血浆同型半胱氨酸水平与认知障碍的关系：西安市农村地区40岁及以上人群横断面研究

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中图分类号：R74 文献标志码：ADOI：10.7652/jdyxb202505006

Relationships between plasma homocysteine levels and cognitive impairment：a cross-sectional study based on the rural population aged 4O years old and above in Xi'an，China

ZHAO Yi1 ，LI Chunyu1，DANG Liangjun1，SHANG Suhang1 ， WANG Jingyi²，WANG Jin1 ，QUQiumin1，LUWenhui1 （1. Department of Neurology，The First Affiliated Hospital of Xi'an Jiaotong University， Xi'an 7l0061；2. Huyi Hospital of Traditional Chinese Medicine，Xi'an 7lO30o，China）

ABSTRACT： ObjectiveTo investigate the relationship between plasma homocysteine （Hcy）levels and cognitive impairment（CI）.MethodsFrom November 2O18 to January 2O19，baseline data and cognitive function were collected from the participantsaged ⩾40 yearswho lived in two villagesin Huyi District，Xi’an，China.Their globalcognitive function was asessed by Mini-Mental State Examination（MMSE）and the diagnosis of cognitive impairment was based on international guidelines.Fasting blood was collcted in the morning，and plasma Hcylevel was measured by the chemiluminometric assy.Multivariate Logistic regresson analysis，subgroup analysis，and interaction analysis were performed to investigate the relationship between plasma Hcy and C1.ResultsA total of 1 805 subjects were included in the analysis.There were 1 O56 females （58.5% ），ageranged from 40 to 88years [mean （58.99±9.52） years]，and 145 participants （8.0% ） were diagnosed as CI. The median plasma Hcy level in the overall population was 14.1 （11.6， 17.8）μmol/L . There were 729（40.4% ）subjects in the HHcy group （>15.0μmol/L） and 1076（59.6% ）in the normal group c{≤15.0μmol/L} .Univariate analysis showed that the prevalence of CI was higher in the HHcy group than in the normal Hcy group（ （11.4% vs. 5.8% ， P<0.001⟩ .In multivariable Logistic regression fully adjusted for potential confounders，each 1μmol/L increase in plasma Hcy level was associated with a3.0% increased risk of CI （ OR=1.030 ， 95% CI：1.012—1.048， P=0.001） . Interaction analysis indicated that sex， age，BMI，systolic blood pressure，history of stroke，and diabetes did not significantly modify this association. ConclusionElevated plasma Hcy levels are associated with an increased risk of CI in people aged ⩾40 years. This indicates that HHcy may be a risk factor for CI.

KEY WORDS：cognitive impairment （CI； risk factor; homocysteine （Hcy）；cros-sectional study

随着全球人口老龄化进展，认知障碍（cognitiveimpairment，CI患病率逐年增高，按照认知受损程度分为轻度认知障碍（mildcognitiveimpairment，MCI和痴呆，中国及其他发展中国家是痴呆的重灾区，给公众和医疗保健系统带来沉重负担[1-2]。（剩余13760字）