血清尿酸与认知功能损害的相关性研究
收稿日期: 2021-05-18
网络出版日期: 2024-01-09
基金资助
科技创新2030“脑科学与类脑研究”重大项目(2022ZD0211600);香港董氏慈善基金会专项支持项目
Relationship between serum uric acid and cognitive impairment
Received date: 2021-05-18
Online published: 2024-01-09
目的:探索血清尿酸与认知功能损害的关系。方法:基于社区的前瞻性研究,选自2011年上海五里桥和马陆社区正常人群的随访队列(≥50岁),终点指标为2016年末次随访的认知功能评估结果。认知功能评估采用简易精神状态检查(mini-mental status examination,MMSE)量表。研究人群的尿酸水平根据性别分别进行四分位分层,从低到高分为Q1~Q4。Logistic回归用于分析血清尿酸与认知功能损害的关系。结果:纳入312名平均年龄为(68.36±6.45)岁,其中男性124名(39.7%)。在5年随访中新发认知功能损害43例,患病率为13.8%。多因素Logistic回归结果提示,在校正了年龄、性别等相关危险因素后,与低尿酸水平人群(Q1)相比,较高尿酸水平人群(Q3)发生认知功能损害的风险更高,优势比(odds ratio,OR)为2.53[95%置信区间(confidence interval, CI):0.91~7.02]。按照年龄分层(50~70岁、70~90岁)后未发现阳性结果。而按照性别分层后,发现男性中最高尿酸水平人群(Q4)比最低尿酸水平人群(Q1)发生认知功能损害的风险高(OR=18.60,95%CI:1.26~274.13);而女性中未发现相关阳性结果。结论:在50岁以上社区人群中,较高尿酸水平(尤其是男性)会增加认知功能损害的风险。
林维志, 付洋, 罗琪, 陈捷, 马建芳 . 血清尿酸与认知功能损害的相关性研究[J]. 内科理论与实践, 2023 , 18(04) : 278 -283 . DOI: 10.16138/j.1673-6087.2023.04.013
Objective To explore the relationship between serum uric acid and cognitive impairment. Methods This was a community-based prospective study. The baseline population(2011) was enrolled from a cohort(≥50 years old) of normal people in Wuliqiao and Malu community in Shanghai. The endpoint was the cognitive function assessment results of the last follow-up (2016). Cognitive assessment was performed using mini-mental status examination(MMSE). The uric acid level of the study population was divided into four quartiles from low to high score (Q1-Q4) in both male and female. Logistic regression was used to analyze the relationship between serum uric acid and cognitive impairment. Results A total of 312 people with an average age of (68.36±6.45) years old were enrolled, and there were 124 males (39.7%). During 5-year follow-up, the total people with cognitive impairments was 43, and the incidence rate was 13.8%. After adjusting age, gender and other related risk factors, multivariate Logistic regression analysis showed that people with higher uric acid level (Q3) had higher risk of cognitive impairment than those with low uric acid level (Q1), with an odds ratio(OR) of 2.53 [95% confidence interval (CI): 0.91-7.02]. After age stratification (50-70 years old; 70-90 years old), no positive results were found. However, stratified by gender, it was found that men with the highest uric acid level(Q4) had a higher risk of cognitive impairment than those with the lowest uric acid level (Q1)(OR=18.60,95%CI: 1.26-274.13), while no positive results were found in women. Conclusions Higher uric acid levels, especially in men, might increase the risk of cognitive impairment in people over 50 years.
Key words: Serum uric acid; Cognitive impairment; Cohort study
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