基于生命八要素的心血管健康评分与老年人群认知功能的关联研究
作者:
作者单位:

(北京中医药大学东直门医院,北京市 100700)

作者简介:

彭景,博士研究生,研究方向为神经变性病的中医药防治,E-mail:pengj1121@163.com。

基金项目:

北京中医药大学解码中医协同攻关项目(BZY-JMZY-2022-002)


Association between cardiovascular health score based on life's essential 8 on cognitive function in older adults
Author:
Affiliation:

Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing 100700, China)

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    摘要:

    目的]探究基于生命八要素(LE8)的心血管健康(CVH)评分与老年人群认知功能之间的关系,以及中性粒细胞/淋巴细胞比值(NLR)在二者之间的中介作用,为认知障碍的预防和控制提供依据。 [方法]选择2011—2014年美国国家健康和营养调查中60岁及以上老年人作为研究对象,收集人口学特征和基础病史等变量,依据美国心脏协会定义的LE8计算受试者CVH评分,使用数字符号转换测试评价认知功能。采用加权线性回归分析探究CVH与认知功能评分的关系,并通过限制性立方样条分析二者之间的剂量-反应关系。最后采用中介分析,探索NLR介导CVH评分与认知功能之间关联的中介作用。 [结果]共纳入2 510名研究对象,校正相关因素后,与低CVH组评分相比,中CVH组评分(β=3.36,95%CI:1.43~5.30)和高CVH组评分(β=6.01,95%CI:2.89~9.13)与认知功能评分呈正相关;LE8单个因素的饮食评分(β=0.04,95%CI:0.01~0.06)、身体活动评分(β=0.04,95%CI:0.02~0.05)、烟草暴露评分(β=0.05,95%CI:0.02~0.08)、血压评分(β=0.03,95%CI:0.01~0.05)和血糖评分(β=0.06,95%CI:0.03~0.09)均与认知功能评分呈正相关;限制性立方样条图结果显示,CVH评分与认知功能评分呈线性正相关;CVH通过NLR影响认知功能的间接效应β值为0.002(P>0.05),中介效应占比1.29%(P>0.05),NLR在二者之间的中介作用不显著。 [结论]老年人群基于LE8的CVH评分与认知功能呈线性正相关,提示在老年阶段保持良好的心血管健康水平对于认知功能的维持和提升具有重要意义。然而,NLR作为炎症标志物并未在CVH评分与认知功能之间表现出明显中介效应,二者之间的关系可能由其他机制所介导。

    Abstract:

    Aim To investigate the association between cardiovascular health (CVH) score based on life's essential 8 (LE8) on cognitive function and the mediation role of neutrophil-to-lymphocyte ratio (NLR) between them in older adults, providing basis for the prevention and control of cognitive impairment. Methods The study population was selected from the National Health and Nutrition Examination Survey (NHANES) 2011—2014 two cycles of 60 years and above, demographic characteristics, medical history and other variables were collected, the participants' CVH scores were calculated according to LE8 defined by American Heart Association, and cognitive function was assessed using the digit symbol substitution test. The relationship between CVH and cognitive function was explored using a weighted linear regression analysis, and the dose-response relationship was analyzed using a restricted cubic spline. Moreover, mediation analysis was used to explore the role of NLR in mediating the relationship between CVH score and cognitive function. Results A total of 2 510 participants were included in this study. After adjusting for relevant factors, cognitive function was positively associated with moderate CVH group score (β=3.6,5%CI:1.43~ 5.30) and high CVH group score (β=6.1,5%CI:2.89~ 9.13) compared with the low CVH group score. The LE8 single factor of diet score (β=0.4,5%CI:0.01~0.06), physical activity score (β=0.4,5%CI:0.02~0.05), tobacco exposure score (β=0.5,5%CI:0.02~0.08), blood pressure score (β=0.3,5%CI:0.01~0.05) and blood glucose score (β=0.6,5%CI:0.03~0.09) were positively correlated with cognitive function score. The results of restricted cubic splines showed that the score of CVH was linear positively correlated with the score of cognitive function. The indirect effect of CVH on cognitive function via NLR was 0.002 (P>0.05), and the proportion of mediating effect was 1.29% (P>0.05), indicating the mediating effect of NLR on the relationship between CVH score and cognitive function was not significant. Conclusions The CVH score based on the LE8 was positively correlated with cognitive function in older adults, underscoring the crucial role of maintaining optimal CVH levels in supporting cognitive health. However, the NLR, as an indicator of inflammation, did not exhibit a significant mediating effect between the CVH score and cognitive function. The relationship between these variables might be influenced by other mechanisms.

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彭景,魏明清,倪敬年,李婷,时晶,田金洲.基于生命八要素的心血管健康评分与老年人群认知功能的关联研究[J].中国动脉硬化杂志,2025,33(1):51~57.

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  • 收稿日期:2024-07-18
  • 最后修改日期:2024-10-08
  • 在线发布日期: 2025-01-26