【摘 要】
：
Lipid lowering is the cornerstone in the prevention of cardiovas-cular disease(CVD),which is based on a plethora of data bolstering the causal role of low-density lipoprotein cholesterol(LDL-C)in the process of atherosclerosis.However,a concern that has b
【机 构】
：
Department of Vascular Medicine,Amsterdam UMC,University of Amsterdam,1105 AZ Amsterdam,the Netherla
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Lipid lowering is the cornerstone in the prevention of cardiovas-cular disease(CVD),which is based on a plethora of data bolstering the causal role of low-density lipoprotein cholesterol(LDL-C)in the process of atherosclerosis.However,a concern that has been raised in this regard is whether LDL-C lowering agents,or the subsequent low LDL-C levels,result in cognitive impairment,offsetting the beneficial effect of LDL-C lowering on CVD outcomes.This concern has been fueled by the fact that cholesterol is the main constituent of the brain myelin encircling neurons[1].Moreover,there have been anecdotal reports of statin induced cognitive symptoms[2].However,clear pathophysiological evidence that(pharmacologi-cally induced)low LDL-C levels negatively influence lipid home-ostasis in the brain is lacking.Practically all cholesterol content present in the central nervous system is synthetized de novo in brain cells since the impermeable blood-brain barrier separates lipoprotein metabolism in the brain from the rest of the body[3].In fact,a number of studies have shown that statins resulted in a lower incidence of different types of dementia,for example Alzhei-mer\'s disease[4,5].Schilling et al.,[5]for example,showed that higher LDL-C and total cholesterol concentrations at baseline were associated with an increased risk of Alzheimer\'s disease with a hazard ratio per standard deviation(SD)increase of 1.3(95％con-fidential interval(CI)1.04-1.22,P = 0.0045),and 1.12(95％CI 1.03-1.22,P = 0.0072),respectively.
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