代谢综合征与轻度认知功能障碍的临床研究

目的探讨代谢综合征(MS)与轻度认知功能障碍(MC)I的关系.方法 124例MS患者(研究组)和71例健康体检者(对照组),据petersen等MCI诊断/排除标准纳入MCI组和认知功能正常组(NC组);MS患者代谢指标每项异常各计1分,按分值0～1、2、3、4、5分为5个亚组.比较MS与NC组间及MS各分亚组间MCI发生率及各代谢指标与认知功能评分间的关系,并对影响MCI相关因子行多因素分析.结果 (1)MCI发生率:MS组高于非MS组(P<0.01),MS组代谢紊乱积分越高发生率越高(P<0.01);(2)MCI组各代谢紊乱指标(舒张压,高密度脂蛋白HDL-C除外)均高于NC组(P<0.05),ISI低于NC组(P<0.05);(3)认知功能总评分及各分量表评分MS组低于非MS组(P<0.05);(4)各认知评分(图像自由回忆除外)与MS负相关,与空腹胰岛素(FIN)负相关(指向记忆、人像特点回忆除外),MoCA、MMSE与血压负相关.排除糖尿病患者后,以上关系不变,而认知评分与FIN由负相关变为不相关;(5)教育程度、胰岛素抵抗和MS最终进入Logistic方程(回归系数分别为-0.460/0.855/1.289).结论 (1)MS影响认知功能各个环节,MS整体对认知功能的影响大于各组份;(2)受教育程度高是MCI的保护因素,MS、胰岛素抵抗是MCI的独立危险因素.

Clinical Study on Relationship between Metabolic Syndrome and Mild Cognitive Impairment

Objective To investigate the relationship between metabolic syndrome(MS)and mild cognitive Impairment(MCI).Methods 124 clinical MS subjects for research group,and 71 non-MS for control,who matched in age,sex and education.According to MCI diagnostic standards of Petersen,all cases were selected into the MCI group and cognitive function normal group(NC group).With each metabolic abnormalities,MS subjects were scored 1 point and divided into five groups according to scores 0 ~1,2,3,4,5.Results(1)MCI incidence in MS was higher than in non-MS(P<0.01).The higher metabolic score in MS,the higher MCI incidence(P<0.01).(2)Indicators of metabolic abnormalities in MCI were serious thants in NC(P<0.05),and ISI is lower than in NC(P<0.05).(3)Scores of MMSE,MoCA,CMS and its componen in MS were lower than in non-MS(P<0.05).(4)Multivariate regression and logistic regressive analysis showed that all scores about cognition(except for Image Free Recall)were correlated negatively with MS,and with FIN(except for Point To Memory,Memories Of Portrait Features).Scores of MMSE and MoCA were correlated negatively with blood pressure.The relationship still remains while diadetes patients were excluded,but the scores above were notcorrelated with FIN.(5)Education,insulin resistance and MS eventually enter the logistic equation(the regression coefficients are-0.460 /0.855 /1.289).Conclusion(1)MS impacts on various aspects of the cognitive function.Impacting on mild cognitive,MS as a whole is greater than the function of each component.(2)High level of education is a protective factor for MCI,and MS and insulin resistance is independent risk factor for MCI.