老年人肥胖与认知功能的相关性  

Correlation of obesity and cognitive function in the elderly

作　　者：董凌燕[1] 张洁 邰胜[1] 王月菊[1] 唐海英[1] 郭健政[1] 李建中[1] 

机构地区：[1]苏州大学附属第一医院老年医学科,江苏省215006 [2]山东省文登人民医院内科

出　　处：《江苏医药》2014年第3期291-293,共3页Jiangsu Medical Journal

摘　　要：目的探讨老年人肥胖与认知功能的相关性。方法根据蒙特利尔认知评估量表(MoCA)将150例老年人分为MoCA异常组(A组,94例)和MoCA正常组(B组,56例);以男性腰围≥90cm、女性腰围≥80cm作为诊断中心性肥胖的标准,150例又分为中心性肥胖组(89例)和腰围正常组(61例)。检测血压、血糖、血脂、颈动脉斑块积分(Crouse积分)和C反应蛋白水平,采用胰岛素抵抗指数(HOMA-IR)及胰岛素敏感指数(ISI)评估患者胰岛素抵抗和胰岛素敏感性。结果 A组年龄、腰围、收缩压、低密度脂蛋白胆固醇、Crouse积分、C反应蛋白、空腹血糖和HOMA-IR均高于B组,受教育年限、高密度脂蛋白胆固醇和ISI低于B组(P<0.05)。中心性肥胖组MoCA评分低于腰围正常组(P<0.05)。Spearman相关分析显示,年龄、腰围、收缩压、空腹血糖和HOMA-IR与MoCA评分呈负相关,高密度脂蛋白胆固醇和ISI与MoCA评分呈正相关。多元逐步回归分析显示,年龄、受教育年限、腰围和HOMA-IR是影响MoCA评分的独立危险因素。结论老年人中心性肥胖与认知功能受损高度相关。Objective To explore the association of obesity and cognitive function in elderly patients. Methods On the basis of Montreal Cognitive Assessment（MoCA）, 150 elder patients were divided into two groups of A（abnormal MoCA, 94 cases） and B（normal MoCA, 56 cases）. Taking the waist circumference（WC）≥ 90 cm in male and WC≥ 80 cm in women as the diagnostic criterion of central obesity, 89 cases were with central obesity（group C） and 61 cases were with normal WC（group D）. The measurments included height, weight, WC, blood pressure and other indicators. The homeostasis model assessment of insulin resistance index（HOMA-IR） and insulin sensitivity index （ISI） were calculated. Results The levels of age, WC, fasting plasma glucose（FPG）, systolic blood pressure（SBP）, low-density lipoprotein cholesterol （ LDL-C）, Crouse score, C-reactive protein （CRP） and HOMA-IR in group A were higher than those in group B（P〈0. 05）. The levels of education, high-density lipoprotein cholesterol（HDL-C） and ISI in group A were lower than those in group B （P〈0.05）. In group C, MoCA score was significantly lower than that in group D（P〈0.05）. Spearman analysis showed that the age, WC, SBP, FPG and HOMA-IR were negatively correlated with MoCA score, while HDL-C and ISI were positively correlated with MoCA score. Stepwise multiple regression analysis showed that the age, WC and HOMA-IR were the independent risk fators for effecting MoCA score. Conclusion In the elderly, central obesity is highly correlated with impaired cognitive function.

关 键 词：中心性肥胖 认知功能 胰岛素抵抗 

分 类 号：R592[医药卫生—老年医学]