上海市社区老年人认知功能障碍与脂代谢的相关性研究

Correlation between cognitive impairment and lipid metabolism of the elderly in Shanghai communities

目的探讨社区老年人认知功能障碍与脂代谢的相关性。方法2016年7月-2019年12月,纳入1156名来自上海市徐汇区枫林街道社区卫生服务中心、徐家汇街道社区卫生服务中心年龄≥60岁的老年人,收集其一般资料和实验室数据,完成MoCA量表,并由临床医师综合评估认知功能,进行一般统计学特征描述,单因素分析,多因素Logistic回归分析,研究认知功能障碍与脂代谢的相关性。结果认知功能正常组与认知功能障碍组的年龄、受教育时间、饮茶比例、红细胞计数(RBC)、血红蛋白(HGB)、空腹血糖(FBG)、高密度脂蛋白胆固醇(HDL-C)、载脂蛋白A1(ApoA1)、载脂蛋白B/载脂蛋白A1(ApoB/ApoA1)、总胆固醇/高密度脂蛋白胆固醇(TC/HDL-C)、非高密度脂蛋白胆固醇/高密度脂蛋白胆固醇(Non-HDL-C/HDL-C)差异均具有统计学意义(P<0.05)。Logistic回归分析显示ApoB/ApoA1(OR=2.801,95%CI:1.4565.390,P=0.002)是认知功能障碍的独立危险因素。结论认知功能下降可能与脂代谢相关,ApoB/ApoA1升高可能是老年人认知功能障碍的危险因素。

Objective To investigate and preliminarily explore the relationship between cognitive impairment and lipid metabolism in the elderly population in Shanghai communities.Methods From July 2016 to December 2019,a total of 1156 elderly individuals aged 60 years and older from the Community Health Service Centers of Fenglin Street and Xujiahui Street in Xuhui District,Shanghai,wereenrolled in this study.Their general clinical information and laboratory data were collected,and the Montreal Cognitive Assessment(MoCA)scale was administered to assess cognitive function.The cognitive function was further evaluated by specialized clinical physicians.General descriptive statistics,univariate analysis,multiple Logistic regression analysis,and correlation analysis were conducted to investigate the association between cognitive impairment and lipid metabolism in the community-dwelling elderly population.Results The cognitive normal group and cognitive impairment group showed statistical differences(P<0.05)in age,education duration,proportion of tea drinkers,red blood cell count(RBC),hemoglobin(HGB),fasting blood glucose(FBG),high-density lipoprotein cholesterol(HDL-C),apolipoprotein A1(ApoA1),apolipoprotein B/apolipoprotein A1(ApoB/ApoA1),total cholesterol/high-density lipoprotein cholesterol(TC/HDL-C),and non-high-density lipoprotein cholesterol/high-density lipoprotein cholesterol(Non-HDL-C/HDL-C).Logistic regression analysis showed that ApoB/ApoA1(OR=2.801,95%CI:1.456-5.390,P=0.002)was an independent risk factor for cognitive impairment.Conclusion Cognitive decline may be related to lipid metabolism,and an increase in ApoB/ApoA1 ratio may be a risk factor for cognitive impairment in the elderly.