老年人血尿酸与轻度认知功能障碍的关系

Relationship between serum uric acid level and mild cognitive impairment in the elderly

目的探究老年人血尿酸水平与轻度认知功能障碍(MCI)的相关性,为开展社区老年人群痴呆早期发现和认知干预提供参考。方法于2017年4—6月采用多阶段整群分层抽样法选取宁夏银川市的兴庆区、吴忠市的利通区和固原市的西吉县及彭阳县4个县(区)60~80岁的1091名社区居民为研究对象,由统一培训的医学生入户完成面对面问卷调查,包括一般社会人口学资料和简易智力状态检查量表,进行体格检查和实验室检测。最终663名研究对象被纳入分析。采用SPSS 23.0统计软件进行t检验,χ^2检验,采用多因素logistic回归分析血尿酸水平与MCI的相关性。结果按是否患MCI将研究对象分为MCI组(106人)和对照组(557人),MCI检出率为16%。MCI组血尿酸平均水平明显低于对照组,差异有统计学意义(P<0.05)。多因素logistic回归分析结果显示,在老年男性中,年龄(OR=1.097,95%CI:1.003~1.200)与MCI患病高风险相关(P<0.05),而血尿酸水平(OR=0.988,95%CI:0.979~0.997)与MCI低风险相关(P<0.05);在老年女性中,年龄(OR=1.067,95%CI:1.009~1.128)和收缩压(OR=1.021,95%CI:1.004~1.037)均与MCI高风险相关(P<0.05),而文化程度(OR=0.214,95%CI:0.093~0.626)与MCI低风险相关(P<0.05)。结论血尿酸与老年男性MCI患病风险密切相关,正常范围内血尿酸水平高的老年男性MCI患病率更低,后续还需要长期研究或干预试验进一步验证。

Objective To explore the correlation between serum uric acid level and mild cognitive impairment(MCI)in the elderly,and to provide the reference for the early detection of Alzheimer’s disease and intervention of cognitive impairment in community residents.Methods A multi-stage cluster stratified sampling method was used to select 1091 community residents(60~80 years old)in Xingqing,Wuzhong,Xiji and Pengyang counties in Ningxia as the subjects from April to June of 2017.The uniformly trained medical students entered the household to complete a face-to-face questionnaire,which included the general sociodemographic data and a simple intellectual state examination scale;and the physical examination and laboratory test were performed.Finally,663 subjects were included in the analysis.The t test and chi-square test were used to analyze the data,the multi-factor logistic regression model was used to analyze the correlation between blood uric acid level and MCI.The used software was SPSS 23.0.Results The subjects were divided into MCI group(106 cases)and control group(557 cases)according to MCI.The detection rate of MCI was 16%.The average serum uric acid level in the MCI group was significantly lower than that in the normal control group(P<0.05).The multi-factor logistic regression analysis showed that in older men,age(OR=1.097,95%CI:1.003-1.200)correlated to high risk of MCI(P<0.05),and the serum uric acid levels(OR=0.988,95%CI:0.979-0.997)correlated to low risk of MCI(P<0.05);among older women,age(OR=1.067,95%CI:1.009-1.128)and systolic blood pressure(OR=1.021,95%CI:1.004-1.037)correlated to high risk of MCI(P<0.05),but the education level(OR=0.214,95%CI:0.093-0.626)correlated to low risk of MCI(P<0.05).Conclusion Serum uric acid level is closely related to the risk of MCI in older men.The morbidity of MCI is lower in older men with the high serum uric acid level in the normal range.Further research or intervention trials will be needed to further verify.