空腹血糖对无症状颈动脉粥样硬化斑块患者认知功能的影响—— 1项针对非城镇居民的调查

doi:10.3969/j.issn.1673-5765.2022.07.013

摘要/Abstract

摘要：

目的探索空腹血糖对无症状颈动脉粥样硬化斑块患者认知功能的影响。

方法研究人群为2015年9月-2017年9月期间参与中国国家脑卒中高危人群筛查和干预（China national stroke screen survey，CNSSS）项目，北京市昌平区北七家社区卫生服务中心和北京市顺义区空港医院筛查点的40岁以上非城镇居民。入组标准为既往无脑血管疾病及相关神经功能缺损症状和体征，且行超声检查确诊存在颈动脉粥样硬化斑块。采用MoCA量表（北京版）评价认知功能。采用多因素logistic回归分析空腹血糖与认知障碍（MoCA<26分）的关系。

结果共有1446名居民纳入本项研究，平均年龄为62.0±8.3岁，男性809人（55.9%），受教育年限≤12年者1364人（94.3%），其中936人（64.7%）存在认知障碍。单因素logistic回归分析显示，空腹血糖与认知障碍相关（趋势P=0.003）。校正混杂因素后，空腹血糖升高仍然是认知障碍的独立危险因素（趋势P=0.008），相较于最低四分位数空腹血糖水平，最高四分位数空腹血糖水平患者的认知障碍风险增加了0.49倍（OR 1.49，95%CI 1.10～2.02，P=0.010）。

结论空腹血糖升高是无症状颈动脉粥样硬化斑块患者认知障碍的独立危险因素。

文章导读： 本研究基于大型非城镇居民的社区队列，探索了无症状颈动脉粥样硬化斑块人群中空腹血糖水平与认知功能的关系，结果提示随着空腹血糖水平的升高，此类人群发生认知障碍的风险显著升高，与糖尿病史和糖血红蛋白升高相比，空腹血糖对认知功能的影响更加明显。

关键词: 空腹血糖; 认知功能; 颈动脉; 动脉粥样硬化斑块

Abstract:

Objective To explore the effect of fasting blood glucose on cognitive function in patients with asymptomatic carotid atherosclerotic plaque.

Methods Participants aged ≥40 years who participated in the China National Stroke Screen Survey (CNSSS) program between September 2015 to September 2017, from two rural communities (Beiqijia community, Changping District, Beijing and Konggang community, Shunyi District, Beijing), were enrolled in this study. The included patients had carotid atherosclerotic plaques confirmed by carotid ultrasound, yet no cerebrovascular diseases and neurological deficits. Cognitive function was evaluated by the Montreal cognitive assessment (Beijing version). The multivariable logistic regression analysis was used to determine the association between fasting blood glucose and cognitive impairment (MoCA<26 points).

Results Finally, a total of 1446 subjects were included in this study, with a mean age of 62.0±8.3 years and 809 males (55.9%). 1364 (94.3%) had an education level of no more than 12 years, and 936 (64.7%) had cognitive impairment. Univariate logistic regression analysis showed that fasting blood glucose was associated with cognitive impairment (P_trend=0.003). After adjusting for the confounding factors, fasting blood glucose was still an independent risk factor for cognitive impairment (P_trend=0.008). The patients with the highest quartile of fasting blood glucose had an increased risk of cognitive impairment by 0.49 times, compared to patients with the lowest quartile (OR 1.49, 95%CI 1.10-2.02, P=0.010).

Conclusions High fasting blood glucose was an independent risk factor for cognitive impairment in patients with asymptomatic carotid atherosclerotic plaque.

Key words: Fasting blood glucose; Cognitive function; Carotid artery; Atherosclerotic plaque

张倩, 张冠一, 张佳, 陈胜云, 赵性泉. 空腹血糖对无症状颈动脉粥样硬化斑块患者认知功能的影响—— 1项针对非城镇居民的调查[J]. 中国卒中杂志, 2022, 17(07): 753-757.

ZHANG Qian, ZHANG Guanyi, ZHANG Jia, CHEN Shengyun, ZHAO Xingquan. Effect of Fasting Blood Glucose on Cognitive Function in Patients with Asymptomatic Carotid Atherosclerotic Plaque: A Survey of Rural Residents[J]. Chinese Journal of Stroke, 2022, 17(07): 753-757.

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