Ma Lina, Feng Ming, Qian Yuying, Yang Wei, Liu Jia, Han Rui, Zhu Hong, Li Yun
Department of Geriatrics, Xuan Wu Hospital, Capital Medical University, Beijing, China.
Yonsei Med J. 2015 Jan;56(1):89-94. doi: 10.3349/ymj.2015.56.1.89.
Insulin resistance plays a role in the development of dementia and hypertension. We investigated a possible relationship between cognitive impairment and insulin resistance in elderly Chinese patients with primary hypertension.
One hundred and thirty-two hypertensive elderly patients (>60 years) were enrolled in this study, and assigned into either the cognitive impairment group (n=61) or the normal cognitive group (n=71). Gender, age, education, body mass index (BMI), waist hip ratio (WHR), total cholesterol (TC), triglyceride (TG), C-reactive protein (CRP), high density lipoprotein cholesterol (HDL-C), low density lipoprotein cholesterol (LDL-C), creatinine (Cr), fasting plasma glucose (FPG), fasting insulin (FINS), homeostasis model of assessment for insulin resistance index (HOMA-IR), systolic blood pressure, diastolic blood pressure, smoking history, atherosclerosis and the proportion of uncontrolled hypertension were compared between the two groups. Multi-factorial logistic regression analysis was performed.
No significant differences were found in gender, age, TC, CRP, HDL-C, LDL-C, Cr, BP, smoking history, atherosclerosis and the proportion of uncontrolled hypertension between the two groups. The cognitive impairment group had lower education levels, and higher BMI, WHR, TG, FPG, FINS, and HOMA-IR levels than the control group. Logistic regression analysis revealed the levels of education, BMI, WHR, and HOMA-IR as independent factors that predict cognitive impairment in patients.
Our study demonstrates that poor education and increased BMI, WHR, and HOMA-IR are independent risk factors for cognitive impairment in elderly patients with hypertension. Insulin resistance plays an important role in the development of cognitive impairment in primary elderly hypertensive patients.
胰岛素抵抗在痴呆和高血压的发生发展中起作用。我们调查了中国老年原发性高血压患者认知障碍与胰岛素抵抗之间的可能关系。
本研究纳入132例年龄>60岁的高血压老年患者，分为认知障碍组（n = 61）和认知正常组（n = 71）。比较两组患者的性别、年龄、教育程度、体重指数（BMI）、腰臀比（WHR）、总胆固醇（TC）、甘油三酯（TG）、C反应蛋白（CRP）、高密度脂蛋白胆固醇（HDL-C）、低密度脂蛋白胆固醇（LDL-C）、肌酐（Cr）、空腹血糖（FPG）、空腹胰岛素（FINS）、胰岛素抵抗指数稳态模型评估（HOMA-IR）、收缩压、舒张压、吸烟史、动脉粥样硬化及血压未控制比例。进行多因素logistic回归分析。
两组在性别、年龄、TC、CRP、HDL-C、LDL-C、Cr、血压、吸烟史、动脉粥样硬化及血压未控制比例方面无显著差异。认知障碍组的教育程度较低，BMI、WHR、TG、FPG、FINS和HOMA-IR水平高于对照组。logistic回归分析显示教育程度、BMI、WHR和HOMA-IR水平是预测患者认知障碍的独立因素。
我们的研究表明，教育程度低以及BMI、WHR和HOMA-IR升高是老年高血压患者认知障碍的独立危险因素。胰岛素抵抗在老年原发性高血压患者认知障碍的发生发展中起重要作用。
