维生素D水平与老年脑小血管病患者认知功能障碍的相关性研究

目的:分析老年脑小血管病（CSVD）患者的血清25-羟基维生素D［25（OH）D］水平与认知功能障碍之间的关系。方法:选择2019年12月至2020年12月于连云港市第二人民医院就诊的老年CSVD患者共97例，其中男56例、女41例，年龄65～85岁，依据蒙特利尔认知评估量表（MoCA）评分结果，分为CSVD认知正常组...

Correlation between vitamin D level and cognitive dysfunction in elderly patients with cerebral small vessel disease

Objective　To investigate the correlation between serum 25-hydroxyvitamin D[25(OH)D] level and cognitive dysfunction in elderly patients with cerebralsmall vessel disease (CSVD). Methods　From December 2019 toDecember 2020, 97 patients with CSVD in The Second People's Hospital ofLianyungang City including 56 males and 41 females, aged 65-85 years wereselected and were divided into a CSVD with normal cognition group (50 cases)and a CSVD with cognitive dysfunction group (47 cases) according to theMontreal Cognitive Assessment Scale (MoCA) score, and other 30 elderly healthypeople were selected as a control group. The clinical data and serum 25(OH)Dlevels of the three groups were collected. One way ANOVA was used forcomparison of the measurement data between groups, χ² test was used for comparison of the count databetween groups. Multivariate logistic regression analysis was used to analyzethe risk factors for cognitive dysfunction in CSVD patients, and Pearsoncorrelation analysis was used to explore the relationship between the MoCAscore and 25(OH)D level in the cognitive dysfunction group. Results　The 25(OH)D levels of the CSVD with normal cognition group [(23.36±2.10)μg/L] and the CSVD with cognitive dysfunction group [(15.66±1.47) μg/L] werelower than that of the control group [(34.03±2.17) μg/L] (F=13.764, P<0.05), andthe level of 25(OH)D in the CSVD with cognitive dysfunction group wassignificantly lower than that in the CSVD with normal cognition group (P<0.05). Compared with those in theCSVD with normal cognition group and the control group, the scores of visualspace and execution, attention and computation, abstraction, delayed recall,and orientation and the total score of MoCA were decreased in the CSVD withcognitive dysfunction group (all P<0.05).Multivariate logistic regression analysis showed that 25(OH)D level was aprotective factor for cognitive dysfunction in elderly patients with CSVD (OR=0.491, P=0.005). In the CSVD with cognitive dysfunction group, the levelof 25(OH)D was positively correlated with the total score of MoCA and thescores of visual space and execution, attention and computation, delayedrecall, and orientation (r=0.74,0.63, 0.59, 0.74, 0.53; all P<0.05). Conclusion　The decline of serum25(OH)D level is a risk factor for cognitive dysfunction in elderly patientswith CSVD, and patients with low serum 25(OH)D level have more obviouscognitive dysfunction.