Predictive Medicine Unit, Sapienza University, Rome, Italy.
Metab Syndr Relat Disord. 2012 Oct;10(5):358-62. doi: 10.1089/met.2012.0043. Epub 2012 Jul 11.
Metabolic syndrome reaches its highest prevalence in the elderly, and evidence suggests that metabolic syndrome could be an independent risk factor for cognitive impairment. The aims of this study were to detect whether patients with metabolic syndrome have lower cognition and to investigate whether there is a relationship with cognition and single metabolic syndrome components.
We assessed fasting blood glucose (FBG), high-density lipoprotein cholesterol (HDL-C), triglycerides, high-sensitivity C-reactive protein (hsCRP), and anthropometric measurements. Metabolic syndrome was diagnosed according to National Cholesterol Education Program Adult Treatment Panel III (NCEP ATP III) criteria. The population sample was divided into two groups according to the presence of metabolic syndrome. Cognitive function was investigated through the Mini-Mental State Examination (MMSE).
We enrolled 159 elderly subjects (mean age, 69.8±4.8 years). Seventy had metabolic syndrome. Metabolic syndrome subjects had higher hsCRP values (P<0.0001) and lower MMSE scores (P<0.0001) than those without metabolic syndrome. MMSE scores were significantly correlated with body mass index (BMI), hsCRP, metabolic syndrome, the number of metabolic syndrome components, and each of them. However, at multivariate regression analysis, only fasting blood glucose [FBG; B=-0.046; 95% confidence interval (CI) -0.066 to -0.028; P<0.0001] and the number of metabolic syndrome components (B=-0.317; 95% CI -0.572 to -0.010; P=0.042) were found to be independent predictors of lower MMSE scores.
We found that subjects with metabolic syndrome have lower MMSE scores than those without, even without symptomatic cognitive impairment, and that the number of metabolic abnormalities is independently associated to lower MMSE scores. We suggest that these patients should always undergo cognitive screening to prevent more severe outcomes.
代谢综合征在老年人中发病率最高，有证据表明代谢综合征可能是认知障碍的独立危险因素。本研究旨在检测代谢综合征患者是否存在认知能力下降，并探讨是否存在与认知能力和单一代谢综合征成分相关的关系。
我们评估了空腹血糖（FBG）、高密度脂蛋白胆固醇（HDL-C）、甘油三酯、高敏 C 反应蛋白（hsCRP）和人体测量学指标。代谢综合征的诊断符合美国国家胆固醇教育计划成人治疗专家组第三版（NCEP ATP III）标准。根据是否存在代谢综合征，将人群样本分为两组。认知功能通过简易精神状态检查（MMSE）进行评估。
我们纳入了 159 名老年受试者（平均年龄 69.8±4.8 岁）。其中 70 人患有代谢综合征。与无代谢综合征者相比，代谢综合征患者的 hsCRP 值更高（P<0.0001），MMSE 评分更低（P<0.0001）。MMSE 评分与体重指数（BMI）、hsCRP、代谢综合征、代谢综合征成分数量以及每个成分均显著相关。然而，多元回归分析显示，仅空腹血糖（FBG；B=-0.046；95%置信区间（CI）-0.066 至-0.028；P<0.0001）和代谢综合征成分数量（B=-0.317；95%CI-0.572 至-0.010；P=0.042）是 MMSE 评分降低的独立预测因素。
我们发现，即使没有症状性认知障碍，患有代谢综合征的患者 MMSE 评分也较低，且代谢异常的数量与 MMSE 评分降低独立相关。我们建议这些患者应始终进行认知筛查，以预防更严重的后果。
