老年人轻度认知功能障碍与代谢综合组分的相关性

The relationship between mild cognition impairment and components of metabolic syndrome in the elderly

目的探索老年人轻度认知功能障碍(MCI)与代谢综合征组分的相关性。方法纳入符合入排标准≥65岁老年患者共293例,年龄(78.8±7.5)岁。采用蒙特利尔认知评估量表(MoCA)评定认知功能,比较MCI组和认知功能正常(NC)组各代谢综合征组分,采用二分类Logistic回归分析MCI与代谢综合征组分的相关性。结果各组代谢综合征组分中,MCI组体质指数(BMI)、三酰甘油(TG)均低于NC组[BMI(22.9±3.7)kg/m^2vs.(25.3±3.3)kg/m^2,t=3.124,P=0.002;TG(1.2±0.6)mmol/Lvs.(1.4±0.7)mmol/L,t=2.615,P=0.009];两组高血压比例、糖尿病比例、空腹血糖、高密度脂蛋白胆固醇水平的差异均无统计学意义(均P>0.05)。二分类Logistic回归分析结果显示,在调整年龄、受教育水平后,BMI与MCI独立相关,且随着BMI升高MCI风险下降(OR=0.901,95%CI:0.838~0.968,P=0.004);在老年男性中,调整年龄、受教育水平、吸烟史后,TG与MCI独立相关,且随着TG升高MCI风险下降(OR=0.446,95%CI:0.249~0.874,P=0.017)。在老年女性中,未观察到TG与MCI的独立相关性。结论代谢综合征组分BMI与老年人MCI独立相关,对BMI处于低水平的老年人进行认知功能筛查有助于MCI识别;代谢综合征组分TG与MCI的相关性在不同性别老年人中不同,对不同性别MCI老年人TG管理应采用不同的标准。

Objective To explore the relationship between mild cognition impairment(MCI)and components of metabolic syndrome in the elderly.Methods A total of 293 patients aged 65 years and older with an average age of(78.8±7.5)years who met the inclusion criteria were included.The Montreal Cognitive Assessment Scale(MoCA)was used to evaluate cognitive function.The components of the metabolic syndrome were compared between the MCI and the normal cognitive function(NC)groups.Binary Logistic regression analysis was used to analyze the relationship between cognitive function and components of the metabolic syndrome.Results The levels of body mass index(BMI)and tryglicerides(TG)were lower in the MCI group than in the NC group[BMI,(22.9±3.7)kg/m^2vs.(25.3±3.3)kg/m^2,t=3.124,P=0.002;TG,1.2±0.6 mmol/L vs.1.4±0.7 mmol/L,t=2.615,P=0.009].The differences in proportions of hypertension and diabetes and in levels of fasting blood glucose and high-density lipoprotein cholesterol had no statistically significance between the MCI group and the NC group(all P>0.05).Binary multivariate Logistic regression analysis showed that after adjusting for age and education,BMI was independently associated with MCI,and as BMI increased,the risk of MCI decreased(OR=0.901,95%CI:0.838-0.968,P=0.004).In elderly men,after adjusting for age,education level and smoking history,TG was independently associated with MCI,and as TG increased,the risk of MCI decreased(OR=0.446,95%CI:0.249-0.874,P=0.017).While in elderly women,no independent correlation between TG and MCI was observed.Conclusions BMI is independently associated with MCI.Screening for cognitive function among low-level BMI elderly is helpful to identify MCI.The relationship between TG and MCI is different between different genders,and different standards might be adopted for the management of TG in elderly MCI patients with different genders.