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目的探讨老年人肥胖与认知功能的相关性。方法根据蒙特利尔认知评估量表(MoCA)将150例老年人分为MoCA异常组(A组,94例)和MoCA正常组(B组,56例);以男性腰围≥90cm、女性腰围≥80cm作为诊断中心性肥胖的标准,150例又分为中心性肥胖组(89例)和腰围正常组(61例)。检测血压、血糖、血脂、颈动脉斑块积分(Crouse积分)和C反应蛋白水平,采用胰岛素抵抗指数(HOMA-IR)及胰岛素敏感指数(ISI)评估患者胰岛素抵抗和胰岛素敏感性。结果 A组年龄、腰围、收缩压、低密度脂蛋白胆固醇、Crouse积分、C反应蛋白、空腹血糖和HOMA-IR均高于B组,受教育年限、高密度脂蛋白胆固醇和ISI低于B组(P<0.05)。中心性肥胖组MoCA评分低于腰围正常组(P<0.05)。Spearman相关分析显示,年龄、腰围、收缩压、空腹血糖和HOMA-IR与MoCA评分呈负相关,高密度脂蛋白胆固醇和ISI与MoCA评分呈正相关。多元逐步回归分析显示,年龄、受教育年限、腰围和HOMA-IR是影响MoCA评分的独立危险因素。结论老年人中心性肥胖与认知功能受损高度相关。
Objective To explore the correlation between obesity and cognitive function in the elderly. Methods According to the Montreal Cognitive Assessment Scale (MoCA), 150 elderly people were divided into MoCA abnormal group (group A, 94 cases) and MoCA normal group (group B, 56 cases). Male WCG≥90cm, As the standard of diagnosis of central obesity, 150 cases were divided into central obesity group (89 cases) and normal waist group (61 cases). Blood pressure, blood glucose, blood lipid, carotid artery plaque score (Crouse score) and C-reactive protein level were measured. Insulin resistance index (HOMA-IR) and insulin sensitivity index (ISI) were used to evaluate insulin resistance and insulin sensitivity. Results Age, waist circumference, systolic blood pressure, low density lipoprotein cholesterol, Crouse score, C-reactive protein, fasting blood glucose and HOMA-IR in group A were higher than those in group B. The years of education, high density lipoprotein cholesterol and ISI were lower in group A than in group B (P <0.05). The MoCA score in central obesity group was lower than that in normal waist group (P <0.05). Spearman correlation analysis showed that age, waist circumference, systolic blood pressure, fasting blood glucose and HOMA-IR were negatively correlated with MoCA score. There was a positive correlation between high-density lipoprotein cholesterol, ISI and MoCA score. Multivariate stepwise regression analysis showed that age, education years, waist circumference and HOMA-IR were independent risk factors influencing MoCA score. Conclusion The elderly central obesity and cognitive impairment are highly correlated.