血清同型半胱氨酸与认知障碍的相关性研究

The association between serum homocysteine and cognitive impairment

目的探讨中国社区人群血清同型半胱氨酸(homocysteine,Hcy)与认知障碍的相关性。方法选取参与2015年国家卒中高危人群筛查和干预项目的北京市昌平区北七家社区服务中心筛查点和2016年度北京市顺义区空港医院筛查点的社区居住人群。蒙特利尔认知评估量表(Montreal Cognitive Assessment,Mo CA)及各分项领域得分越低提示认知功能损伤越重,作为连续变量纳入分析。采用多因素线性回归分析Hcy与认知障碍之间的关系。结果研究共纳入3310例(平均年龄58.46岁,男性占42.8%),Hcy水平与认知障碍(Mo CA总分)负相关(P<0.001),且主要表现在命名、语言和延迟回忆方面(P<0.001)。在校正了可能的混杂因素后,Hcy水平与认知障碍的相关性仍存在(β=-0.027,P=0.015),但仅影响语言(β=-0.011,P<0.001)和延迟回忆(β=-0.019,P=0.042)的功能。结论随着Hcy水平升高,认知功能水平下降,尤其表现在语言和延迟回忆方面。

Objective This study aims to investigate the association between serum homocysteine(Hcy)and cognitive impairment in general community Chinese population.Method The subjects were selected from China National Stroke Screen Survey(CNSSS),from Beiqijia community in Changping District in 2015,and Beijing Airport Hospital in Shunyi District in 2016,Beijing.Cognition status was evaluated via the Montreal Cognitive Assessment(Mo CA).The lower the score of Mo CA,the more severe the cognitive decline.The score of each domain was included in the analysis as continuous variables.Multivariate linear regression models were used to assess the association between serum Hcy and cognitive function.Result A total of 3310 participants with a mean age of 58.46 years old were included.42.8%of them were male.Hcy was negatively correlated with the total score of Mo CA(P<0.001).Naming,language and delayed recall showed the significance(P<0.001).After adjusting for the potential confounders,the negative correlation between Hcy and cognitive impairment(total score of Mo CA)remained significant(β=-0.027,P=0.015),and mainly affected language(β=-0.011,P<0.001)and recall(β=-0.019,P=0.042).Conclusion Elevated level of homocysteine is independently associated with the cognitive decline in Chinese community population,especially the language ability and recall.