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天津市社区老年人血脂水平与轻度认知障碍发生关系病例对照研究

刘柯杉 竹丽萍 吴晓敏 熊英 赵会朝 马菲

刘柯杉, 竹丽萍, 吴晓敏, 熊英, 赵会朝, 马菲. 天津市社区老年人血脂水平与轻度认知障碍发生关系病例对照研究[J]. 中国公共卫生, 2023, 39(3): 348-352. doi: 10.11847/zgggws1138304
引用本文: 刘柯杉, 竹丽萍, 吴晓敏, 熊英, 赵会朝, 马菲. 天津市社区老年人血脂水平与轻度认知障碍发生关系病例对照研究[J]. 中国公共卫生, 2023, 39(3): 348-352. doi: 10.11847/zgggws1138304
LIU Ke-shan, ZHU Li-ping, WU Xiao-min, . Association of blood lipid levels with mild cognitive impairment in the elderly: community-based case-control study in Tianjin city[J]. Chinese Journal of Public Health, 2023, 39(3): 348-352. doi: 10.11847/zgggws1138304
Citation: LIU Ke-shan, ZHU Li-ping, WU Xiao-min, . Association of blood lipid levels with mild cognitive impairment in the elderly: community-based case-control study in Tianjin city[J]. Chinese Journal of Public Health, 2023, 39(3): 348-352. doi: 10.11847/zgggws1138304

天津市社区老年人血脂水平与轻度认知障碍发生关系病例对照研究

doi: 10.11847/zgggws1138304
基金项目: 国家自然科学基金(81874261);中国营养学会 – 振东国人体质与健康研究基金(CNS – ZD2019080)
详细信息
    作者简介:

    刘柯杉(1999 – ),女,四川巴中人,硕士在读,研究方向:营养流行病学

    通信作者:

    马菲,E-mail:mafei@tmu.edu.cn

  • 中图分类号: R 181.2

Association of blood lipid levels with mild cognitive impairment in the elderly: community-based case-control study in Tianjin city

  • 摘要:   目的  了解天津市社区老年人血脂水平与轻度认知障碍(MCI)发生的关系,为采取MCI相应的预防措施提供参考依据。  方法  采用以社区为基础1 : 1匹配的病例对照研究方法,于2016年3月在天津市王顶堤街道辖区内随机选取4个社区卫生服务中心,将体检时诊断为MCI的210例 ≥ 65岁老年人作为病例组,按病例组同性别、年龄( ± 1岁)匹配210名认知正常老年人作为对照组,两组进行问卷调查和实验室检测,《精神障碍诊断和统计手册 – V》(DSM-V)用于诊断MCI,采用多因素条件logistic回归模型分析社区老年人血脂水平与MCI发生的关系。  结果  天津市病例组MCI社区老年人和对照组认知正常社区老年人的总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)、LDL-C/HDL-C水平分别为186.50(160.75,215.00)mg/dL和195.50(168.00,217.25)mg/dL、101.00(77.75,121.00)mg/dL和100.00(79.75,123.00)mg/dL、58.50(46.75,71.25)mg/dL和58.00(47.00,70.00)mg/dL、1.71(1.30,2.35)和1.66(1.31,2.26),2组老年人TC、LDL-C、HDL-C、LDL-C/HDL-C水平差异均无统计学意义(均P > 0.05);在调整了文化程度及是否患高血压、糖尿病、心脏病、脑卒中等混杂因素后,多因素条件logistic回归分析结果显示,天津市TC为200 ~ 240 mg/dL社区老年人发生MCI的风险为 < 200 mg/dL社区老年人的0.52倍(OR = 0.52,95 % CI = 0.27 ~ 0.99),HDL-C为 > 40 mg/dL社区老年人发生MCI的风险为 ≤ 40 mg/dL社区老年人的0.30倍(OR = 0.30,95 % CI = 0.14 ~ 0.67),LDL-C为100 ~ 130 mg/dL、130 ~ 160 mg/dL和 > 160 mg/dL社区老年人发生MCI的风险分别为 < 100 mg/dL社区老年人的2.37倍(OR = 2.37,95 % CI = 1.21 ~ 4.65)、3.22倍(OR = 3.22,95 % CI = 1.09 ~ 9.49)和9.33倍(OR = 9.33,95 % CI = 1.59 ~ 54.61),LDL-C/HDL-C为 > 2.30社区老年人发生MCI的风险为 < 1.31社区老年人的0.37倍(OR = 0.37,95 % CI = 0.16 ~ 0.88)。  结论  高水平的LDL-C为天津市社区老年人MCI发生的危险因素,而高水平的HDL-C和LDL-C/HDL-C比值及中等水平的TC则为天津市社区老年人MCI发生的保护因素。
  • 表  1  天津市社区老年人血脂水平与MCI发生关系多因素条件logistic回归分析

    项目病例组对照组OR 95 % CI
    例数%人数%
    TC(mg/dL)< 20013162.411956.71.00
    200~2405325.26932.90.520.27~0.99
    > 2402612.42210.50.470.17~1.35
    HDL-C(mg/dL) ≤ 403215.2157.11.00
    > 4017884.819592.90.300.14~0.67
    LDL-C(mg/dL)< 10010047.610650.51.00
    100~1306932.96631.42.371.21~4.65
    131~1603014.33315.73.221.09~9.49
    > 160115.252.49.331.59~54.61
    LDL-C/HDL-C< 1.315526.25224.81.00
    1.31~1.684822.95526.20.660.35~1.24
    1.69~2.305325.25325.20.540.27~1.10
    > 2.305425.75023.80.370.16~0.88
      注:a 调整了文化程度以及是否患高血压、糖尿病、心脏病、脑卒中情况等混杂因素。
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  • 接收日期:  2022-02-23
  • 网络出版日期:  2023-01-10
  • 刊出日期:  2023-03-10

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