Abstract
Background: Alzheimer’s disease (AD) is the most common subtype of dementia. In the last ten years, the relationship between cholesterol and AD has been investigated. Evidence suggests that cholesterol is associated with AD and represents promising targets for intervention. However, the causality of these associations is unclear. Therefore, we sought to conduct a meta-meta-analysis to determine the effect of cholesterol on the development AD. Then, we assessed the effect of serum levels of low-density lipoprotein cholesterol (LDL-C) and high-density lipoprotein cholesterol (HDL-C), total cholesterol (TC) and triglycerides (TG), on AD risk. Methods: A systematic search of meta-analyses was conducted. Scopus, Web of Science, Science direct, PubMed and Google academic system databases were reviewed. Results: We found 100 primary studies and five meta-analyses to analyze the relationships between cholesterol and AD. The total effect of cholesterol on risk of AD was significant and heterogeneous. Subgroup analysis shows that LDL-C levels influence the development of AD. However, non-significant effects of HDL-C, TC and TG levels on AD were found. Conclusions: These results strengthen the evidence that LDL-C cholesterol levels increase risk for AD. More initiatives to investigate the relationship between cholesterol and AD are needed.
Highlights
Alzheimer’s disease (AD) is the most common neurodegenerative disorder resulting in cognitive impairment
A total of 331 studies were identified from major databases: 64 in ISI Web of Science (WOS), 141 in Scopus, 45 in PubMed, 79 in the Elsevier Science Direct and two in Google Scholar
17 were excluded because: (a) k = 2 did not report an effect size; (b) k = 2 did not provide information on the relationship between cholesterol and AD; (c) k = 6 were duplicated; (d) k = 5 were systematic reviews about other issues; (e) k = 1 aimed to study the effect of medication on AD; and (f) one meta-analysis that included the same primary studies as another study
Summary
Alzheimer’s disease (AD) is the most common neurodegenerative disorder resulting in cognitive impairment. AD is characterized by a gradual decline in memory and other cognitive and executive functions, and the progressive development of affective and behavioral disorders [1]. The onset of AD is insidious, and its progression is gradual As it progresses, various patterns of deficits are seen, but the disorder most commonly begins with deficits in recent memory, which are followed by aphasia, apraxia and agnosia after several years [2]. We sought to conduct a meta-meta-analysis to determine the effect of cholesterol on the development AD. Results: We found 100 primary studies and five meta-analyses to analyze the relationships between cholesterol and AD. The total effect of cholesterol on risk of AD was significant and heterogeneous. Non-significant effects of HDL-C, TC and TG levels on AD were found
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