摘要
目的探讨轻度认知障碍(MCI)风险与血糖代谢异常的相关性,并为MCI的预防提供依据。方法本研究对1074例认知功能正常且无糖尿病、高脂血症、痛风的老年门诊患者进行了调查。随访5年,根据简易智力状态检查量表(MMSE)和蒙特利尔认知评估量表(MoCA)进行认知功能评估,有121例受试者被诊断出患有MCI。此外,监测受试者每年血糖、糖化血红蛋白。结果入组的1074例受试者根据认知功能的不同分为MCI组和非MCI组,与非MCI组相比,MCI组中空腹血糖(FBG)、糖化血红蛋白(HbA1c)、三酰甘油(TG)和总胆固醇(TC)的平均值更高(均P<0.05)。在高血糖组中,FBG的临界值为6.2 mmol/L(敏感性=84.1%,特异性=90.9%,曲线下面积=0.875,P<0.001);在低血糖组中,FBG的临界值为4.5 mmol/L(灵敏性=77.4%,特异性=87.3%,曲线下面积=0.823,P<0.001)。HbA1c的临界值为5.5%(敏感性=76.0%,特异性=87.0%,曲线下面积=0.815,P<0.001)。多元Logistic回归分析MCI的风险增加与空腹血糖平均值<4.5 mmol/L和≥6.2 mmol/L(RR:1.69,95%CI:1.11~2.59;RR:1.81,95%CI:1.15~2.86)以及糖化血红蛋白平均值≥5.5%(RR:2.13,95%CI:1.51~2.99)相关。结论空腹糖耐量受损及空腹血糖偏低是老年人MCI发生风险的独立危险因素。
Objective To investigate the correlation between mild cognitive impairment(MCI)and abnormal glucose metabolism and thus to provide a basis for MCI prevention.Methods A total of 1074 elderly outpatients with normal cognitive function and without confirmed diabetes mellitus,hyperlipoidemia or gout were enrolled.During a five-year follow-up period,121 subjects were diagnosed with MCI based on the mini mental state examination(MMSE)and the Montreal cognitive assessment(MoCA).Furthermore,annual blood glucose and glycated hemoglobin monitoring was carried out to examine the long-term effects of abnormal glucose metabolism on MCI risk.Results According to cognitive function,1074 subjects were divided into the MCI group and the non-MCI group.Compared with the non-MCI group,the mean values of fasting blood glucose(FBG),glycosylated hemoglobin(HbA1c),triglycerides(TG)and total cholesterol(TC)in the MCI group were elevated(P<0.05).The receiver operating characteristic(ROC)curve showed that the cut-off value of FBG was 6.2 mmol/L for the hyperglycemia group(sensitivity:84.1%,specificity:90.9%,area under curve:0.875,P<0.001)and 4.5mmol/L for the hypoglycemic group(sensitivity:77.4%,specificity:87.3%,area under curve:0.823,P<0.001);the cut-off value of HbA1c was 5.5%(sensitivity:76.0%,specificity:87.0%,area under curve:0.815,P<0.001).Multiple Logistic regression analysis showed that increased risk of MCI was associated with the mean values of fasting blood glucose<4.5 mmol/L(RR:1.69,95%CI:1.11-2.59)or≥6.2 mmol/L(RR:1.81,95%CI:1.15-2.86)and of glycosylated hemoglobin≥5.5%(RR:2.13,95%CI:1.51-2.99).Conclusions Impaired fasting glucose tolerance and low fasting blood glucose are independent risk factors for MCI in the elderly.
作者
李世彬
雷平
肖广辉
王艳惠
张雯琴
Li Shibin;Lei Ping;Xiao Guanghui;Wang Yanhui;Zhang Wenqin(Department of Health Care,Tianjin Medical University General Hospital,Tianjin 300052,China)
出处
《中华老年医学杂志》
CAS
CSCD
北大核心
2021年第1期48-52,共5页
Chinese Journal of Geriatrics
关键词
空腹糖耐量受损
血糖
认知障碍
Impaired fasting glucose tolerance
Blood glucose
Cognition disorders
