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ORIGINAL RESEARCH article

Front. Endocrinol.
Sec. Clinical Diabetes
Volume 15 - 2024 | doi: 10.3389/fendo.2024.1505234

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

Provisionally accepted
Huimeng Jia Huimeng Jia 1Liuyu Zhang Liuyu Zhang 1Huijuan Liao Huijuan Liao 1*Yiming Li Yiming Li 1*Pan Liu Pan Liu 1*Qin Shi Qin Shi 1*Bo Jiang Bo Jiang 1*Xian Zhang Xian Zhang 2*Yufeng Jiang Yufeng Jiang 1*ZhiHong Nie ZhiHong Nie 1*Mei Jiang Mei Jiang 3*
  • 1 Gongli Hospital of Shanghai Pudong New Area, shanghaishi, China
  • 2 Ningbo Haishu People’s Hospital, Ningbo, Zhejiang Province, China
  • 3 Department of Neurology, Gongli Hospital, Pudong New Area, Shanghai, shanghaishi, China

The final, formatted version of the article will be published soon.

    Objective: Alzheimer'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.Methods: We 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.Results: Over 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).Conclusion: RC 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.

    Keywords: Alzheimer's disease, Remnant cholesterol, Real world study, Cholesterol, biomarker

    Received: 02 Oct 2024; Accepted: 25 Oct 2024.

    Copyright: © 2024 Jia, Zhang, Liao, Li, Liu, Shi, Jiang, Zhang, Jiang, Nie and Jiang. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence:
    Huijuan Liao, Gongli Hospital of Shanghai Pudong New Area, shanghaishi, China
    Yiming Li, Gongli Hospital of Shanghai Pudong New Area, shanghaishi, China
    Pan Liu, Gongli Hospital of Shanghai Pudong New Area, shanghaishi, China
    Qin Shi, Gongli Hospital of Shanghai Pudong New Area, shanghaishi, China
    Bo Jiang, Gongli Hospital of Shanghai Pudong New Area, shanghaishi, China
    Xian Zhang, Ningbo Haishu People’s Hospital, Ningbo, Zhejiang Province, China
    Yufeng Jiang, Gongli Hospital of Shanghai Pudong New Area, shanghaishi, China
    ZhiHong Nie, Gongli Hospital of Shanghai Pudong New Area, shanghaishi, China
    Mei Jiang, Department of Neurology, Gongli Hospital, Pudong New Area, Shanghai, shanghaishi, China

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