Zhongguo gonggong weisheng (Mar 2024)
Relationship between the ratio of triglyceride to high-density lipoprotein cholesterol and cognitive impairment incidence in middle-aged and elderly residents in China: an analysis on CHARLS data
Abstract
ObjectiveTo investigate the association between the triglyceride (TG) to high-density lipoprotein cholesterol (HDL-C) ratio and cognitive impairment incidence among middle-aged and elderly Chinese residents, aiming to develop intervention strategies for cognitive impairment. MethodsThe study data were obtained from four waves of the China Health and Retirement Longitudinal Study (CHARLS) conducted in 2011, 2013, 2015, and 2018. The analysis included 6 883 residents who were aged ≥ 45 years at the enrollment, with complete baseline information including TG and HDL-C, and free from cognitive impairment as determined by the Mini-Mental State Examination (MMSE) and Telephone Interview for Cognitive Status (TICS) assessments at the baseline survey in 2011 and were successfully followed up till 2018. The residents' baseline TG/HDL-C ratios were computed and categorized into quartile groups. The association between the baseline TG/HDL-C ratio and the cumulative incidence of cognitive impairment in residents was examined using a non-conditional multivariate logistic regression model. The relationship between the baseline TG/HDL-C ratio and the risk of cognitive impairment was then modeled using a restricted cubic spline (RCS) curve. ResultsAt the end of the follow-up period, a total of 2 532 out of 6883residents were diagnosed with cognitive impairment, resulting in a cumulative incidence rate of 36.79% over seven years. The TG/HDL-C ratio was 3.08 ± 4.69 in the individuals with cognitive impairment, which was significantly lower than the ratio of 3.64 ± 6.28 observed in those without the disorder (t = – 3.875, P < 0.001). After adjusting for covariates including sex, age, education, marital status, place of residence, smoking status, alcohol consumption, hypertension, diabetes, dyslipidemia, heart disease, body mass index, fasting blood glucose, uric acid, creatinine, total cholesterol, and low-density lipoprotein cholesterol, the multivariate unconditional logistic regression analysis revealed that the individuals in the highest quartile of TG/HDL-C ratio was at a significantly increased risk of cognitive impairment compared to those in the lowest quartile of TG/HDL-C ratio (odds ratio =1.257, 95 confidence interval: 1.045 – 1.513). The results of the trend test indicated a significant dose-response relationship between the TG/HDL-C ratio and the risk of cognitive impairment in the residents (χ2 = 2.636, P = 0.008). Furthermore, the RCS curve exhibited an approximate "J" shape (χ2 = 11.810, P = 0.019). ConclusionThe elevated TG/HDL-C ratio constitutes a significant risk factor for cognitive impairment in the middle-aged and elderly population of China.
Keywords
