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高尿酸血症作为非肥胖老年人轻度认知障碍的保护因素

Hyperuricemia as a Protective Factor for Mild Cognitive Impairment in Non-Obese Elderly.

作者信息

Wang Feng, Zhao Minghui, Han Zhaoli, Li Dai, Zhang Shishuang, Zhang Yongqiang, Kong Xiaodong, Sun Ning, Zhang Qiang, Lei Ping

机构信息

Department of Geriatrics, Tianjin Medical University General Hospital.

出版信息

Tohoku J Exp Med. 2017 May;242(1):37-42. doi: 10.1620/tjem.242.37.

Abstract

Mild cognitive impairment (MCI) is regarded as incipient dementia. Patients with MCI have increased risk of later progressing to dementia. Blood uric acid (UA) is an important non-enzymatic antioxidant in peripheral circulation, and plays an unconfirmed protective role in MCI. Furthermore, obesity-induced inflammation, which affects UA metabolism and MCI onset, might regulate such protective role. Thus, the aim of the study was to determine the relationship of UA to MCI and the potential effect from inflammation. The study consisted of 933 MCI patients diagnosed by neuropsychological scales and 933 controls with normal cognitive function. All subjects were ≥ 60 years old. There were 378 obese subjects in MCI group and 410 obese subjects in control group. A relationship between lower serum UA levels and higher risk of MCI was found in all MCI patients and non-obese MCI patients (OR: 0.78, 95% CI: 0.72 ~ 0.86; OR: 0.66, 95% CI: 0.55 ~ 0.78), but not in obese MCI patients (OR: 0.94, 95% CI: 0.81 ~ 1.12). Serum UA and hypersensitive C reactive protein (hs-CRP) levels were higher in obese MCI patients than in non-obese MCI patients (P < 0.001 and P < 0.001). Serum UA levels showed a positive linear correlation with serum hs-CRP levels in obese MCI patients (r = 0.284, P < 0.001), but not in non-obese MCI patients (r = 0.030, P = 0.481). In conclusion, we show the significant association between lower serum UA levels and higher risk of MCI in non-obese subjects. Obesity-induced inflammation may weaken such relationship.

摘要

轻度认知障碍(MCI)被视为早期痴呆。MCI患者日后发展为痴呆的风险增加。血尿酸(UA)是外周循环中一种重要的非酶抗氧化剂,在MCI中发挥的保护作用尚未得到证实。此外,影响UA代谢和MCI发病的肥胖诱导炎症可能调节这种保护作用。因此,本研究的目的是确定UA与MCI的关系以及炎症的潜在影响。该研究包括933例经神经心理量表诊断的MCI患者和933例认知功能正常的对照者。所有受试者年龄均≥60岁。MCI组有378例肥胖受试者,对照组有410例肥胖受试者。在所有MCI患者和非肥胖MCI患者中均发现血清UA水平较低与MCI风险较高之间存在关联(OR:0.78,95%CI:0.720.86;OR:0.66,95%CI:0.550.78),但在肥胖MCI患者中未发现(OR:0.94,95%CI:0.81~1.12)。肥胖MCI患者的血清UA和超敏C反应蛋白(hs-CRP)水平高于非肥胖MCI患者(P<0.001和P<0.001)。肥胖MCI患者的血清UA水平与血清hs-CRP水平呈正线性相关(r=0.284,P<0.001),而非肥胖MCI患者则无此相关性(r=0.030,P=0.481)。总之,我们发现非肥胖受试者血清UA水平较低与MCI风险较高之间存在显著关联。肥胖诱导的炎症可能会削弱这种关系。

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