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老年人心脏心室复极与血清黏附分子和认知功能的关系:MIND-China 研究。

Associations of Cardiac Ventricular Repolarization with Serum Adhesion Molecules and Cognitive Function in Older Adults: The MIND-China Study.

机构信息

Department of Neurology, Shandong Provincial Hospital, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, P.R. China.

Department of Neurology, Shandong Provincial Hospital affiliated to Shandong First Medical University, Jinan, Shandong, P.R. China.

出版信息

J Alzheimers Dis. 2023;92(1):273-283. doi: 10.3233/JAD-220874.

Abstract

BACKGROUND

Emerging evidence has linked electrocardiographic parameters with serum adhesion molecules and cognition; however, their interrelationship has not been explored.

OBJECTIVE

We sought to investigate the associations of ventricular depolarization and repolarization intervals with serum adhesion molecules and cognitive function among rural-dwelling older adults.

METHODS

This population-based study engaged 4,886 dementia-free participants (age ≥60 years, 56.2% women) in the baseline examination (March-September 2018) of MIND-China. Of these, serum intercellular and vascular adhesion molecules (ICAM-1 and VCAM-1) were measured in 1591 persons. We used a neuropsychological test battery to assess cognitive function. Resting heart rate, QT, JT intervals, and QRS duration were assessed with electrocardiogram. Data were analyzed using general linear models adjusting for multiple confounders.

RESULTS

Longer JT interval was significantly associated with lower z-scores of global cognition (multivariable-adjusted β= -0.035; 95% confidence interval = -0.055, -0.015), verbal fluency (-0.035; -0.063, -0.007), attention (-0.037; -0.065, -0.010), and executive function (-0.044; -0.072, -0.015), but not with memory function (-0.023; -0.054, 0.009). There were similar association patterns of QT interval with cognitive functions. In the serum biomarker subsample, longer JT and QT intervals remained significantly associated with poorer executive function and higher serum adhesion molecules. We detected statistical interactions of JT interval with adhesion molecules (pinteraction <0.05), such that longer JT interval was significantly associated with a lower executive function z-score only among individuals with higher serum ICAM-1 and VCAM-1.

CONCLUSION

Longer ventricular depolarization and repolarization intervals are associated with worse cognitive function in older adults and vascular endothelial dysfunction may play a part in the associations.

摘要

背景

新出现的证据将心电图参数与血清黏附分子和认知联系起来;然而,它们之间的相互关系尚未得到探索。

目的

我们旨在研究心室去极化和复极化间期与血清黏附分子和农村老年人认知功能之间的关系。

方法

这项基于人群的研究纳入了 MIND-China 研究基线检查(2018 年 3 月至 9 月)中的 4886 名无痴呆症的参与者(年龄≥60 岁,56.2%为女性)。其中,有 1591 人测量了血清细胞间和血管黏附分子(ICAM-1 和 VCAM-1)。我们使用神经心理学测试量表评估认知功能。使用心电图评估静息心率、QT、JT 间期和 QRS 持续时间。数据通过一般线性模型进行分析,模型中调整了多个混杂因素。

结果

较长的 JT 间期与整体认知功能(多变量调整后的β=-0.035;95%置信区间=-0.055,-0.015)、语言流畅性(-0.035;-0.063,-0.007)、注意力(-0.037;-0.065,-0.010)和执行功能(-0.044;-0.072,-0.015)的 z 评分降低显著相关,但与记忆功能(-0.023;-0.054,0.009)无关。QT 间期与认知功能也存在类似的关联模式。在血清生物标志物亚组中,较长的 JT 和 QT 间期与较差的执行功能和较高的血清黏附分子仍显著相关。我们检测到 JT 间期与黏附分子之间存在统计学交互作用(pinteraction <0.05),即只有在血清 ICAM-1 和 VCAM-1 较高的个体中,较长的 JT 间期才与执行功能 z 评分降低显著相关。

结论

心室去极化和复极化间期延长与老年人认知功能下降有关,血管内皮功能障碍可能在这些关联中起作用。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8af6/10200176/9a8ac933ddfa/jad-92-jad220874-g001.jpg

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