老年女性骨质疏松患者认知功能障碍与皮质醇水平的相关研究  

The correlation of cognitive impairment in female elderly patients with osteoporosis and cortisol levels

作　　者：彭文芳[1] 黄珊[1] 易正辉[2] 李则挚[3] 

机构地区：[1]上海市长宁区中心医院内分泌科,上海200336 [2]上海交通大学附属精神卫生中心,上海200030 [3]上海第二军医大学附属长海医院神经内科,上海200433

出　　处：《中华骨质疏松和骨矿盐疾病杂志》2013年第3期219-224,共6页Chinese Journal Of Osteoporosis And Bone Mineral Research

基　　金：国家自然科学基金(81000581);上海市卫生局青年课题(20114y098)

摘　　要：目的探讨老年女性骨质疏松患者的认知功能障碍与血浆皮质醇水平变化的关系。方法应用老年成套神经心理测验量表评估72例老年女性骨质疏松患者及78名正常对照者的神经认知功能,采用放射免疫法检测血浆皮质醇、25羟维生素D3、甲状旁腺素、骨钙素、β-胶原特殊序列及性激素水平。结果 2组受试者各时点(8∶00、16∶00、24∶00)的皮质醇水平差异有统计学意义(均P<0.05),2组皮质醇分泌节律差异有统计学意义(均P<0.001),皮质醇分泌节律消失与8∶00 AM皮质醇水平和多项心理测验指标相关(均P<0.05)。结论骨质疏松可能与患者出现多项认知功能损伤相关,并伴有血浆皮质醇水平升高以及皮质醇分泌节律异常。HPA轴功能紊乱可能是女性骨质疏松所致认知功能障碍的病理机制之一。Objective The aims of this study were to investigate the characteristics of cognitive function in female elderly patients with osteoporosis and their relationships with the plasma levels of cortisol. Methods 72 patients with osteoporosis and 78 controls with ages and education levels matched were included in this study, all the subjects have received a set of neuropsychological test battery for elderly for the cognitive assessment, radioimmunoassay was used to measure plasma cortisol, 25 （OH） vitamin D3 , parathyroid hormone and 13-CTX concentrations. Results Plasma eortisol levels in case group at time points of 8： 00; 16： 00; 24：00 were significantly higher than those in control group （ P 〈 0. 05 ）. The loss of normal diurnal rhythm of cortisol secretion in case group was significantly more than that in control group （P 〈0. 001）. Furthermore, plasma cortisol levels at 8：00 and the loss of normal diurnal rhythm of cortisol secretion showed correlation with the scores had multi-domain cognitive impairments （ P 〈 0. 05 ）. Conclusion Patients with osteoporosis prone to trail making were obviously worse than those of controls group. Higher plasma levels of cortisol and more abnormal rhythm of cortisol secretion may play a critical role in cognitive impairments of osteoporosis patients.

关 键 词：骨质疏松 认知功能 皮质醇 

分 类 号：R681[医药卫生—骨科学]