血清胆红素和尿酸浓度与轻度认知障碍的相关性研究

Correlation between serum bilirubin and uric acid concentration and mild cognitive impairment

目的探讨轻度认知功能障碍(MCI)患者血清胆红素和尿酸水平与认知功能的关系。方法检测71例MCI患者(MCI组)及80名认知正常者(对照组)患者的血尿酸、总胆红素(TB)、直接胆红素(DBIL)、间接胆红素(IBIL)水平。采用MMSE和蒙特利尔认知评估量表(MoCA)对入组者行神经心理学评定。结果与对照组比较,MCI组年龄及吸烟史比率显著升高(均P<0.05),受教育年限、MMSE评分、MoCA评分、MoCA子评分中的视空间与执行能力、注意力、抽象思维、延迟回忆及TB、IBIL、尿酸浓度显著降低(P<0.05~0.01)。TB与MMSE、MoCA评分呈正相关(r=0.287,P=0.030;r=0.347,P=0.024),与MoCA子项目中的视空间与执行功能、抽象思维、延迟回忆呈正相关(r=0.327,P=0.040;r=0.310,P=0.028;r=0.315,P=0.038)。尿酸与MMSE、MoCA评分呈正相关(r=0.293,P=0.030;r=0.337,P=0.013),与MoCA子项目中的视空间与执行功能、注意力、延迟回忆、抽象思维呈正相关(r=0.300,P=0.021;r=0.318,P=0.013;r=0.302,P=0.020;r=0.296,P=0.025)。多因素Logistic回归分析显示,高龄、低教育程度和吸烟是MCI的独立危险因素(P<0.05~0.01),TB及尿酸水平是MCI的保护性因素(均P<0.05)。结论高龄、低教育程度和吸烟可促进MCI发生,TB及尿酸水平可防止MCI。

Objective To investigate the relationship between serum bilirubin and uric acid levels and cognitive function in patients with mild cognitive impairment(MCI).Methods Serum uric acid, total bilirubin(TB), direct bilirubin(DBIL) and indirect bilirubin(IBIL) levels were measured in 71 patients with MCI(MCI group) and 80 cognitive normal controls(control group). Neuropsychological assessment was performed on the enrollees by MMSE and montreal cognitive assessment scale(MoCA).Results Compared with those in control group, the age and smoking history ratio in MCI group were significantly increased(all P<0.05), the years of education, MMSE score, MoCA score and visual space and executive function, abstract thinking, delayed recall in MoCA subproject and the levels of TB, IBIL, uric acid in MCI group were significantly lower(P<0.05-0.01). TB was positively correlated with MMSE and MoCA scores(r=0.287, P=0.030;r=0.347, P=0.024), and it was positively correlated with visual space and executive function, abstract thinking and delayed recall in MoCA subproject(r=0.327, P=0.040;r=0.310, P=0.028;r=0.315, P=0.038). Uric acid was positively correlated with MMSE and MoCA scores(r=0.293, P=0.030;r=0.337, P=0.013), and it was positively correlated with visual space and executive function, attention, delayed recall and abstract thinking in the MoCA subproject(r=0.300, P=0.021;r=0.318, P=0.013;r=0.302, P=0.020;r=0.296, P=0.025). Multivariate Logistic regression analysis showed that advanced age, low education level and smoking were independent risk factors for MCI(P<0.05-0.01), and TB and uric acid levels were protective factors of MCI(all P<0.05).Conclusion Advanced age, low education level and smoking can promote the MCI, and TB and uric acid levels can prevent the MCI.