高尿酸血症与非肥胖老年人轻度认知障碍的关系

The relationship between hyperuricemia and mild cognitive impairment in non-obese elderly

目的确定尿酸(UA)与轻度认知障碍(MCI)的关系以及其对炎症的潜在影响。方法本研究纳入经神经心理学量表诊断为MCI的患者450名和认知功能正常的对照组450名。所有受试者年龄均≥60岁。MCI组有184名肥胖受试者,对照组有199名肥胖受试者。结果在所有MCI患者和非肥胖MCI患者中均发现较高的血清UA水平与较低的MCI风险之间存在相关性(OR:0.60,95%CI 0.45~0.78;OR:0.42,95%CI 0.29~0.62),但肥胖的MCI患者则不然(OR:0.86,95%CI 0.54~1.35)。肥胖MCI患者的血清UA和超敏C反应蛋白(hypersensitive C-reactive protein,hs-CRP)水平均高于非肥胖MCI患者(P<0.01)。肥胖MCI患者的血清UA水平与血清hs-CRP水平呈线性正相关(r=0.505,P<0.01),而非肥胖MCI患者血清hs-CRP水平与UA水平无明显相关性(r=0.053,P=0.385)。结论在非肥胖受试者中,较低的血清尿酸水平与较高的MCI风险之间存在显著的相关性。肥胖引起的炎症可能会削弱这种关系。

Objective To determine the relationship between uric acid(UA)and mild cognitive impairment(MCI),and its potential effect on inflammation.Methods 450 patients with MCI diagnosed by neuropsychological scale and 450 controls with normal cognitive function were included.All subjects were≥60 years old.There were 184 obese subjects in MCI group and 199 obese subjects in control group.Results A correlation between increased serum UA level and decreased risk of MCI was found in all MCI patients and non-obese MCI patients(OR:0.60,95%CI 0.45-0.78;OR:0.42,95%CI 0.29-0.62),but not in obese MCI patients(OR:0.86,95%CI:0.54-1.35).The levels of UA and hypersensitive C reactive protein(hs-CRP)in obese patients with MCI were higher than those in non-obese patients(P<0.01).There was a linear positive correlation between serum UA and hs-CRP levels in obese patients with MCI(r=0.505,P<0.01),but not in non-obese MCI patients(r=0.053,P=0.385).Conclusion A significant correlation between lower serum uric acid levels and higher risk of MCI in non-obese subjects was found.Inflammation caused by obesity may weaken this relationship.