Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA.
Alzheimer Dis Assoc Disord. 2010 Jan-Mar;24(1):11-8. doi: 10.1097/WAD.0b013e3181a4485c.
The metabolic syndrome (MetS) is more strongly associated with cognitive impairment in the presence of inflammation. This suggests that the association of MetS with mild cognitive impairment (MCI) may vary with the etiology and the subtype of MCI. This study investigated the association between MetS with or without inflammation and MCI [amnestic (a-MCI) and nonamnestic (na-MCI)]. We studied a randomly selected sample of 1969 participants (ages 70 to 89 y) from Olmsted County, MN, using the Clinical Dementia Rating Scale, a neurologic evaluation, and neuropsychologic testing. Data for participants were reviewed for a diagnosis of normal cognition, MCI, or dementia. Clinical components of MetS were ascertained by interview and confirmed from the medical records; biochemical measurements were assayed from a blood draw. We compared 88 na-MCI cases and 241 a-MCI cases with 1640 cognitively normal participants. MetS was not associated with either na-MCI or a-MCI. High C-reactive protein (CRP; highest tertile vs lowest tertile) was associated with na-MCI [odds ratio (OR)=1.85; 95% confidence interval (CI)=1.05, 3.24] but not with a-MCI, after adjusting for sex, age, and years of education. The combination of MetS and high CRP (compared to no MetS and lowest CRP tertile) was associated with na-MCI (OR=2.31; 95% CI=1.07, 5.00), but not with a-MCI (OR=0.96; 95% CI=0.59, 1.54). The combined presence of MetS and high levels of inflammation is associated with na-MCI in this elderly cohort, and suggests etiologic differences in MCI subtypes.
代谢综合征（MetS）与炎症存在时的认知障碍关系更密切。这表明代谢综合征与轻度认知障碍（MCI）的关联可能因病因和 MCI 的亚型而异。本研究调查了伴有或不伴有炎症的代谢综合征与 MCI[遗忘型（a-MCI）和非遗忘型（na-MCI）]之间的关联。我们研究了明尼苏达州奥姆斯特德县的一个随机选择的 1969 名参与者（年龄 70 至 89 岁）的样本，使用临床痴呆评定量表、神经学评估和神经心理学测试。对参与者的数据进行了审查，以确定他们是否患有正常认知、MCI 或痴呆。代谢综合征的临床成分通过访谈确定，并从病历中得到确认；生化测量则通过血液检测得出。我们比较了 88 例非遗忘型 MCI 病例、241 例遗忘型 MCI 病例和 1640 例认知正常的参与者。代谢综合征与非遗忘型 MCI 或遗忘型 MCI 均无关联。高 C 反应蛋白（CRP；最高三分位与最低三分位相比）与非遗忘型 MCI 相关（优势比[OR]=1.85；95%置信区间[CI]=1.05，3.24），但与遗忘型 MCI 无关，调整性别、年龄和受教育年限后。与没有代谢综合征和最低 CRP 三分位相比，代谢综合征和高 CRP（比较）与非遗忘型 MCI 相关（OR=2.31；95%CI=1.07，5.00），但与遗忘型 MCI 无关（OR=0.96；95%CI=0.59，1.54）。在这个老年队列中，代谢综合征和高水平炎症的共同存在与非遗忘型 MCI 相关，提示 MCI 亚型的病因学差异。
