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代谢综合征、轻度认知障碍与痴呆进展。意大利老龄化纵向研究。

Metabolic syndrome, mild cognitive impairment, and progression to dementia. The Italian Longitudinal Study on Aging.

机构信息

Department of Geriatrics, Center for Aging Brain, Memory Unit, University of Bari, Policlinico, Piazza Giulio Cesare 11, 70124 Bari, Italy.

出版信息

Neurobiol Aging. 2011 Nov;32(11):1932-41. doi: 10.1016/j.neurobiolaging.2009.12.012. Epub 2009 Dec 31.

Abstract

We investigated the relationship of metabolic syndrome (MetS) and its individual components with incidence of mild cognitive impairment (MCI) and its progression to dementia in a large longitudinal Italian population-based sample with a 3.5-year follow-up. A total of 2097 participants from a sample of 5632 65-84-year-old subjects from the Italian Longitudinal Study on Aging were evaluated. MetS was defined according to the Third Adults Treatment Panel of the National Cholesterol Education Program criteria. MCI, dementia, Alzheimer's disease (AD), and vascular dementia (VaD) were classified using current published criteria. Among MCI patients those with MetS (N=49) had a higher risk of progression to dementia (HR, 4.40; 95% CI, 1.30-14.82) compared with those without MetS (N=72). After a multivariate adjustment, the risk in MCI patients with MetS approximately doubled (multivariate adjusted HR, 7.80, 95% CI 1.29-47.20) compared with those MCI without MetS. Finally, among non-cognitively impaired individuals there were no significant differences in risks of developing MCI in those who were affected by MetS (N=608) in comparison with those without MetS (N=837), as well as excluding those individuals with undernutrition or low inflammatory status with or without undernutrition. In our population, among MCI patients the presence of MetS independently predicted an increased risk of progression to dementia over 3.5 years of follow-up.

摘要

我们在一个大型的意大利纵向人群样本中,对代谢综合征(MetS)及其各个成分与轻度认知障碍(MCI)的发病风险及其向痴呆的进展进行了研究,随访时间为 3.5 年。共有 2097 名参与者来自意大利老龄化纵向研究中的 5632 名 65-84 岁的受试者样本。MetS 根据国家胆固醇教育计划成人治疗小组第三版的标准来定义。MCI、痴呆、阿尔茨海默病(AD)和血管性痴呆(VaD)采用当前公布的标准进行分类。在 MCI 患者中,患有 MetS 的患者(N=49)进展为痴呆的风险更高(HR,4.40;95%CI,1.30-14.82),而无 MetS 的患者(N=72)。经过多变量调整后,患有 MetS 的 MCI 患者的风险增加了近两倍(多变量调整后的 HR,7.80,95%CI 1.29-47.20)。最后,在非认知障碍个体中,患有 MetS(N=608)和无 MetS(N=837)的个体在发展为 MCI 的风险方面没有显著差异,并且排除了营养不良或低炎症状态的个体,无论其是否存在营养不良。在我们的人群中,患有 MetS 的 MCI 患者在 3.5 年的随访期间,其进展为痴呆的风险独立增加。

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