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A range of serum lipids is explored in association with brain structure and cognitive function amongst rural\u2010dwelling older adults.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This population\u2010based cross\u2010sectional study included 184 rural\u2010dwelling adults (age\u00a0\u2265\u00a065\u00a0years, 39.1% women) in Shandong, China. In 2014\u20132016, data on demographics, lifestyle, health conditions and serum lipids were collected. Volumes of gray matter, white matter, ventricles, hippocampus and white matter hyperintensity were automatically estimated on brain magnetic resonance imaging. Global cognitive function was assessed with the Mini\u2010Mental State Examination (MMSE), and mild cognitive impairment (MCI) was defined according to Petersen's criteria. Data were analyzed using the general linear regression, logistic regression and mediation models.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Of the 184 participants, 47 were defined with MCI. Low high\u2010density lipoprotein cholesterol (HDL\u2010C; &lt;1.55 vs. \u22651.55\u00a0mmol\/l) was significantly associated with reduced volumes of total white matter (multi\u2010adjusted <jats:italic>\u03b2<\/jats:italic>\u00a0=\u00a0\u22129.77, 95% confidence interval \u221219.48\u20130.06) and hippocampus (\u22120.23, \u22120.46\u20130.01), a lower MMSE score (\u22121.49, \u22122.67\u20130.31) and a higher likelihood of MCI (multi\u2010adjusted odds ratio\u00a03.21, 95% confidence interval 1.42\u20137.29). The mediation effects of structural brain measures on the associations between a low level of HDL\u2010C and MMSE score or MCI were not statistically significant (<jats:italic>p<\/jats:italic>\u00a0&gt;\u00a00.05).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>This study suggests that low HDL\u2010C may be involved in structural brain aging and cognitive dysfunction amongst rural\u2010dwelling older adults in China, but the association of low HDL\u2010C with cognitive aging phenotypes appears not to be mediated by brain structure.<\/jats:p><\/jats:sec>","DOI":"10.1111\/ene.14939","type":"journal-article","created":{"date-parts":[[2021,5,25]],"date-time":"2021-05-25T11:57:10Z","timestamp":1621943830000},"page":"2882-2892","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":23,"title":["High\u2010density lipoprotein cholesterol and brain aging amongst rural\u2010dwelling older adults: a population\u2010based magnetic resonance imaging study"],"prefix":"10.1111","volume":"28","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9563-4206","authenticated-orcid":false,"given":"Mingqi","family":"Wang","sequence":"first","affiliation":[{"name":"Department of Neurology Shandong Provincial Hospital Cheeloo College of Medicine Shandong University Jinan Shandong China"},{"name":"Shandong Provincial Clinical Research Center for Neurological Diseases Jinan Shandong China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuanjing","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Neurobiology, Care Sciences and Society Aging Research Center Karolinska Institutet Stockholm University Stockholm Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lin","family":"Cong","sequence":"additional","affiliation":[{"name":"Department of Neurology Shandong Provincial Hospital Cheeloo College of Medicine Shandong University Jinan 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