men only, TC decline from first-visit was significantly associated with increased dementia risk (HR=4.21; 95% CI: 1.28–13.85). Statins may have multifactorial effects on dementia but not MCI risk. Future interventions may be warranted and research should focus on optimal serum TC, HDL-C:TC ratio and TC change trajectories.
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影响因子：
158.5
作者：
in 't Veld, BA;Ruitenberg, A;Stricker, BHC
通讯作者：
Stricker, BHC
影响因子：
9.9
作者：
Kawas, C;Gray, S;Zonderman, A
通讯作者：
Zonderman, A
影响因子：
168.9
作者：
Jick, H;Zornberg, GL;Drachman, DA
通讯作者：
Drachman, DA
DOI：
10.1093/gerona/57.7.m414
发表时间：
2002-07-01
影响因子：
5.1
作者：
Hajjar, L;Schumpert, J;Eleazer, GP
通讯作者：
Eleazer, GP
影响因子：
9.9
作者：
Cramer, C.;Haan, M. N.;Kalbfleisch, J. D.
通讯作者：
Kalbfleisch, J. D.