老年高血压及痴呆患者IGF-1水平检测及临床意义探讨

The Study of the Level and Clinical Significance of IGF-1 in Elderly Hypertensive Patients with Dementia

目的 探讨与老年高血压及痴呆患者血清胰岛素样生长因子-1(IGF-1)水平及其相关意义。方法 选取2021年1月至2022年12月期间我院收治的老年高血压患者,分成老年高血压伴痴呆、老年高血压无痴呆2个研究组,门诊老年无高血压且无痴呆体检者为正常对照组;分析上述3组受试者的IGF-1水平与老年高血压和痴呆之间的相关性及其意义。结果 (1)老年高血压伴痴呆患者的IGF-1水平均显著低于老年高血压无痴呆患者(分别为70.3±38.5μg/L和88.7±26.2μg/L)(P<0.05);(2)老年高血压伴痴呆患者、老年高血压无痴呆患者的IGF-1水平与正常对照组IGF-1水平(111.3±40.1μg/L)比较显著降低(均P<0.05);(3)多因素Logistic回归分析,IGF-1、高血压病史、左室后壁厚度、室间隔厚度可能是老年高血压伴痴呆的危险因素(OR>1,P<0.05),性别、年龄、空腹血糖、TC、HDL-C、LDL-C、TG、hs-CRP不是老年高血压伴痴呆的危险因素(OR<1,P<0.05);(4)IGF-1水平与老年高血压伴痴呆相关性的ROC曲线分析显示,ROC曲线下面积(AUC)为0.889(95%CI 0.823~0.955,P<0.05);IGF-1为93.5μg/L时,对本组病例诊断老年血压伴痴呆的灵敏度为0.927,特异性为0.711。结论 老年高血压患者IGF-1水平显著低于无高血压人群,而高血压合并老年痴呆患者IGF-1水平进一步降低,差异具有统计学意义,提示高血压和痴呆均为导致IGF-1表达下降的重要因素。IGF-1下降、高血压病史、左室后壁厚度及室间隔厚度增加可能是老年高血压伴痴呆的危险因素,IGF-1水平降低对老年高血压伴痴呆有较好的诊断价值。

Objective To investigate the level and clinical significance of insulin-like growth factor-1(IGF-1)in elderly hypertensive patients with dementia.Methods Elderly hypertensive patients admitted to our hospital from January,2021 to December,2022 were divided into two study groups:elderly hypertensive patients with dementia and elderly hypertensive patients without dementia.During the same period,elderly outpatients without hypertension or dementia were selected as the control group.We then retrospectively analyzed the correlation and significance between IGF-1 level and senile hypertension and dementia in these three groups.Results(1)IGF-1 levels in elderly hypertensive patients with dementia were significantly lower than those in elderly hypertensive patients without dementia(respectively:70.3±38.5μg/L,88.7±26.2μg/L)(P<0.05);(2)IGF-1 levels in elderly hypertensive patients with dementia and elderly hypertensive patients without dementia were significantly lower than those in the control group(111.3±40.1μg/L)(both P<0.05);(3)Multivariate logistic regression analysis showed that IGF-1,hypertension history,left ventricular posterior wall thickness,and interventricular septal thickness were risk factors for hypertension and dementia in the elderly(OR>1,P<0.05),while gender,age,fasting blood glucose,TC,HDL-C,LDL-C,TG,hs-CRP were not(OR<1,P<0.05);(4)ROC curve analysis of the correlation between IGF-1 levels and elderly hypertension with dementia showed that the area under the ROC curve(AUC)was 0.889(95%CI 0.823-0.955,P<0.05).When IGF-1 was 93.5μg/L,the sensitivity for diagnosing elderly hypertension with dementia in this group of cases was 0.927 and the specificity was 0.711.Conclusion The level of IGF-1 in elderly hypertensive patients is significantly lower than that in non-hypertensive individuals,while it decreases further in elderly hypertensive patients with dementia,with significant difference,suggesting that both hypertension and dementia are important factors leading to the decrease of IGF-1 expression.Decreased IGF-1,hypertension history,increased left ventricular posterior wall thickness and interventricular septal thickness could be risk factors for hypertension and dementia in the elderly.The decreased IGF-1 level has a good diagnostic value for hypertension with dementia in the elderly.