摘要
目的研究40岁及以上农村人群冠心病与认知障碍的相关性。方法2014年10月—2015年3月,选取西安市鄠邑区2个自然村所有40岁及以上的常住村民作为研究对象,收集人口学信息、生活习惯、既往病史、家族史等,完成体格检查及血液生化检查。采用简易精神状态量表(Mini-Mental State Examination,MMSE)评估总体认知功能,MMSE评分低于分界值(文盲≤17分;小学≤20分;初中及以上文化程度≤24分)定义为认知障碍。冠心病组和非冠心病组认知障碍的患病率组间比较应用卡方检验;多因素Logistic回归分析冠心病与认知障碍之间的关系。结果共纳入研究对象1833人,其中男性735人(40.1%),冠心病57人(3.1%),符合认知障碍标准234人(13.3%)。单因素分析显示,冠心病组认知功能障碍患病率高于非冠心病组(24.6%vs.12.9%,P=0.016)。未校正混杂因素的二元Logistic分析结果显示,冠心病与认知障碍正相关(OR=2.199,95%CI:1.185~4.084,P=0.013)。校正性别、年龄、受教育年限、高血压、糖尿病、血脂异常、卒中病史、身体质量指数等混杂因素后,冠心病未显著增加认知障碍风险。(OR=1.265,95%CI:0.656~2.441,P=0.483)。分层分析中,糖尿病患者中冠心病和认知障碍显著相关(OR=4.191,95%CI:1.464~12.000,P=0.008)。校正混杂因素后,冠心病合并糖尿病组认知障碍患病率显著增加(OR=4.712,95%CI:1.651~13.449,P=0.004)。结论本研究未确定冠心病和认知障碍的直接关联,但是冠心病合并糖尿病与认知障碍患病风险增加显著相关,应开展更大样本的前瞻性研究以进一步确认两者之间的关联。
Objective To investigate the correlation between coronary heart disease(CHD)and cognitive impairment in rural populations aged 40 and above.Methods From October 2014 to March 2015,all residents aged 40 and above from two villages in Huyi District,Xi’an,were selected as study subjects.Information regarding their demographics,lifestyle habits,medical history,family history,physical examinations,and biochemical tests was collected.The participants were categorized into those with and without the history of CHD.Cognitive function was assessed using the Mini-Mental State Examination(MMSE),with scores below the cutoff(illiteracy≤17;primary school≤20;junior high school and above≤24)defined as cognitive impairment.Chi-square test was used to compare the prevalence of cognitive impairment between the CHD and non-CHD groups.Multivariate Logistic regression was employed to adjust for confounding factors in analyzing the relationship between CHD and cognitive impairment.Results A total of 1833 subjects were included in the analysis,comprising 735 males(40.1%)and 57 individuals with CHD(3.1%).Among them,234 participants(13.3%)met the criteria for cognitive impairment.Univariate analysis showed a higher prevalence of cognitive impairment in the CHD group compared to the non-CHD group(24.6%vs.12.9%,P=0.016).Unadjusted binary Logistic regression analysis indicated a positive correlation between CHD and cognitive impairment(OR=2.199,95%CI:1.185-4.084,P=0.013).However,after adjusting for confounding factors such as gender,age,education level,hypertension,diabetes,dyslipidemia,stroke history and BMI,the association between CHD and cognitive impairment was not statistically significant(OR=1.265,95%CI:0.656-2.441,P=0.483).In the stratified analysis,among diabetic patients,CHD was significantly associated with a high risk of cognitive impairment(OR=4.191,95%CI:1.464-12.000,P=0.008).The prevalence of cognitive impairment significantly increased in patients with CHD combined with diabetes(OR=4.712,95%CI:1.651-13.449,P=0.004).Conclusion This study did not establish a direct association between CHD and cognitive impairment.However,this study suggests that the presence of CHD and diabetes mellitus is significantly associated with an increased risk of cognitive impairment.Future prospective studies with larger sample sizes should be conducted to further confirm the relationship between the two.
作者
卫萌
翁宇轩
刘洁
高玲
党亮君
王瑾
屈秋民
商苏杭
WEI Meng;WENG Yuxuan;LIU Jie;GAO Ling;DANG Liangjun;WANG Jin;QU Qiumin;SHANG Suhang(Department of Neurology,The First Affiliated Hospital of Xi’an Jiaotong University,Xi’an 710061,China)
出处
《西安交通大学学报(医学版)》
北大核心
2025年第5期789-795,共7页
Journal of Xi’an Jiaotong University(Medical Sciences)
基金
科技创新-2030资助项目(No.2021ZD0201808)
国家自然科学基金资助项目(No.82301364,No.82201580)。
关键词
认知障碍
危险因素
冠心病(CHD)
糖尿病
横断面研究
cognitive impairment
risk factor
coronary heart disease(CHD)
diabetes mellitus
cross-sectional study
作者简介
通信作者:商苏杭,主治医师.E-mail:shangsuhang@mail.xjtu.edu.cn;第一作者:卫萌;共同第一作者:翁宇轩。
