合并心血管疾病的老年高脂血症患者血清HbA_(1c)、γ-GT及ICAM-1水平与认知功能障碍的相关性  

Correlation between serum HbA_(1c),γ-GT,ICAM-1 levels and cognitive impairment in elderly patients with hyperlipidemia complicated with cardiovascular diseases

作　　者：原琳[1] 米玉红[1] 孙黎黎[1] 王溪[1] 李红[2] Yuan Lin;Mi Yuhong;Sun Lili;Wang Xi;Li Hong(Department of Emergency,Beijing Anzhen Hospital Affiliated to Capital Medical University,Beijing 100029,China;Infection Management Office,Beijing Anzhen Hospital Affiliated to Capital Medical University,Beijing 100029,China)

机构地区：[1]首都医科大学附属北京安贞医院急诊科,北京100029 [2]首都医科大学附属北京安贞医院感染管理办公室,北京100029

出　　处：《中华健康管理学杂志》2024年第4期284-288,共5页Chinese Journal of Health Management

基　　金：国家卫生健康委员会科研课题(2022YB63)。

摘　　要：目的分析合并心血管疾病的老年高脂血症患者血清糖化血红蛋白(HbA_(1c))、γ-谷酰转肽酶(γ-GT)及细胞间黏附因子-1(ICAM-1)水平与认知功能障碍的相关性。方法本研究为回顾性队列研究,选取2022年1—12月在首都医科大学附属北京安贞医院接受检查及明确诊断的158例合并心血管疾病的老年高脂血症患者为研究对象,结合受试者文化程度进行简易智能精神状态量表(MMSE)评估,文盲≤17分、小学≤20分、中学及以上≤24分为认知障碍组(67例),其余为非认知障碍组(91例),另选同一时期在院体检的50例健康老年人为对照组,抽取3组血液样本,测定血清HbA_(1c)、γ-GT及ICAM-1水平,分析血清HbA_(1c)、γ-GT及ICAM-1水平与认知功能障碍的相关性。结果认知障碍组血清HbA_(1c)、γ-GT及ICAM-1水平均显著高于非认知障碍组和对照组[5.41%±1.04%比4.82%±0.95%、4.39%±0.86%,(52.01±10.96)比(41.28±9.23)、(25.03±7.17)U/L,(336.61±85.36)比(286.93±72.53)、(143.52±64.20)g/ml],MMSE评分显著低于非认知障碍组和对照组[(20.19±2.85)比(25.30±1.24)、(27.14±1.56)分](均P<0.05)。血清HbA_(1c)、γ-GT及ICAM-1水平均与MMSE评分呈显著负相关(r=-0.512、-0.498、-0.563)(均P<0.05)。血清HbA_(1c)、γ-GT及ICAM-1水平对认知功能障碍诊断的受试者工作特征曲线下面积分别为0.657、0.816、0.691(均P<0.05),最佳截点分别为5.115%、47.65 U/L、304.58 g/ml。结论合并心血管疾病的老年高脂血症患者血清HbA_(1c)、γ-GT及ICAM-1水平与认知功能障碍呈负相关,对于认知功能障碍的评估和早期诊断具有一定价值。Objective To analyze the correlation between serum glycated hemoglobin(HbA_(1c)),γ-glutamyltranspeptidase(γ-GT)and intercellular adhesion factor-1(ICAM-1)levels and cognitive impairment in elderly patients with hyperlipidemia complicated with cardiovascular disease.Methods In this retrospective cohort study,158 elderly patients who underwent examination and were diagnosed with hyperlipidemia complicated with cardiovascular disease at Beijing Anzhen Hospital Affiliated with Capital Medical University from January to December 2022 were selected as study subjects.The simple mental state scale(MMSE)was assessed in the subjects in combination with the subject's level of education.Illiteracy≤17 points,primary school≤20 points,middle school and above≤24 points were classified as cognitive impairment group(67 cases),the rest were were classified into the non-cognitive impairment group(91 cases);and another 50 healthy elderly people who received physical examination in the same period were selected as the control group.The blood samples in the three groups were extracted to measure serum HbA_(1c),γ-GT and ICAM-1.The correlation between HbA_(1c),γ-GT and ICAM-1 levels with cognitive impairment were analyzed.Results The serum levels of HbA_(1c),γ-GT and ICAM-1 in the cognitive impairment group were all significantly higher than those in the non-cognitive impairment group and the control group[5.41%±1.04%vs 4.82%±0.95%,4.39%±0.86%;(52.01±10.96)vs(41.28±9.23),(25.03±7.17)U/L;(336.61±85.36)vs(286.93±72.53),(143.52±64.20)g/ml],and the MMSE score was significantly lower[(20.19±2.85)vs(25.30±1.24),(27.14±1.56)points](all P<0.05).Serum levels of HbA_(1c),γ-GT and ICAM-1 were all significantly negatively correlated with MMSE score(r=-0.512,-0.498,-0.563)(all P<0.05).The areas under the receiver operating characteristic curves(AUCs)for serum HbA_(1c),γ-GT,and ICAM-1 levels in the assessment of cognitive dysfunction were 0.657,0.816,and 0.691,respectively(all P<0.05).The optimal cut-off values were 5.115%,47.

关 键 词：老年人 高脂血症 心血管疾病 糖化血红蛋白 γ-谷酰转肽酶 细胞间黏附因子-1 认知功能障碍 

分 类 号：R54[医药卫生—心血管疾病] R589.2[医药卫生—内科学] R749.1[医药卫生—临床医学]