Clinical Study On Correlation Among Metabolic Syndrome, Its Individual Components And Mild Cognitive Impairment

Objective 1.to approach whether the relationship between the metabolic syndrome (MS) in aged people and mild cognitive impairment(MCI) are or not,and whether the metabolic syndrome is a risk factor of mild cognitive impairment.2.to approach the effect of metabolic syndrome and the individual components of syndrome on cognitive function。It will provide theoretical support for treatment the early stage of dementia.Method 124 clinical metabolic syndrome patients were made into a group for research,and 71 clinical non-metabolic syndrome subjects were made into another group for control,who matched in age,sex and education.In accord with MS diagnostic and excluding standards of IDF(2005).All the subjects were evaluated with cognitive function,which included Mini-Mental State Examination,Montreal Cognitive Assessment,Clinical Memory Scale,Center of epidemiological survey depression scale,Global Deterioration Scale and Activity of Daily Living,and they were selected into the MCI and cognitive function normal group,according to the MCI diagnostic and excluding standards of petersen.The authors finished patient's blood pressure,body height,waist circumference,body weight,then blood routine, liver and kidney function,fasting plasma glucose,fasting insulin,glycated hemoglobin and blood fat were tested,and urite color ultrasonic diagram, electrocardiogram and Cranial Computed tomography were carried out.Group t test was made to all data,as well as Wilcoxon signed rank test,x~2 test,one-way ANOVA, multivariate regression and logistic regressive analysis,so as to define relationship between the indices of the observation and MCI.Results 1.MCI was more frequently detected in subjects with MS than in subjects without MS(33.1%vs 14.1%,p＜0.01).the prevalence of MCI was significant different in the five group, based on the number of individual components(p＜0.05).With the number of individual components of metabolic syndrome's adding,the prevalence of MCI was increase,then comparison in ampho-group,the prevalence of MCI was different between group one and group four,the same as group one and five(p＜0.005),but other groups were not significant different(p＞0.005).2.scores of MMSE,MoCA general CMS and several parts of CMS were obviously lower in subjects with MS than in subjects without MS(P＜0.05).3.compared with normal cognitive function subjects, patients with MCI had a significantly larger mean waist circumference,higher mean systolic blood pressure,higher plasma concentrations of triglyceride,fasting glucose, fasting insulin and glycated hemoglobin(P＜0.05),but they had a lower mean insulin sensitivity index(P＜0.01),except diastolic blood pressure and high density lipoprotein cholesterol(P＞0.05).4.In correlation analysis among metabolic syndrome,its individual components and each cognitiye scores,metabolic syndrome was negatively associated with scores in MMSE,MoCA general CMS and several parts of CMS(p＜0.05),except image free memory(p＞0.05),fasting insulin was negatively associated with scores in MMSE,MoCA general CMS and several parts of CMS which were association study,image free memory,meaningless graph recognition and human figure feature associated memory(p＜0.05),blood pressure was negatively associated with scores in MMSE,MoCA(p＜0.05),whereas waist circumference,fasting plasma glucose,triglyceride and high density lipoprotein cholesterol were not associated with cognitive function(p＞0.05).When except diabetes mellitus,linear regression was also done in correlation analysis,it was still existence that the negative correlation between cognitive scores and metabolic syndrome(p＜0.05),but the relationship between fasting insulin and cognitive scores had become absent(p＞0.05).Blood pressure remained negative correlation with scores in MMSE,MoCA(p＜0.05).Waist circumference,fasting plasma glucose,triglyceride and high density lipoprotein cholesterol were not associated with cognitive function yet(p＞0.05).5.In logistic regressive analysis,the last to enter the equation were the degree of education,insulin resistance and metabolic syndrome.Among these,high degree of education was the protective factor of MCI(OR=0.631,95%CI:0.412～0.967),while insulin resistance(OR=3.631,95%CI:1.727～7.573) and metabolic syndrome(OR=2.350,95%CI:1.052～5.251) were the independent dangerous factors of MCI.6.Sensitivity and specificity of MMSE and MoCA for the detection of MCI were different.The MMSE was specific to MCI,whatever using a cut -off scores 26 or 24.there were 90.8%and 96.6%,respectively,whereas they were poor sensitivity to detection of MCI,33.4%and 20.5%respectively.Using a cut-off scores 26 or below,the MoCA had a sensitivity of 96.1%to detect MCI,while specificity was only 31.4%.When Using a cut-off scores 24 or below,the MoCA maintained a excellent sensitivity of 94.1%,and specificity of 90.6%.Conclusions 1. Metabolic syndrome can affect cognitive impairment,and with the individual components of metabolic syndrome's adding,the lesion on cognitive function is increase.2.Lesion of metabolic syndrome upon cognitive function is not only mainly reflected in memory,but imposes impact on various aspects of the cognitive function.3.Metabolic syndrome,as a whole,has a greater effect on cognitive function than its individual components,and the association is still existence after exclusion diabetes mellitus.Diabetes mellitus affects cognitive function probably via hyperinsulinemia.4.High degree of education is the protective factor of MCI,while metabolic syndrome and insulin resistance are the independent dangerous factors of MCI.5.The Montreal cognitive assessment can be as a brief screening tool of MCI, providing reference for physician to detect MCI quickly.Therefore,active interference into metabolic syndrome and insulin resistance,and improvement of sensitivity of insulin will benefit cognitive function of metabolic syndrome patients.