低密度脂蛋白胆固醇变异性对老年认知功能的影响

Effect of LDL-C variability on cognitive function in the elderly

目的探讨LDL-C变异性对老年认知功能的影响。方法筛选济南市章丘区年龄≥60岁老年人436例,根据LDL-C变异性三分位分为低分位组143例、中分位组151例和高分位组142例。检测受试者血脂水平,并采用简易智能状态检查量表(MMSE)评估认知功能。结果 3组年龄、男性、吸烟、受教育水平、TC、LDL-C及LDL-C变异性水平比较,差异有统计学意义(P<0.05,P<0.01)。最后1次随访,低、中、高分位组MMSE评分、认知功能损伤发生率、MMSE评分变化值比较,差异有统计学意义[(27.88±1.329)分vs(27.79±1.36)分vs(27.45±1.345)分,7.0%vs 10.6%vs 15.5%,(-1.02±0.99)分vs(-1.22±1.00)分vs(-1.44±1.02)分,P<0.05]。高分位组MMSE评分变化值明显高于低分位组,差异有统计学意义(P=0.004)。Spearman分析显示,LDL-C变异性与MMSE评分变化值呈负相关(P<0.01)。校正混杂因素后,logistics回归分析显示,LDL-C变异性是认知功能损伤的独立危险因素(P<0.05),高分位组发生认知功能损伤的危险为低分位组的2.551倍(P<0.05)。结论高LDL-C变异性是老年人认知功能损伤的独立危险因素。

Objective To study the effect of LDL-C variability on cognitive function in the elderly.Methods Four hundred and thirty-six ≥60 years old subjects from Zhangqiu district of Jinan were divided into low tertile group（n=143）,intermediate tertile group（n=151）and high tertile group（n=142）according to their LDL-C variability tertile.Their serum LDL-C level was measured.Their cognitive function was assessed according to the MMSE.Results The age,number of males,smoking history,education level,serum TC and LDL-C level,and LDL-C variability were significantly different in 3 groups（P〈0.05,P〈0.01）.The MMSE score was higher while the incidence of cognitive impairment and changing MMSE score were lower in 3 tertile groups during the last follow-up（P〈0.05）.The changing MMSE score was significantly higher in high tertile group than in low tertile group（P=0.004）.Spearman correlation analysis showed that the LDL-C variability was negatively related with the MMSE score（P〈0.01）.Logistic regression analysis revealed that LDL-C variability was an independent risk factor for cognitive impairment in elderly subjects after adjustment of confounders（P〈0.05）.The risk of cognitive impairment was 2.551-fold higher in high tertile group than in low tertile group（P〈0.05）.Conclusion Elevated LDL-C variability is an independent risk factor for cognitive impairment in the elderly.