老年高血压患者血浆同型半胱氨酸对胰岛素抵抗指数及认知功能的影响

Effects of Plasma Homocysteine on Insulin Resistance Index and Cognitive Function in Elderly Patients with Hypertension

摘要: 目的：探讨老年高血压患者血浆同型半胱氨酸(homocysteine, Hcy)对胰岛素抵抗指数(insulin re-sistance index, HOMA-IR)及认知功能的影响。方法：选取2020年9月至2021年8月就诊的老年高血压患者86例，根据血浆同型半胱氨酸(homocysteine, Hcy)水平将受试者分为单纯高血压组(n = 42)、高Hcy组(n = 50)，以稳态模型HOMA-IR评价胰岛素抵抗(insulin resistance, IR)水平，选用蒙特利尔认知评估(MoCA)进行认知功能评估，相关性分析采用Pearson相关分析。结果：高Hcy组FINS、HOMA-IR高于单纯高血压组；高Hcy组认知功能障碍检出27例，单纯高血压组检出认知功能障碍16例，高Hcy组在MoCA评分、视空间与执行能力、注意力、计算能力、语言、延迟回忆均低于单纯高血压组，差异具有统计学意义(P < 0.05)；Pearson相关分析显示，Hcy与FINS、HOMA-IR呈正相关(r = 0.438, 0.435, P < 0.05)，Hcy与MoCA评分呈负相关。结论：老年高Hcy组IR、认知功能障碍的发生率明显高于单纯高血压患者，老年高血压中Hcy是IR、认知功能障碍发生的危险因素之一。

Abstract: Objective: To investigate the effects of plasma homocysteine on insulin resistance index (HOMA- IR) and cognitive function in elderly patients with hypertension. Methods: The 86 elderly patients with hypertension from September 2020 to August 2021 were selected, according to Hcy, the subjects were divided into simple hypertension group (n = 42) and high Hcy group (n = 44), the level of insu-lin resistance was evaluated by homeostasis model HOMA-IR, Montreal Cognitive Assessment (MoCA) was used to evaluate the cognitive function of the subjects, Pearson correlation analysis was used for correlation analysis. Results: FINS, HOMA-IR in high Hcy group were higher than that in simple hypertension group; 27 patients with cognitive impairment in high Hcy group and 16 pa-tients with cognitive impairment in simple hypertension group, the MoCA score, visual space and executive ability, attention, computational ability, language and delayed recall of type high Hcy group were lower than those of simple hypertension group, the difference was statistically signifi-cant (P < 0.05); Pearson correlation analysis showed that Hcy was positively correlated with FINS and HOMA-IR (r = 0.438, 0.435, P < 0.05), and Hcy was negatively correlated with MoCA score. Con-clusion: The incidence of IR and cognitive impairment in the elderly high Hcy group was signifi-cantly higher than that in patients with simple hypertension. Hcy is one of the risk factors of IR and cognitive impairment in elderly hypertension.