[西安脑卒中高危人群血浆同型半胱氨酸水平与认知功能的调查]

[Investigation on plasma homocysteine level and cognition in population at high risk for stroke in Xi'an].

作者信息

Ma Hongni, Yan Fei, Li Zaili, Deng Meiying, Qu Qiumin

机构信息

Department of Neurology, First Affiliated Hospital of Medical College of Xi'an Jiaotong University, Xi'an 710061, China.

Department of Neurology, First Affiliated Hospital of Medical College of Xi'an Jiaotong University, Xi'an 710061, China. Email:

出版信息

Zhonghua Liu Xing Bing Xue Za Zhi. 2014 Jul;35(7):769-72.

PMID:25301241

Abstract

OBJECTIVE

To investigate the relationship between plasma homocysteine (Hcy) and cognitive impairment so as to provide basis for dementia prevention.

METHODS

Subjects at high risk for stroke were selected from the Screening and Prevention Program of Stroke (organized by the Ministry of Health, from August to December, 2012) in Yanta area, Xi'an. Fasting blood was taken from cubital vein to measure Hcy. When Hcy>15 µmol/L was defined as hyperhomocysteinemia, Hcy in the range of 16-30 µ mol/L was considered mild, ≥ 31 µ mol/L as moderate-severe hyperhomocysteinemia. The cognitive function was evaluated by the Mini Mental State Examination (MMSE). MMSE grades under normal value were defined as cognitive impairment.

RESULTS

393 subjects were randomly recruited, including 173 men (44.0%) and 220 women (56.0%). Number of cases with cognitive impairment was 70 (17.8% of the total subjects), with hyperhomocysteinemia was 220 (56.0% of the total subjects). The prevalence of cognitive impairment did not show significant difference with hyperhomocysteinemia or normal Hcy group (16.8% vs. 19.1%, P>0.05), neither with mild and moderate-severe hyperhomocysteinemia group (17.0% vs. 16.3% , P > 0.05). Results from Spearman correlation analysis indicated that there was no correlation between MMSE grades and Hcy (rs = -0.01, P = 0.85). Prevalence of cognitive impairment in the smoking group was higher than that in the non-smoking group (21.3% vs. 7.8%, P < 0.01), but higher in hypertension group than that in the normal blood pressure group (21.7% vs. 8.0%, P < 0.01). In the stroke group, prevalence of cognitive impairment was seen higher than that in the non-stroke group (25.3% vs. 15.4%, P < 0.05). Based on the results from Binary logistic regression, cognitive impairment appeared to be associated with the levels of education (OR = 0.90, 95% CI:0.81-0.98, P = 0.02), histories of hypertension (OR = 1.02, 95%CI:1.01-1.04, P = 0.01) and stroke(OR = 1.86, 95%CI:1.04-3.33, P = 0.04), but there was no correlation seen between Hcy and cognitive impairment (OR = 0.90, 95% CI:0.51-1.58, P = 0.71).

CONCLUSION

Plasma homocysteine did not seem a risk factor for cognitive impairment.

摘要

目的

探讨血浆同型半胱氨酸（Hcy）与认知功能障碍之间的关系，为预防痴呆提供依据。

方法

从西安市雁塔区脑卒中筛查与预防项目（由卫生部组织，2012年8月至12月）中选取脑卒中高危人群。采集肘静脉空腹血检测Hcy。当Hcy>15 μmol/L定义为高同型半胱氨酸血症，16 - 30 μmol/L为轻度，≥31 μmol/L为中度至重度高同型半胱氨酸血症。采用简易精神状态检查表（MMSE）评估认知功能。MMSE评分低于正常值定义为认知功能障碍。

结果

随机招募393名受试者，其中男性173名（44.0%），女性220名（56.0%）。认知功能障碍患者70例（占总受试者的17.8%），高同型半胱氨酸血症患者220例（占总受试者的56.0%）。认知功能障碍的患病率在高同型半胱氨酸血症组与正常Hcy组之间无显著差异（16.8%对19.1%，P>0.05），在轻度与中度至重度高同型半胱氨酸血症组之间也无显著差异（17.0%对16.3%，P>0.05）。Spearman相关性分析结果表明，MMSE评分与Hcy之间无相关性（rs = -0.01，P = 0.85）。吸烟组认知功能障碍的患病率高于非吸烟组（21.3%对7.8%，P<0.01），高血压组高于正常血压组（21.7%对8.0%，P<0.01）。脑卒中组认知功能障碍的患病率高于非脑卒中组（25.3%对15.4%，P<0.05）。基于二元逻辑回归结果，认知功能障碍似乎与教育程度（OR = 0.90，95%CI：0.81 - 0.98，P = 0.02）、高血压病史（OR = 1.02，95%CI：1.01 - 1.04，P = 0.01）和脑卒中（OR = 1.86，95%CI：1.04 - 3.33，P = 0.04）有关，但Hcy与认知功能障碍之间无相关性（OR = 0.90，95%CI：0.51 - 1.58，P = 0.71）。