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High-density lipoprotein (HDL) oxylipins are potent inflammatory mediators. HDL dyshomeostasis and inflammation increase mild cognitive impairment (MCI) and dementia risk, which vary by gender and race/ethnicity. It is unknown whether and how HDL oxylipin profiles differ between non-MCI and MCI individuals, or if potential differences are gender- and/or race/ethnicity dependent. In this targeted lipidomics study, we profiled plasma HDL oxylipins in older (70+) adults (N = 222) with or without MCI to determine how HDL oxylipin composition relates to cognitive impairment status. HDL oxylipin concentrations were analyzed by cognitive status, gender, and race/ethnicity (non-Hispanic Black, Hispanic, and non-Hispanic white). We found a gender- and race/ethnicity-specific association between MCI and lower HDL oxylipin content, which was independent of overall HDL-c concentrations. The HDL of MCI men contained lower amounts of anti-inflammatory and vasodilatory omega (ω)3 EPA C20:5ω3-derived hydroxyeicosapentaenoic acids (HEPEs) and DHA C22:6ω3-derived hydroxydocosahexaenoic acids than that of non-MCI men. Similarly, Hispanic participants with MCI had lower HDL concentrations of EPA C20:5ω3-derived HEPEs and DHA C22:6ω3-derived hydroxydocosahexaenoic acids than non-MCI Hispanic participants. Higher HDL concentrations of EPA C20:5ω3-derived HEPEs appeared protective against MCI in both men and Hispanic individuals. Further, higher oxylipin concentrations within HDL correlated with better cognition in non-Hispanic white women. This work identifying altered HDL oxylipin composition in MCI highlights a novel dysregulated lipid signaling pathway in cognitive decline. Reduced anti-inflammatory and vasodilatory ω3 oxylipins within HDL in MCI men and Hispanic individuals provide molecular evidence linking together HDL functionality, inflammation, and dementia risk.
Kelliher et al. (2026) studied this question.