中国中老年人群甘油三酯葡萄糖指数-腰围身高比与认知障碍关联的队列研究  

A cohort study of association between triglyceride glucose index-waist to height ratio and cognitive impairment in middle-aged and elderly population in China

作　　者：侯丁淳 魏玥 孙玉梅[2] 裴丽君[1] 陈功 Hou Dingchun;Wei Yue;Sun Yumei;Pei Lijun;Chen Gong(Institute of Population Research,Peking University,Beijing 100871,China;School of Nursing,Peking University,Beijing 100191,China;Chinese Center for Population Health and Development,Peking University,Beijing 100871,China)

机构地区：[1]北京大学人口研究所,北京100871 [2]北京大学护理学院,北京100191 [3]北京大学中国老龄事业发展研究中心,北京100871

出　　处：《中华流行病学杂志》2024年第6期802-808,共7页Chinese Journal of Epidemiology

基　　金：国家社会科学基金(23ZDA101);中国工程院战略研究与咨询项目(2022-XBZD-30)。

摘　　要：目的分析中老年人中甘油三酯葡萄糖指数(TyG)-腰围身高比(WHtR)(TyG-WHtR)与认知障碍的关联。方法应用中国健康与养老追踪调查数据,以2011年和2015年的8946名中老年人为基线人群,构建队列数据库。应用Cox比例风险回归模型估计中老年人基线TyG-WHtR不同水平与认知障碍风险的关联,并分别进行年龄和性别分层分析。结果8946名研究对象平均随访7.08人年,认知障碍发病密度为21.15/1000人年。与TyG-WHtR的Q_(1)水平相比,其Q_(3)和Q_(4)水平分别使认知障碍风险增加32%(HR=1.32,95%CI:1.09~1.60)和47%(HR=1.47,95%CI:1.14~1.91)。趋势检验显示,认知障碍风险随TyG-WHtR水平升高而增加,且存在剂量-反应关系(P=0.001)。分层分析显示,45~59岁人群中,与TyG-WHtR的Q_(1)水平相比,其Q_(3)水平使认知障碍风险增加34%(HR=1.34,95%CI:1.02~1.78);≥60岁人群中,相比于TyG-WHtR的Q_(1)水平,其Q_(3)和Q_(4)水平分别使认知障碍风险增加31%(HR=1.31,95%CI:1.01~1.72)和63%(HR=1.63,95%CI:1.15~2.31);男性中,TyG-WHtR水平与认知障碍风险无统计学关联(P>0.05);女性中,相比于TyG-WHtR的Q_(1)水平,其Q_(4)水平使认知障碍风险增加76%(HR=1.76,95%CI:1.26~2.46)。结论中老年人中较高的TyG-WHtR水平可增加认知障碍风险,且存在年龄、性别差异,早期的心血管健康管理和科学合理的体重管理对预防认知障碍具有重要意义。Objective To explore the association between triglyceride glucose index(TyG)-waist to height ratio(WHtR)(TyG-WHtR)and cognitive impairment in middle-aged and elderly population.Methods A cohort database was constructed using the data from the China Health and Retirement Longitudinal Study,with 8946 participants in 2011 and 2015 as the baseline population.Cox proportional hazards regression models were used to estimate the association between TyG-WHtR levels at baseline and the risk of cognitive impairment in middle-aged and elderly population.The analysis was stratified by age and gender,respectively.Results A total of 8946 participants were included,with an average follow-up of 7.08 person-years and incidence density of cognitive impairment for 21.15 per 1000 person-years.Compared with the Q_(1) level of TyG-WHtR,its Q_(3) and Q_(4) level increased the risk of cognitive impairment by 32%(HR=1.32,95%CI:1.09-1.60)and 47%(HR=1.47,95%CI:1.14-1.91),respectively.Trend test showed that the risk of cognitive impairment increased with the increase of TyG-WHtR level,and there was a dose-response relationship(P=0.001).Stratified analysis showed that in the population aged 45-59 years,compared with the Q_(1) level of TyG-WHtR,its Q_(3) level increased the risk of cognitive impairment by 34%(HR=1.34,95%CI:1.02-1.78).In the population aged 60 years and above,compared with the Q_(1) level,its Q_(3) and Q_(4) level increased the risk of cognitive impairment by 31%(HR=1.31,95%CI:1.01-1.72)and 63%(HR=1.63,95%CI:1.15-2.31),respectively.In the male group,there was no significant association between TyG-WHtR level and the risk of cognitive impairment(P>0.05).In the female group,compared with the Q_(1) level of TyG-WHtR,its Q_(4) level increased the risk of cognitive impairment by 76%(HR=1.76,95%CI:1.26-2.46).Conclusions Middle-aged and elderly population with a higher TyG-WHtR level may increase the risk of cognitive impairment,and there were age and sex differences.Early cardiovascular health management and scientific and reasonabl

关 键 词：认知障碍 甘油三酯葡萄糖指数-腰围身高比 队列研究 中老年人 

分 类 号：R749.1[医药卫生—神经病学与精神病学]