摘要
目的:探讨肝脏纤维化指标与认知功能减退的关系。方法:在本横断面研究中,共纳入2017—2018年来自深圳市罗湖区51个社区卫生中心,年龄大于60岁的患者8669人。根据患者简易精神状态量表(MMSE)评分,教育程度分为认知功能低风险组(n=8202)和认知功能高风险组(n=467)。采集患者空腹血样检测血常规和肝功指标,利用ALT、AST、PLT等参数通过公式计算得出肝脏纤维化指标FIB-4和APRI。采用t检验、秩和检验和卡方检验分析两组患者一般统计学特征及肝脏纤维化指标差异性,并对各指标进行二元Logistic回归分析,采用秩相关分析研究肝脏纤维化指标和饮酒习惯的关系。结果:与认知功能低风险组相比,认知功能高风险组的FIB-4明显增高[1.40(1.13,1.78)vs.1.49(1.21,1.88),Z=3.595,P<0.001],但不是认知功能减退的独立危险因素[OR(95%CI):0.718(0.444~1.159),P=0.175]。对于饮酒群体,FIB-4与开始饮酒年龄(r_(s)=0.089,P=0.005)和饮酒频次(r_(s)=0.149,P<0.001)呈正相关,APRI与饮酒频次(r_(s)=0.078,P=0.013)也呈正相关;对于戒酒群体,FIB-4与戒酒年龄(r_(s)=0.172,P=0.014)呈正相关关系。结论:认知功能减退人群的FIB-4增高,饮酒频次增加和FIB-4、APRI升高有关,尽早戒酒可保护肝脏、延缓认知功能衰退。
Objective:We aimed to explore the association of liver fibrosis markers with cognitive decline.Methods:In this crosssectional study,there were 8669 participants over 60 years old from 51 Community Health Centers in the Luohu District of Shenzhen from 2017 to 2018.All participants were divided into a cognitive low-risk group(n=8202)and a cognitive high-risk group(n=467)according to their scores of mini-mental state examination and education status.Blood routine examination and liver function markers were tested from fasting blood samples.The liver fibrosis markers FIB-4 and APRI were calculated with parameters such as ALT,AST,and PLT using specific formulas.We used the t-test,Mann-Whitney test,and Chi-square test to analyze the differences in general statistical characteristics and live fibrosis markers between the two groups,and binary Logistic regression analysis was used to analyze each parameter.The association between the liver fibrosis markers and alcohol drinking habits was tested by Spearman rank correlation.Results:FIB-4 was significantly higher in the cognitive high-risk group than the cognitive low-risk group[1.40(1.13,1.78)vs.1.49(1.21,1.88),Z=3.595,P<0.001]but FIB-4 was not an independent risk factor of cognitive decline[OR(95%CI):0.718(0.444~1.159),P=0.175].For alcohol drinkers,FIB-4 was significantly positively correlated with the age of starting drinking(r_(s)=0.089,P=0.005)and frequency of drinking(r_(s)=0.149,P<0.001).There was a positive correlation between APRI and frequency of drinking(r_(s)=0.078,P=0.013)as well.For people abstaining from alcohol,FIB-4 exhibited a positive correlation with the age of abstinence(r_(s)=0.172,P=0.014).Conclusion:FIB-4 was elevated in people with cognitive decline,and increased frequency of drinking was correlated with raised FIB-4 and APRI,and giving up drinking as soon as possible might be beneficial to prevent the cognitive decline by liver health.
作者
王昊
吴凯钰
邱国真
陈淳淳
黎明坤
郭启雯
许春燕
王敏
刘威
刘建军
刘佩意
刘亢丁
朱飞奇
Hao WANG;Kaiyu WU;Guozhen QIU;Chunchun CHEN;Mingkun LI;Qiwen GUO;Chunyan XU;Min WANG;Wei LIU;Jianjun LIU;Peiyi LIU;Kangding LIU;Feiqi ZHU(Department of Neurology,The First Bethune Hospital of Jilin University,Changchun 130021,China;Geriatric Cognitive Impairment Ward,Department of Neurology,Shenzhen Luohu District People's Hospital,Shenzhen 518001,Guangdong,China;College of Public Health,Shaanxi University of Chinese Medicine,Xianyang 712000,Shanxi,China;Shenzhen Center for Disease Control and Prevention,Shenzhen 518055,Guangdong,China)
出处
《阿尔茨海默病及相关病杂志》
2025年第3期164-169,193,共7页
Chinese Journal of Alzheimer's Disease and Related Disorders
基金
深圳市医疗卫生三名工程项目“瑞典卡罗琳斯卡医学院NVS系Bengt Winblad教授阿尔茨海默病团队”(SZSM201801014)
深圳市科创委重点项目“AD前期及患者健康管理大数据构建及其预测预警模型研究”(JCYJ20200109143431341)。
