老年人体质量指数与轻度认知功能障碍的关系  

Relationship between BMI and mild cognitive impairment in the elderly

作　　者：赵晨昭 李娇娇 张茗 李捷思 陈陵霞[1] Zhao Chenzhao;Li Jiaojiao;Zhang Ming;Li Jiesi;Chen Lingxia(Department of Geriatrics , Peking University People's Hospital,Beijing 100044,China)

机构地区：[1]北京大学人民医院老年科

出　　处：《中华老年心脑血管病杂志》2019年第10期1058-1062,共5页Chinese Journal of Geriatric Heart,Brain and Vessel Diseases

基　　金：北京市科技计划(Z161100000116095)

摘　　要：目的探讨老年人体质量指数(BMI)与轻度认知功能障碍(MCI)的关系。方法选择2016年10月~2018年6月北京大学人民医院老年科住院的老年患者648例,根据MCI诊断标准分为MCI组216例,对照组432例。收集既往病史资料,计算BMI,其中低体质量45例,正常体质量279例,超重244例,肥胖80例,分析BMI与MCI的关系。结果 MCI组年龄、慢性肾功能不全、糖尿病病程、尿素、尿微量白蛋白/肌酐较对照组明显升高,BMI、蒙特利尔认知评估量表评分、受教育年限、白蛋白、估算肾小球滤过率较对照组明显降低,差异有统计学意义(P<0.05,P<0.01)。与正常体质量比较,低体质量患者MoCA评分明显降低,MCI患病率明显升高,超重和肥胖患者MoCA评分明显升高,MCI患病率明显降低,差异有统计学意义(P<0.05)。低体质量、正常体质量、超重和肥胖患者MCI患病率分别为62.2%、41.6%、24.2%、16.3%,差异有统计学意义(P<0.01)。logistic回归分析显示,与正常体质量比较,超重患者发生MCI的风险降低(OR=0.413,95%CI:0.200~0.851,P=0.016)。结论在一定范围内BMI可能为老年人MCI发生的保护因素。Objective To study the relationship between BMI and mild cognitive impairment (MCI) in the elderly. Methods Six hundred and forty-eight elderly patients admitted to our hospital from October 2016 to June 2018 were divided into MCI group (n=216) and control group (n=432) according to their MoCA score.Their clinical data and BMI were recorded. There were 45 cases of low weight ,279 cases of normal weight ,244 cases of overweight and 80 cases of obesity. The relationship between BMI and MCI was analyzed by logistic regression analysis. Results The age was significantly older, the incidence of chronic renal dysfunction, serum urea level and ratio of urine microalbumin/creatinine were significantly higher while the BMI,MoCA score,serum albumin level and eGFR were significantly lower and the duration of diabetes was significantly shorter in MCI group than in control group (P<0.05,P<0.01). The MoCA score of low body mass was significantly lower and the incidence of MCI of overweight or obesity was significantly lower while the incidence of MCI was significantly higher in low BMI patients than in normal BMI patients (P<0.05). The incidence of MCI was 62.2%,41.6%,24.2% and 16.3% respectively in low BMI patients, normal BMI patients,overweight or obesity patients (P<0.01). Logistic regression analysis showed that the risk of MCI was significantly lower in overweight patients than in normal BMI patients (OR =0.413,95% CI:0.200-0.851,P =0.016). Conclusion BMI is a protective factor for MCI in the elderly.

关 键 词：人体质量指数 认知障碍 肾小球滤过率 糖尿病 肥胖症 

分 类 号：R749.1[医药卫生—神经病学与精神病学]