摘要
目的观察代谢综合征(MS)及载脂蛋白Eε4 (ApoEε4)等位基因对老年人认知功能的影响。方法选择2016年5月—2018年4月首都医科大学宣武医院老年医学科诊治的老年代谢综合征患者73例作为研究对象(病例组),随机选择非代谢综合征的老年患者90例作为对照组,使用简易精神状态量表(MMSE)及蒙特利尔认知评价量表(MoCA)评估认知功能,并进行生化及ApoEε4基因检测,比较2组的认知功能水平与MS、ApoEε4等位基因的关系,并采用Logistic回归进行多因素分析等。结果 (1)病例组血压(SBP、DBP)、腰围、BMI和HOMA-IR均明显高于对照组(t/P=4. 100/0. 001、2. 710/0. 007、4. 370/0. 001、2. 600/0. 010、4. 594/0. 001);(2)病例组MMSE、MoCA、ADL评分均低于对照组(t/P=2. 129/0. 036、2. 537/0. 012、2. 431/0. 017);(3)病例组认知功能受损发生率高于对照组(46. 6%vs 25. 6%,χ2/P=7. 831/0. 005),而ApoEε4基因检出率2组比较差异无统计学意义(P> 0. 05);(4)认知损害亚组ApoEε4基因阳性率高于认知正常亚组(χ2/P=9. 603/0. 002);(5)Logistic回归分析显示,MS患者发生认知损害的风险是非MS的2. 787倍(OR=2. 787,P=0. 004),ApoEε4基因携带者的认知损害发生风险是非携带者的4. 202倍(OR=4. 202,P=0. 002)。但代谢综合征与ApoE4基因之间未发现存在交互作用(P=0. 819)。结论代谢综合征是老年人发生认知功能损害的危险因素,ApoEε4等位基因是暴露因素,未发现两者之间存在交互作用。
Objective To explore the effects of metabolic syndrome （MS） and apolipoprotein E ε4（ApoEε4） allele on cognitive function in elderly patients. Methods Seventy-three elderly patients with metabolic syndrome diagnosed and treated in the Department of Geriatrics, Xuanwu Hospital, Capital Medical University from May 2016 to April 2018 were selected as study subjects （case group）. Ninety elderly patients with non-metabolic syndrome were randomly selected as control group. Simple Mental State Inventory （MMSE） and Montreal Cognitive Assessment Scale （MCE） were used. Cognitive function was assessed, and biochemical and ApoEε4 gene tests were performed. The relationship between cognitive function and MS, ApoEε4 gene were compared between the two groups. Logistic regression was used for multivariate analysis. Results （1） The blood pressure （SBP, DBP）, waist circumference, BMI and HOMA-IR in the case group were significantly higher than those in the control group （ t/P =4.100/0.001, t/P =2.710/0.007, t/P =4.370/0.001, t/P =2.600/0.010, t/P =4.594/ 0.001 ）; （2） The scores of MMSE, MoCA and ADL in the case group were significantly lower than those in the control group （ t/P =2.129/0.036, t/P =2.537/0.012, t/P =2.431/0.017）; （3） The incidence of cognitive impairment in the case group was higher than that in the control group （46.6% vs 25.6%, χ 2/ P =7.831/0.005）, but there was no significant difference in the detection rate of ApoEεgene between the two groups （ P 〉0.05）; （4） The positive rate of ApoEεgene in the subgroup of cognitive impairment was higher than that in the subgroup of normal cognition （χ 2/ P =9.603/0.002）; （5） Logistic regression analysis showed that the risk of cognitive impairment in MS patients was 2.787 times higher than that in non-MS patients （ OR =2.787, P =0.004）, and the risk of cognitive impairment in ApoEεgene carriers was 4.202 times higher than that in non-carriers （ OR =4.202, P =0.002）. However, there was no int
作者
王洁妤
刘佳
张丽
马丽娜
王宏娟
李耘
WANG Jieyu;LIU Jia;ZHANG Li;MA Lina;FANG Hongjuan;LI Yun(Department of Geriatrics,Xuanwu Hospital,Capital Medical University,Beijing 100053,China)
出处
《疑难病杂志》
CAS
2018年第10期1140-1144,1152,共6页
Chinese Journal of Difficult and Complicated Cases
基金
首都医科大学基础-临床科研合作基金(16JL82)
