代谢综合征、基质金属蛋白酶-9活性与老年人轻度认知功能障碍的相关性研究

Relationship of metabolic syndrome and MMP-9 activity with mild cognitive impairment in elderly patients

目的 探讨老年患者代谢综合征（MS）与轻度认知功能障碍（MCI）的相关性及基质金属蛋白酶9（MMP-9）活性的作用。方法 采用简明智力状态量表（MMSE）对135例MS患者及75例健康老年人（对照组）进行认知功能评定；通过测定MMP-9和金属蛋白酶组织抑制因子1（TIMP-1）的血清浓度，计算MMP-9∶TIMP-1比值作为MMP-9的活性指标。结果 MS组MCI的发生率显著高于对照组（22.2% vs 9.33%，P＜0.05）；MS组的MMSE评分显著低于对照组[（26.12±1.15） vs （29.37±0.58），P＜0.05]；MS组的MMP-9活性则显著高于对照组[（0.81±0.35） vs （0.59±0.27）, P＜0.05]，在MS组内MMP-9活性与MMSE呈显著性负相关（r＝-0.519，P＜0.05）；文化程度高是MCI的保护性因素（OR＝0.615，P＝0.023），而MS、糖尿病和MMP-9活性是MCI发生的独立危险因素（OR1＝6.981，P1＝0.011；OR2＝6.250，P2＝0.017；OR3＝3.262，P3＝0.031）。结论 MS是MCI的独立危险因素，MS患者的MMP-9活性水平与其认知功能损伤的程度呈正相关。

Objective To determine the correlations of metabolic syndrome （MS） with mild cognitive impairment （MCI） in the elderly, and investigate the role of matrix metalloproteinase 9 （MMP-9） activity in the process. Methods A total of 135 MS patients [MS group, with an age ranging from 65 to 76 （67.8±6.1） years] and 75 healthy control subjects [Control group, with an age ranging from 65 to 75 （66.3±5.9） years] admitted in our department from March 2009 to June 2012 were enrolled in this study. Mini-mental status examination （MMSE） was applied to evaluate their cognitive function. The plasma levels of MMP-9 and tissue inhibitor of metalloproteinase 1 （TIMP-1） were measured to estimate MMP-9 activity by calculating the ratio of MMP-9 to TIMP-1. Results MCI was more common in MS group than in control group （22.2% vs 9.33%, P〈0.05）. The scores of MMSE were significantly lower in MS group than in control group [（26.12±1.15） vs （29.37±0.58）, P〈0.05]. MS group had significant higher MMP-9 activity than the control group [（0.81±0.35） vs （0.59±0.27）, P〈0.05]. In MS group, the MMP-9 activity was negatively correlated with MMSE score （r=-0.519, P〈0.05）. A high level of education was a protective factor of MCI （OR=0.615, P=0.023）, while MS, diabetes and MMP-9 activity were independent risk factors of MCI （OR1=6.981, P1=0.011; OR2=6.250, P2=0.017; OR3=3.262, P3=0.031）. Conclusion MS is an independent risk factor of MCI. In MS patients, MMP-9 activity is positively correlated with the severity of MCI.