高血压病患者认知功能与胰岛素抵抗的相关性研究

Relationship between cognition and insulin resistance in primary hypertensive patients

目的探讨高血压病患者认知功能损害与胰岛素抵抗的关系。方法我院就诊的高血压病患者180例,根据国际通用的简易智力状况量表(mini mental state examination,MMSE)进行认知功能评定,将患者分为两组:认知功能障碍者41例作为病例组,认知功能正常者139例作为对照组。采集一般临床资料,测量血压、身高、体质量,测定总胆固醇,甘油三酯,空腹血糖,空腹胰岛素等指标,用胰岛素抵抗指数(IRI)作为胰岛素敏感性评价指标。结果单因素分析结果显示:年龄、文化程度、饮酒史、IRI、舒张压5个因素在病例组和对照组之间的差异有统计学意义(均P<0.05);对180例患者进行Logistic多因素回归分析显示,与认知功能下降有关的指标是:年龄,文化程度和IRI,OR值分别为1.11(95%CI:1.05-1.16,P<0.05)、10.42(95%CI:2.37-45.78,P<0.05)、2.14(95%CI:1.06-4.30,P<0.05)。结论高血压病人群除文化程度和年龄因素外,胰岛素抵抗与认知功能降低密切相关,且胰岛素抵抗独立于其他危险因素,与认知功能障碍的发生有关。胰岛素抵抗是高血压病患者认知功能障碍重要的危险因素。

Objective To study the relationship between insulin resistance and cognitive impairment in primary hypertensive patients. Methods A total of 180 hypertensive patients were included. The Mini Mental State Examination（MMSE） was applied to test the cognitive function and the scores were calculated. Primary hypertensive patients were divided into two groups： the patients with impaired cognition were classified as ease group（ n = 41）, the patients with normal cognition as control group （ n = 139）. The basic information was collected. Blood pressure, body height and body mass were measured. Total cholesterol,triglycerlde, fasting plasma glucose, fasting plasma insulin were tested. Insulin resistance index（IRI） was applied to estimate insulin resistance. Results Univariate analysis showed that significant difference existed in age, educational level, alcohol drink history, IRI and diastolic blood pressure between ease group and control group（ P 〈0.05）. Multi-variate logistic regression analysis in 180 patients showed that age（OR ：1.11,95%CI：1.05-1.16, P 〈0.05） ,educational level（OR：10.42,95%CI：2.37-45.78, P 〈0. 05） and IRI（OR ：2.14,95%CI. 06-4.30, P 〈0. 05） were correlated with cognitive impairment. Conclusion Besides educational level and age, only insulin resistance is associated with cognitive impairment. Furthermore, insulin resistance, independent of other factors, is correlated with cognitive impairment. Insulin resistance is an important risk factor for the cognitive impairment in primary hypertensive patients.