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血糖而非代谢综合征与认知功能下降有关:欧洲男性衰老研究的结果

Glycemia but not the Metabolic Syndrome is Associated with Cognitive Decline: Findings from the European Male Ageing Study.

作者信息

Overman Margot J, Pendleton Neil, O'Neill Terence W, Bartfai Gyorgy, Casanueva Felipe F, Forti Gianni, Rastrelli Giulia, Giwercman Aleksander, Han Thang S, Huhtaniemi Ilpo T, Kula Krzysztof, Lean Michael E J, Punab Margus, Lee David M, Correa Elon S, Ahern Tomas, Laurent Michaël R, Verschueren Sabine M P, Antonio Leen, Gielen Evelien, Rutter Martin K, Vanderschueren Dirk, Wu Frederick C W, Tournoy Jos

机构信息

Gerontology and Geriatrics, Department of Clinical and Experimental Medicine, KU Leuven, Leuven, Belgium.

Clinical & Cognitive Neurosciences, Institute of Brain, Behaviour and Mental Healthy, The University of Manchester, UK.

出版信息

Am J Geriatr Psychiatry. 2017 Jun;25(6):662-671. doi: 10.1016/j.jagp.2017.02.004. Epub 2017 Feb 7.

Abstract

OBJECTIVE

Previous research has indicated that components of the metabolic syndrome (MetS), such as hyperglycemia and hypertension, are negatively associated with cognition. However, evidence that MetS itself is related to cognitive performance has been inconsistent. This longitudinal study investigates whether MetS or its components affect cognitive decline in aging men and whether any interaction with inflammation exists.

METHODS

Over a mean of 4.4 years (SD ± 0.3), men aged 40-79 years from the multicenter European Male Ageing Study were recruited. Cognitive functioning was assessed using the Rey-Osterrieth Complex Figure (ROCF), the Camden Topographical Recognition Memory (CTRM) task, and the Digit Symbol Substitution Test (DSST). High-sensitivity C-reactive protein (hs-CRP) levels were measured using a chemiluminescent immunometric assay.

RESULTS

Overall, 1,913 participants contributed data to the ROCF analyses and 1,965 subjects contributed to the CTRM and DSST analyses. In multiple regression models the presence of baseline MetS was not associated with cognitive decline over time (p > 0.05). However, logistic ordinal regressions indicated that high glucose levels were related to a greater risk of decline on the ROCF Copy (β = -0.42, p < 0.05) and the DSST (β = -0.39, p < 0.001). There was neither a main effect of hs-CRP levels nor an interaction effect of hs-CRP and MetS at baseline on cognitive decline.

CONCLUSION

No evidence was found for a relationship between MetS or inflammation and cognitive decline in this sample of aging men. However, glycemia was negatively associated with visuoconstructional abilities and processing speed.

摘要

目的

先前的研究表明,代谢综合征(MetS)的组成部分,如高血糖和高血压,与认知呈负相关。然而,关于MetS本身与认知表现相关的证据并不一致。这项纵向研究调查了MetS及其组成部分是否会影响老年男性的认知衰退,以及是否存在与炎症的相互作用。

方法

从多中心欧洲男性衰老研究中招募了年龄在40 - 79岁之间的男性,平均随访4.4年(标准差±0.3)。使用雷-奥斯特里思复杂图形(ROCF)、卡姆登地形识别记忆(CTRM)任务和数字符号替换测试(DSST)评估认知功能。采用化学发光免疫分析法测量高敏C反应蛋白(hs-CRP)水平。

结果

总体而言,1913名参与者为ROCF分析提供了数据,1965名受试者为CTRM和DSST分析提供了数据。在多元回归模型中,基线时存在MetS与随时间的认知衰退无关(p > 0.05)。然而,逻辑顺序回归表明,高血糖水平与ROCF临摹(β = -0.42,p < 0.05)和DSST(β = -0.39,p < 0.001)下降的风险增加有关。基线时hs-CRP水平对认知衰退既没有主效应,hs-CRP与MetS之间也没有交互效应。

结论

在这个老年男性样本中,未发现MetS或炎症与认知衰退之间存在关联的证据。然而,血糖与视觉构建能力和处理速度呈负相关。

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