血清维生素D水平与高龄老年人轻度认知障碍的关系

The Relationship Between Serum Vitamin D Level and Mild Cognitive Impairment in the Elderly

目的探讨血清25-羟基维生素D[25(OH)D]水平与轻度认知障碍(MCI)的关系。方法选择2012-2014年中国老年健康影响因素跟踪调查(CLHLS)基线调查数据,纳入25(OH)D、MMSE和体质指数(BMI)数据完整且没有痴呆病史的80岁及以上研究对象1720名,根据MMSE评分结果分为认知功能正常者和MCI者,分析研究对象基本情况,采用Logistic回归模型评估血清25(OH)D水平与MCI的关系。结果1720名高龄老年人中认知功能正常者1280名,MCI者440例,MCI患病率为25.58%。25(OH)D水平为(40.07+18.47)nmol/L,其中维生素D缺乏(<30 nmol/L)586例,占34.07%;维生素D不足(30~49.9 nmol/L)680例,占39.53%;维生素D正常(>50 nmol/L)454例,占26.40%。MCI者与认知功能正常者年龄、性别、BMI、25(OH)D水平、居住地、教育程度、体育锻炼情况、婚姻状况、现在吸烟及从不吸烟占比、既往饮酒及从不饮酒占比、高血压史及糖尿病史占比比较,差异有统计学意义(P<0.05);多因素Logistic回归分析显示,调整了混杂因素后,随着25(OH)D水平的降低,MCI的患病率呈下降趋势(P<0.05)。结论高龄老人中低水平25(OH)D与MCI密切相关,补充维生素D可能对年龄相关性认知衰退有保护作用。

Objective To explore the relationship between serum 25-hydroxyvitamin D[25(OH)D]level and mild cognitive impairment(MCI).Methods The 2012-2014 China Elderly Health Influencing Factors Tracking Survey(CLHLS)baseline survey data were selected,and 1720 subjects who were 80 years old and above with complete 25(OH)D,MMSE and body mass index(BMI)data and no history of dementia were included.According to the MMSE score,the subjects were divided into normal cognitive function and MCI.The basic situation of the research subjects was analyzed,and the relationship between serum 25(OH)D level and MCI was evaluated by Logistic regression model.Results Among the 1720 elderly people,1280 had normal cognitive function and 440 had MCI.The prevalence of MCI was 25.58%.The 25(OH)D level was(40.0718.47)nmol/L,of which 586 cases of vitamin D deficiency(<30 nmol/L),accounting for 34.07%;680 cases of vitamin D deficiency(30-49.9 nmol/L),accounting for 39.53%;Vitamin D was normal(>50 nmol/L)in 454 cases,accounting for 26.40%.The age,gender,BMI,25(OH)D level,residence,education level,physical exercise status,marital status,current smoking and never smoking percentage of MCI people and people with normal cognitive function,previous drinking and never drinking ratio,history of hypertension and history of diabetes,the difference was statistically significant(P<0.05);Multivariate Logistic regression analysis showed that after adjusting for confounding factors,with the decrease of 25(OH)D level,the prevalence of MCI showed a downward trend(P<0.05).Conclusion The low and medium level of 25(OH)D in the elderly is closely related to MCI.Vitamin D supplementation may have a protective effect on age-related cognitive decline.