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Background: Cerebrovascular disease has been suggested as one of the mechanisms to explain the pathogenesis of Alzheimer’s disease (AD) as well as vascular dementia (VaD). Although remnant lipoprotein (RLP) is strongly atherogenic and known as an independent risk factor of cardiovascular disease, there are few studies on the role in cerebrovascular disease. We conducted this study to evaluate the association between RLP and dementia, in terms of vascular etiology. Methods: Subjects were classified into 3 groups of control, AD and VaD. Plasma RLP cholesterol (RLP-C) concentrations were measured by the immunoseparation method. A total of 173 participants, who were 87 ADs, 28 VaDs, and 58 controls, were analyzed and age-matched. Results: RLP-C level was elevated in VaD (11.95±6.67 mg/dL) and AD (10.04±5.90 mg/dL)groups more than in control (6.31±5.18 mg/dL) (p<0.001, ANCOVA). In addition to the control for age, the findings were also independent of the levels of triglyceride (TG), total cholesterol,low-density lipoprotein cholesterol, and high-density lipoprotein cholesterol. The elevation of RLP-C level in AD and VaD was further distinct in subjects with normotriglyceridemia (p=0.001,ANCOVA). Conclusions: Our results demonstrated that RLP-C is elevated in VaD and AD, and can overcome the limitation of TG with heterogenous atherogenic particles. RLP-C might be a useful marker to indicate the cerebrovascular disease with large vessel problem.

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