中老年轻度认知障碍人群血脂及胰岛素抵抗相关指标与认知评分的相关性  

Correlation of related indexes of blood lipid and insulin resistance with cognition scores in middle-aged and elderly people with mild cognitive impairment

作　　者：刘晓楠[1] 洪音 隗春玉 冯蕾[1] 李汶逸 李润芝 徐俊 王瑞青[1] 郑华光[1] Xiaonan Liu;Yin Hong;Chunyu Huai;Lei Feng;Wenyi Li;Runzhi Li;Jun Xu;Ruiqing Wang;Huaguang Zheng(Health Management Center,Beijing Tiantan Hospital,Capital Medical University,Beijing 100070,China;Department of Cognitive Neurology,Beijing Tiantan Hospital,Capital Medical University,Beijing 100070,China)

机构地区：[1]首都医科大学附属北京天坛医院健康管理中心,北京100070 [2]首都医科大学附属北京天坛医院神经病学中心认知障碍性疾病科,北京100070

出　　处：《中华健康管理学杂志》2023年第1期13-18,共6页Chinese Journal of Health Management

基　　金：国家重点研发计划(2018YFC1311203,2019YFC0120902);国家自然科学基金(82071187,81870821);北京市青年拔尖团队项目(2018000021223TD08);北京市自然科学基金-海淀原始创新联合基金(L182055)。

摘　　要：目的分析中老年轻度认知障碍(MCI)人群血脂及胰岛素抵抗相关指标与认知评分的相关性。方法本研究为横断面研究,连续选取2021年1月1日—7月31日在首都医科大学附属北京天坛医院健康管理中心进行体检且蒙特利尔认知功能量表(MoCA)评分≥18分的262例中老年人群为研究对象,根据认知功能和MoCA评分分为MCI组(143例)和认知正常组(119例)。收集两组基本资料、空腹血糖、甘油三酯(TG)、总胆固醇、载脂蛋白E(ApoE)基因型等临床指标,采用假设检验比较两组基本资料、血脂及胰岛素抵抗相关指标差异,采用Spearman相关性分析评估两组血脂及胰岛素抵抗相关指标与MoCA评分的相关性。结果MCI组年龄及高血压、冠心病、糖尿病患者比例均显著高于认知正常组[(54.83±8.29)比(50.76±6.34)岁、37.76%比31.93%、4.20%比0.84%、16.08%比8.40%](均P<0.05)。MCI组血清TG升高(r=-0.50,95%CI:-0.88~-0.12)、TG葡萄糖乘积指数(TyG)升高(r=-0.75,95%CI:-1.29~-0.20)、TG高密度脂蛋白胆固醇比值(TG/HDL-C)升高(r=-0.52,95%CI:-0.91~-0.13)均与MoCA评分呈负相关(均P<0.05);校正年龄、性别后,TG升高(r=-0.39,95%CI:-0.75~-0.31)、TG/HDL-C升高(r=-0.43,95%CI:-0.80~-0.05)仍与MoCA评分呈负相关(均P<0.05)。认知正常组各指标与MoCA评分的相关性差异均无统计学意义(均P>0.05)。MCI组携带ApoEε4基因型人群TG升高与MoCA评分呈负相关(r=-0.70,95%CI:-1.23~0.16,P=0.017);携带ApoEε2、ApoEε3基因型人群TG与MoCA评分的相关性差异均无统计学意义(均P>0.05)。结论中老年MCI人群血脂及胰岛素抵抗相关指标升高与认知评分呈负相关,这在携带ApoEε4基因型人群中更为明显。Objective To analyze the correlation between related indexes of serum lipid and insulin resistance and cognitive impairment in middle-aged and elderly people with mild cognitive impairment(MCI).Methods In this cross-sectional study,262 middle-aged and elderly patients with a Montreal Cognitive Function Scale(MoCA)cognitive score greater than or equal to 18 points who underwent physical examination in the Health Management Center of Beijing Tiantan Hospital Affiliated to Capital Medical University from January 1 to July 31,2021 were selected as subjects.According to the cognitive function and MoCA score,the patients were divided into MCI group(143 cases)and normal cognition group(119 cases).Basic data,fasting blood glucose,triglyceride(TG),total cholesterol,apolipoprotein E(ApoE)genotype and other clinical indicators were collected.Hypothesis test was used to compare the differences in basic data,related indicators of blood lipid and insulin resistance between the two groups.Spearman correlation analysis was used to analyze the correlation between related indicators of blood lipid and insulin resistance and MoCA score in the two groups.Results The age and the proportion of patients with hypertension,coronary heart disease and diabetes in the MCI group were all significantly higher than those in normal cognition group[(54.83±8.29)vs(50.76±6.34)years,37.76%vs 31.93%,4.20%vs 0.84%,16.08%vs 8.40%](all P<0.05).The elevation of serum TG(r=-0.50,95%CI:-0.88--0.12),TG glucose product index(TyG)(r=-0.75,95%CI:-1.29--0.20)and TG to high-density lipoprotein cholesterol ratio(TG/HDL-C)(r=-0.52,95%CI:-0.91--0.13)were all negatively correlated with MoCA score(all P<0.05).After adjusting for age and gender,the elevation of TG(r=-0.39,95%CI:-0.75--0.31)and TG/HDL-C(r=-0.43,95%CI:-0.80--0.05)were both still negatively correlated with MoCA score(both P<0.05).There was no significant correlation between all indexes and MoCA scores in the normal cognition group(all P>0.05).The elevated TG was negatively correlated with MoCA score i

关 键 词：认知障碍 血脂 胰岛素抵抗 载脂蛋白E 

分 类 号：R749.1[医药卫生—神经病学与精神病学]