Abstract
Background and Aims: The relationships between blood lipid levels and obesity and cognitive impairment have not been fully determined. Considering that the lipid accumulation product (LAP) is a composite index of blood lipid levels and obesity, we investigated the relationships between LAP levels at baseline and cognitive decline over 4 years.Methods: A total of 983 subjects (≥40 years) from a longitudinal cohort in a village of Xi’an, China, who completed the baseline survey were followed-up for 4 years. All participants underwent face-to-face interviews and cognitive assessments at baseline and at the 4-year follow-up. The Mini-Mental State Examination (MMSE) was used to assess cognitive function, and an MMSE score dropping ≥ 2 points from baseline was defined as cognitive decline. The relationships between LAP and cognitive decline were analyzed by linear regression models.Results: During the 4-year follow-up, 172 patients exhibited cognitive decline (17.5%). Univariate analysis showed that the rate of change in MMSE score was significantly different between the low-LAP group and the high-LAP group (t = −2.26, p = 0.024). Multiple linear regression indicated that a high LAP was positively associated with cognitive decline (β = 0.564, p = 0.012). Stratified multivariate analysis showed that LAP was positively associated with cognitive decline in the normal blood pressure female subgroup (β = 1.29, p = 0.002) but not in the high blood pressure group or the male group.Conclusions: High LAP is associated with cognitive decline in females with normal blood pressure but not in those with high blood pressure or males. This indicates that the relationships between blood lipid levels and obesity and cognitive impairment may be affected by blood pressure and sex.
Highlights
Cognitive impairment has received much attention due to alarming increases in its prevalence, making it a major public health concern exerting societal pressure worldwide
In previous studies by our team, we found that triglycerides (TGs) negatively correlated with cognitive impairment in middleaged male participants (Zhao et al, 2019), and abdominal obesity measured by waist circumference (WC) or waist-hip ratio (WHR) alone does not appear to be associated with a higher risk of cognitive impairment (Li et al, 2018)
The characteristics of the total study population at follow-up were shown in Table 1, there were significant differences in age, sex, smoking, hypertension, diabetes mellitus, hyperlipidemia, hip circumstance, WC, body mass index (BMI), SBP, DBP, fasting blood glucose (FBG), TG, total cholesterol (TC), HDL-C, LDL-C, ApoEε4 carrier status and rate of change in MMSE score between the low-lipid accumulation product (LAP) group and the high-LAP group
Summary
Cognitive impairment has received much attention due to alarming increases in its prevalence, making it a major public health concern exerting societal pressure worldwide. Abdominal obesity plays an important role in cognitive decline. Some studies support the detrimental effect of abdominal adiposity measured by waist circumference (WC) or waist-hip ratio (WHR) on cognitive decline (Gustafson et al, 2009; Cui et al, 2013; Gardener et al, 2020). A Brazilian autopsy study showed that abdominal visceral fat was inversely associated with cognitive impairment (Nishizawa et al, 2019). In previous studies by our team, we found that triglycerides (TGs) negatively correlated with cognitive impairment in middleaged male participants (Zhao et al, 2019), and abdominal obesity measured by WC or WHR alone does not appear to be associated with a higher risk of cognitive impairment (Li et al, 2018). Considering that the lipid accumulation product (LAP) is a composite index of blood lipid levels and obesity, we investigated the relationships between LAP levels at baseline and cognitive decline over 4 years
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