老年代谢综合征合并轻度认知功能障碍患者危险因素相关性分析

目的 分析老年人代谢综合征(MS)合并轻度认知功能障碍(MCI)的临床特点,探讨老年人MS合并MCI患者的高危代谢因素,降低MS合并MCI的发病率。 方法 选取2015年11月—2016年11月在南京仙林及华侨路社区卫生服务中心健康体检的老年人493例,分为MS合并MCI组(58例)、单纯MS组(79例)、单纯MCI组(103例)及对照组(253例)。记录年龄、性别、吸烟及既往史,测量收缩压(SBP)、舒张压(DBP);检测空腹血糖(FBG)、血总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)指标,计算体质指数(BMI);完成简易精神状态检查表(MMSE)、日常生活能力量表(ADL)、医院焦虑抑郁量表(HAD)的评估。采用多因素Logistic回归分析对MS合并MCI的相关危险因素进行分析。 结果 (1) MS合并MCI组SBP、FBG、TG、BMI明显高于对照组;单纯MS组FBG、TG、BMI明显高于对照组,而HDL-C明显低于对照组;单纯MCI组SBP明显高于对照组,TG明显低于对照组(均P<0.05)。(2)多因素Logistic回归模型分析结果显示,肥胖(BMI≥28 kg/m2)(OR=3.685,95%CI 1.663~8.167)、高血压(血压≥140/90 mm Hg,1 mm Hg=0.133 kPa)(OR=2.669,95%CI 1.247~4.598)、高TG (≥1.7 mmol/L)(OR=5.920,95%CI 3.064~11.438)是MS合并MCI的独立危险因素(均P<0.05)。 结论 老年人MCI受MS多种代谢异常影响,肥胖、高血压、高TG等因素与老年人MS合并MCI密切相关。 

Correlation analysis of risk factors in mild cognitive impairment combined with metabolic syndrome in elderly patients

Objective To analyze the clinical features and high-risk metabolic factors of metabolic syndrome (MS) combined with mild cognitive impairment (MCI) in elderly patients, in order to reduce the incidence of MS combined with MCI. Methods A total of 493 elderly patients who did health examinations in Nanjing community health service centers including Xianlin and Huaqiao road from November, 2015 to November, 2016 was divided into MS combined with MCI group (group A, 58 patients), MS group (group B, 79 patients), MCI group (group C, 103 patients) and control group (group D, 253 patients). Age, smoking history and past history were recorded. The systolic blood pressure (SBP), diastolic blood pressure (DBP), levels of fasting blood glucose (FBG), total cholesterol (TC), triglyceride (TG), low density lipoprotein cholesterol (LDL-C), high density lipoprotein cholesterol (HDL-C) were detected. Body mass index (BMI) was calculated. All subjects were evaluated with regards to the scores of Mini-Mental Status Examination (MMSE), daily living skills assessment (ADL), Hospital Anxiety and Depression scale (HAD). Make use of multivariable logistic regression analysis to analyze related risk factors of MS combined with MCI. Results (1) Levels of SBP, FBG, TG and BMI were significantly higher in group A than in group D. Levels of FBG, TG and BMI were significantly higher in group B than in group D, but HDL-C level was lower than that in group D. Levels of SBP were significantly higher in group C than that in group D, and TG were significantly lower in group C than that in group D (all P < 0. 05). (2) Multivariate Logistic regression analysis showed that obesity (BMI ≥ 28 kg/m2, OR=3. 685, 95% CI:1. 663-8. 167), hypertension (blood pressure ≥ 140/90 mm Hg, 1 mm Hg=0. 133 kPa, OR=2. 669, 95% CI:1. 247-4. 598), and high TG (≥ 1. 7 mmol/L, OR=5. 920, 95% CI:3. 064-11. 438) were the independent risk factors in mild cognitive impairment combined with MS (all P < 0. 05). Conclusion Mild cognitive impairment is affected by multiple metabolic abnormalities of MS in elderly patients. Obesity, high blood pressure, and hypertriglyceridemia are closely related to mild cognitive impairment combined with MS in the elderly.