| 解馨瑜,何阳,沈伟,张薇薇,葛余浩,康冬梅.城市社区老年人胰岛素抵抗与认知障碍的相关性研究[J].中国临床保健杂志,2024,(1):60-64. |
| 城市社区老年人胰岛素抵抗与认知障碍的相关性研究 |
| A study on the correlation between insulin resistance and cognitive impairment in elderly people in urban communities |
| 投稿时间：2023-11-20 |
| DOI：10.3969/J.issn.1672-6790.2024.01.013 |
| 中文关键词: 认知障碍 胰岛素抵抗 危险因素 老年人 |
| 英文关键词: Cognition disorders Insulin resistance Risk factors Aged 〖FL |
| 基金项目:国家自然科学基金项目(82271617)；中国科学院战略性先导科技专项(B类)(XDB39040500)；安徽省科技厅重点研发项目(202004j07020012) |
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| 中文摘要: |
| 目的 探究城市社区老年人胰岛素抵抗与认知功能障碍的关系,为老年人认知障碍的早期识别和防治提供新思路。方法 2019年1月至2022年7月纳入合肥市某社区60岁及以上老年人群,共495例,记录受试者基本资料(包括性别、年龄、文化程度、身高、体重、体重指数、腰臀比等),既往病史,检测生化指标(包括血脂、空腹血糖、空腹胰岛素、糖化血红蛋白、25羟维生素D等),并行蒙特利尔认知评估量表(MoCA)评估认知功能水平,根据MoCA评分将受试者分为认知障碍组(MC组)与非认知障碍组(n-MC组),分析认知障碍发生的影响因素,根据稳态模型胰岛素抵抗指数(HOMA-IR)评估胰岛素抵抗(IR)程度,并以HOMA-IR值四分位法分为4组,即Q1:HOMA-IR≤1.325 2,Q2:1.325 2＜HOMA-IR≤1.995 8,Q3:1.995 8＜HOMA-IR≤2.646 5,Q4:HOMA-IR＞2.646 5,比较4组患者认知障碍的患病率,采用二元logistic回归分析胰岛素抵抗与认知障碍的关系。结果 与n-MC组相比,MC组年龄更高、文化程度更低(P＜0.05)；而2组间高血压史、糖尿病史、婚姻状况、工作状况比较,差异无统计学意义(P＞0.05)；MC组糖化血红蛋白、总胆固醇、HOMA-IR水平更高,而维生素D水平更低,差异有统计学意义(P＜0.05)。HOMA-IR值的增高与认知功能障碍的发生呈正相关(P＜0.01)。结论 胰岛素抵抗是城市社区老年人认知障碍发生的危险因素之一。 |
| 英文摘要: |
| Objective To explore the relationship between insulin resistance and cognitive dysfunction in the elderly in urban communities,and to provide new ideas for the early identification and prevention of cognitive dysfunction in the elderly.Methods From January 2019 to July 2022,a total of 495 elderly people aged 60 and above were included in a community in Hefei City.Basic data(including gender,age,educational level,height,weight,body mass index,waist-to-hip ratio,etc.),medical history,and biochemical indicators(including blood lipid,fasting blood glucose,fasting insulin,glycated hemoglobin,25 hydroxyvitamin D,etc.) were recorded.Cognitive function level was assessed by the Montreal Cognitive Assessment(MoCA).Subjects were divided into a cognitive impairment group(MC group) and a non-MC group(non-MC group) according to MoCA score.Factors affecting the occurrence of cognitive impairment were analyzed,and insulin resistance(IR) level was assessed according to the homeostasis model Insulin resistance index(HOMA-IR),and divided into 4 groups by HOMA-IR quartile method,Q1:HOMA-IR≤1.325 2,Q2:1.325 22.646 5,the prevalence of cognitive impairment in the four groups was compared,and the relationship between insulin resistance and cognitive impairment was analyzed by binary logistic regression.Results Compared with the n-MC group,the MC group was older and less educated(P<0.05),but there was no significant difference in hypertension history,diabetes history,marital status,and working status between the two groups(P>0.05).The levels of HbA1c,total cholesterol,and HOMA-IR in the MC group were higher,while the levels of vitamin D were lower,and the difference was statistically significant(P<0.05).The increase in HOMA-IR value was positively correlated with the occurrence of cognitive dysfunction(P<0.01).Conclusion Insulin resistance is a risk factor for cognitive impairment in elderly people in urban communities. |
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