Association between calculated remnant cholesterol levels and incident risks of Alzheimer’s disease among elderly patients with type 2 diabetes: a real-world study

ObjectiveAlzheimer’s disease (AD) is a leading cause of dementia, with a rising global burden. Remnant cholesterol (RC), a component of triglyceride-rich lipoproteins, has been implicated in cardiovascular diseases and metabolic disorders, but its role in AD remains unclear. This study investigated...

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Main Authors: Huimeng Jia, Liuyu Zhang, Huijuan Liao, Yiming Li, Pan Liu, Qin Shi, Bo Jiang, Xian Zhang, Yufeng Jiang, Zhihong Nie, Mei Jiang
Format: Article
Language:English
Published: Frontiers Media S.A. 2024-11-01
Series:Frontiers in Endocrinology
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Online Access:https://www.frontiersin.org/articles/10.3389/fendo.2024.1505234/full
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author Huimeng Jia
Liuyu Zhang
Huijuan Liao
Yiming Li
Pan Liu
Qin Shi
Bo Jiang
Xian Zhang
Yufeng Jiang
Zhihong Nie
Mei Jiang
author_facet Huimeng Jia
Liuyu Zhang
Huijuan Liao
Yiming Li
Pan Liu
Qin Shi
Bo Jiang
Xian Zhang
Yufeng Jiang
Zhihong Nie
Mei Jiang
author_sort Huimeng Jia
collection DOAJ
description ObjectiveAlzheimer’s disease (AD) is a leading cause of dementia, with a rising global burden. Remnant cholesterol (RC), a component of triglyceride-rich lipoproteins, has been implicated in cardiovascular diseases and metabolic disorders, but its role in AD remains unclear. This study investigated the association between RC levels and the risk of AD among elderly patients with type 2 diabetes (T2D) in a real-world clinical setting.MethodsWe conducted a retrospective cohort study using electronic medical records from Gongli Hospital of Shanghai Pudong New Area, covering the period from 2013 to 2023. The study included 15,364 elderly patients aged 65-80 years with T2D. RC levels were calculated using the equation. The primary outcome was the diagnosis of AD, validated by neurologists using ICD-10-CM code G30. Cox proportional hazards models were employed to estimate hazard ratios (HRs) for AD across quartiles of RC levels, adjusting for potential confounders.ResultsOver a mean follow-up of 3.69 ± 1.33 years, 312 new cases of AD were identified. A U-shaped relationship was observed between RC levels and AD risk, with the lowest risk associated with RC levels between 0.58-0.64 mmol/L. Both lower (<0.52 mmol/L) and higher (≥0.77 mmol/L) RC levels were linked to increased AD risk. Compared to the reference group (Q2: 0.52-0.64 mmol/L), the adjusted HRs (95% CI) for the lowest and highest quartiles were 1.891 (1.368-2.613) and 1.891 (1.363-2.622), respectively. Each 1 mmol/L increase in RC was associated with a 3.47-fold higher risk of AD (HR=4.474, 95% CI 2.330-8.592).ConclusionRC levels may serve as a predictive biomarker for AD risk, with both extremes posing a higher risk. Future studies should explore the mechanistic pathways and potential interventions targeting RC to prevent AD in high-risk populations.
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spelling doaj-art-7be43679afec41d28d9b35dcb79ac3fd2025-08-20T02:06:54ZengFrontiers Media S.A.Frontiers in Endocrinology1664-23922024-11-011510.3389/fendo.2024.15052341505234Association between calculated remnant cholesterol levels and incident risks of Alzheimer’s disease among elderly patients with type 2 diabetes: a real-world studyHuimeng Jia0Liuyu Zhang1Huijuan Liao2Yiming Li3Pan Liu4Qin Shi5Bo Jiang6Xian Zhang7Yufeng Jiang8Zhihong Nie9Mei Jiang10Department of General Medicine, Gongli Hospital of Shanghai Pudong New Area, Shanghai, ChinaDepartment of General Medicine, Gongli Hospital of Shanghai Pudong New Area, Shanghai, ChinaDepartment of General Medicine, Gongli Hospital of Shanghai Pudong New Area, Shanghai, ChinaDepartment of General Medicine, Gongli Hospital of Shanghai Pudong New Area, Shanghai, ChinaDepartment of General Medicine, Gongli Hospital of Shanghai Pudong New Area, Shanghai, ChinaDepartment of General Medicine, Gongli Hospital of Shanghai Pudong New Area, Shanghai, ChinaDepartment of General Medicine, Gongli Hospital of Shanghai Pudong New Area, Shanghai, ChinaDepartment of Neurology, Haishu District People’s Hospital, Ningbo, ChinaDepartment of Cardiology, Gongli Hospital of Shanghai Pudong New Area, Shanghai, ChinaDepartment of General Medicine, Gongli Hospital of Shanghai Pudong New Area, Shanghai, ChinaDepartment of Neurology, Gongli Hospital of Shanghai Pudong New Area, Shanghai, ChinaObjectiveAlzheimer’s disease (AD) is a leading cause of dementia, with a rising global burden. Remnant cholesterol (RC), a component of triglyceride-rich lipoproteins, has been implicated in cardiovascular diseases and metabolic disorders, but its role in AD remains unclear. This study investigated the association between RC levels and the risk of AD among elderly patients with type 2 diabetes (T2D) in a real-world clinical setting.MethodsWe conducted a retrospective cohort study using electronic medical records from Gongli Hospital of Shanghai Pudong New Area, covering the period from 2013 to 2023. The study included 15,364 elderly patients aged 65-80 years with T2D. RC levels were calculated using the equation. The primary outcome was the diagnosis of AD, validated by neurologists using ICD-10-CM code G30. Cox proportional hazards models were employed to estimate hazard ratios (HRs) for AD across quartiles of RC levels, adjusting for potential confounders.ResultsOver a mean follow-up of 3.69 ± 1.33 years, 312 new cases of AD were identified. A U-shaped relationship was observed between RC levels and AD risk, with the lowest risk associated with RC levels between 0.58-0.64 mmol/L. Both lower (<0.52 mmol/L) and higher (≥0.77 mmol/L) RC levels were linked to increased AD risk. Compared to the reference group (Q2: 0.52-0.64 mmol/L), the adjusted HRs (95% CI) for the lowest and highest quartiles were 1.891 (1.368-2.613) and 1.891 (1.363-2.622), respectively. Each 1 mmol/L increase in RC was associated with a 3.47-fold higher risk of AD (HR=4.474, 95% CI 2.330-8.592).ConclusionRC levels may serve as a predictive biomarker for AD risk, with both extremes posing a higher risk. Future studies should explore the mechanistic pathways and potential interventions targeting RC to prevent AD in high-risk populations.https://www.frontiersin.org/articles/10.3389/fendo.2024.1505234/fullAlzheimer’s diseaseremnant cholesterolreal world studycholesterolbiomarker
spellingShingle Huimeng Jia
Liuyu Zhang
Huijuan Liao
Yiming Li
Pan Liu
Qin Shi
Bo Jiang
Xian Zhang
Yufeng Jiang
Zhihong Nie
Mei Jiang
Association between calculated remnant cholesterol levels and incident risks of Alzheimer’s disease among elderly patients with type 2 diabetes: a real-world study
Frontiers in Endocrinology
Alzheimer’s disease
remnant cholesterol
real world study
cholesterol
biomarker
title Association between calculated remnant cholesterol levels and incident risks of Alzheimer’s disease among elderly patients with type 2 diabetes: a real-world study
title_full Association between calculated remnant cholesterol levels and incident risks of Alzheimer’s disease among elderly patients with type 2 diabetes: a real-world study
title_fullStr Association between calculated remnant cholesterol levels and incident risks of Alzheimer’s disease among elderly patients with type 2 diabetes: a real-world study
title_full_unstemmed Association between calculated remnant cholesterol levels and incident risks of Alzheimer’s disease among elderly patients with type 2 diabetes: a real-world study
title_short Association between calculated remnant cholesterol levels and incident risks of Alzheimer’s disease among elderly patients with type 2 diabetes: a real-world study
title_sort association between calculated remnant cholesterol levels and incident risks of alzheimer s disease among elderly patients with type 2 diabetes a real world study
topic Alzheimer’s disease
remnant cholesterol
real world study
cholesterol
biomarker
url https://www.frontiersin.org/articles/10.3389/fendo.2024.1505234/full
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