Department of Medicine , Rush University Medical Center, Chicago, Illinois 60612.
Department of Preventive Medicine, Rush University Medical Center, Chicago, Illinois 60612.
J Clin Endocrinol Metab. 2020 Apr 1;105(4):e1093-105. doi: 10.1210/clinem/dgaa067.
Metabolic syndrome (MetS) affects cognitive function in late life, particularly in women. But longitudinal research is scarce on associations of MetS with cognitive function during midlife.
To determine associations between MetS exposure and cognitive function trajectories in midlife women.
This is a 17-year prospective, longitudinal study of multiracial/ethnic women in 7 US communities, with annual/biennial assessments.
Participants were 2149 US women traversing menopause.
Exposure consisted of MetS assessments (median 4 assessments over 4 years).
Main outcome measures were assessments of cognitive function in 3 domains: perceptual speed (symbol digit modalities test, SDMT), episodic memory (East Boston Memory Test, EBMT), and working memory (Digit Span Backward Test, DSB).
By their first cognitive assessment (age 50.7 ± 2.9 years), 29.5% met the criteria for MetS. Women completed a median (interquartile range [IQR]) of 6 (IQR 4-7) follow-up cognitive assessments over 11.2 (IQR 9.2-11.5) years. Women with MetS, compared with those without, had a larger 10-year decline in SDMT z-score (estimate -0.087, 95% confidence interval, -0.150 to -0.024; P = 0.007), after adjustment for cognitive testing practice effects, sociodemographics, lifestyle, mood, and menopause factors. As such, MetS accelerated the 10-year loss of perceptual speed by 24%. MetS did not differentially affect the rate of decline in either immediate (P = 0.534) or delayed (P = 0.740) episodic memory or in working memory (P = 0.584).
In midlife women MetS exposure was associated with accelerated decline in perceptual speed, but not episodic or working memory.
代谢综合征（MetS）会影响老年人的认知功能，尤其是女性。但关于代谢综合征与中年人认知功能之间关联的纵向研究还很少。
确定代谢综合征（MetS）在中年女性中的暴露与认知功能轨迹之间的关联。
这是一项在美国 7 个社区进行的、为期 17 年的、多种族/族裔女性的前瞻性、纵向研究，每 1-2 年进行一次评估。
参与者为 2149 名经历绝经期的美国女性。
暴露情况包括代谢综合征（MetS）评估（中位数为 4 次评估，历时 4 年）。
主要观察指标为认知功能的 3 个领域的评估结果：知觉速度（符号数字模式测试，SDMT）、情景记忆（东波士顿记忆测试，EBMT）和工作记忆（数字广度测试倒背，DSB）。
在首次认知评估（年龄 50.7±2.9 岁）时，29.5%的女性符合代谢综合征（MetS）的标准。女性在 11.2（IQR9.2-11.5）年的时间里完成了中位数（IQR）6（IQR4-7）次的随访认知评估。与没有代谢综合征的女性相比，患有代谢综合征的女性在 SDMT z 分数的 10 年下降幅度更大（估计值为-0.087，95%置信区间为-0.150 至-0.024；P=0.007），这是在考虑了认知测试实践效果、社会人口统计学因素、生活方式、情绪和绝经期因素后得出的结果。因此，代谢综合征加速了知觉速度的 10 年损失，损失速度快了 24%。代谢综合征对即时（P=0.534）或延迟（P=0.740）情景记忆或工作记忆的下降率没有差异影响（P=0.584）。
在中年女性中，代谢综合征的暴露与知觉速度的加速下降有关，但与情景记忆或工作记忆无关。
