Inflammation mediates the association between metabolic syndrome and vascular dementia: A large prospective cohort study.

BACKGROUND AND AIMS: The association between Metabolic Syndrome (MetS) and Vascular Dementia (VaD) remains unclear, we investigated the impact of MetS on VaD in a large prospective study in the UK Biobank.

METHODS

313,179 participants were enrolled in the UK Biobank between 2006 and 2010 to explore the associations of MetS and its components with VaD, using Cox proportional hazards models and restricted cubic spline regression. The potential mediating effect of inflammation was further investigated within these associations. A series of sensitivity analyses were conducted to assess the robustness of the results.

RESULTS

During the 3,808,722.27 person-years of follow-up, 994 cases of VaD were identified. MetS at baseline significantly affected the risk of developing VaD (HR: 1.362, 95 % CI: 1.195, 1.551), with 13 % of this significant association mediated by INFLA-index, an inflammation factor. MetS components such as central obesity, hyperglycemia, and low high-density lipoprotein (HDL) levels each contributed to an elevated risk of VaD to varying degrees (HR: Central obesity: 1.261, Hyperglycemia: 2.373, low HDL: 1.194, all P < 0.001). MetS patients under 60 years had a greater risk of developing VaD compared to older MetS patients. Moreover, the results of sensitivity analyses aligned with formal findings, indicating that MetS increased the risk of developing VaD.

CONCLUSIONS

Individuals with MetS are at an increased risk of developing VaD in their later life, with population under 60 years having a relatively higher risk. These findings emphasize the importance of managing MetS, particularly before old age.