基于中国社区成年人群超敏C反应蛋白及无症状性颈动脉狭窄与认知障碍的关系研究

Study on the Relationship between Hypersensitive C-reactive Protein,Asymptomatic Carotid Artery Stenosis and Cognitive Impairment in Chinese Community Adults

目的拟在一项中国社区研究基础上探索hs-CRP、无症状性颈动脉狭窄(asymptomatic carotid stenosis,ACS)与认知障碍的关系。方法本研究对2012年无症状性多血管床狭窄的社区(asymptomatic polyvascular abnormalities community,APAC)研究的随访数据进行了横断面分析,MMSE评分<24分被认为存在认知障碍。校正性别、年龄、BMI、受教育程度、吸烟、饮酒、体力活动、高血压病史、高脂血症病史、糖尿病病史、卒中病史等混杂因素后,采用logistic回归模型分析hs-CRP水平、ACS与认知障碍的关系。结果共有3925名受试者(其中女性1688名,占43.01%)纳入该研究。logisti c回归分析结果显示,在未校正相关因素情况下,hs-CRP水平≥3 mg/L在有无ACS患者中均对认知障碍无影响(无ACS:OR 0.67,95%CI 0.30~1.45;有ACS:OR 0.86,95%CI 0.58~1.28);在校正混杂因素后,hs-CRP水平≥3 mg/L在有无ACS患者中亦对认知障碍无影响(无ACS:OR 0.65,95%CI 0.24~1.75;有ACS:OR 0.97,95%CI 0.59~1.60)。结论hs-CRP水平在有无ACS患者中均对认知障碍没有明显影响,因此,无论患者有无ACS,hs-CRP水平可能都与早期认知功能下降无明显相关。

Objective To explore the relationship between hs-CRP,asymptomatic carotid stenosis(ACS)and cognitive impairment based on a Chinese community study.Methods This study is based on a cross-sectional analysis of the follow-up data of asymptomatic polyvascular abnormalities community(APAC)study in 2012.The Chinese MMSE was used as the cognitive screening scale,and less than 24 is considered cognitive impairment.After adjusting for confounding factors such as sex,age,BMI,education,smoking,alcohol consumption,physical activity,history of hypertension,hyperlipidemia,diabetes,and stroke,the logistic regression model was used to analyze the correlation between hs-CRP,ACS and cognitive impairment.Results A total of 3925 subjects(including 1688 women,accounting for 43.01%)were included in the study.Logistic regression analysis showed that hs-CRP≥3 mg/L had no significant difference in the effect with or without ACS on cognitive impairment without adjusting for relevant factors(without ACS:OR 0.67,95%CI 0.30-1.45;with ACS:OR 0.86,95%CI 0.58-1.28).After adjusting for confounding factors,hs-CRP≥3 mg/L also had no significant difference in the effect with or without ACS on cognitive impairment(without ACS:OR 0.65,95%CI 0.24-1.75;with ACS:OR 0.97,95%CI 0.59-1.60).Conclusions The levels of hs-CRP has no significant impact on cognitive impairment in patients with or without ACS.Therefore,regardless of whether patients have ACS or not,hsCRP may not be significantly associated with early cognitive declin e.