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| Relationship between serum 25-hydroxyvitamin D, homocysteine, uric acid and mild cognitive impairment in elderly patients with hypertension |
| FENG Meiting1, LIU Jiahao2, WANG Xiaoli1 |
| 1. Department of Geriatrics; 2. Department of Respiratory Medicine, the First Affiliated Hospital of Jinzhou Medical University, Jinzhou Liaoning 121000, China |
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Abstract Objective： To explore the relationship between the levels of serum 25-hydroxyvitamin D ［25(OH)D］, homocysteine (Hcy), uric acid and the occurrence of mild cognitive impairment (MCI) in elderly patients with hypertension and their predictive value for MCI. Methods： A total of 206 elderly patients with hypertension in the Department of Geriatrics, the First Affiliated Hospital of Jinzhou Medical University from January 2020 to December 2021 were selected to evaluate their cognitive function with the Montreal Cognitive Assessment scale (MoCA), including 138 patients without MCI (non-MCI group) and 68 patients with MCI (MCI group). Spearman correlation analysis was used to analyze the correlation between general data and other indexes and MoCA scores. Multivariate Logistic regression analysis was used to analyze the factors affecting cognitive function. Receiver operating characteristic (ROC) curve was used to evaluate the predictive value of 25(OH)D, Hcy, uric acid and the three integrated prediction models for MCI. Results： Compared with non-MCI group, the score of MoCA in MCI group was lower, the levels of serum 25(OH)D and uric acid significantly decreased, and the level of Hcy significantly increased (P<0.05). The results of Spearman correlation analysis showed that the scores of serum 25(OH)D and uric acid were positively correlated with the score of MoCA (rs=0.492, rs=0.407, P<0.001), and the score of serum Hcy was negatively correlated with the score of MoCA (rs=-0.513, P<0.05). Multivariate Logistic regression analysis showed that the course of hypertension (OR=1.063, 95%CI: 1.005-1.125, P=0.034), Hcy (OR=1.313, 95%CI: 1.166-1.477, P<0.001) were independent risk factors for senile hypertension with MCI. 25(OH)D (OR=0.832, 95%CI: 0.765-0.905, P<0.001) and uric acid (OR=0.993, 95%CI: 0.988-0.998, P=0.011) was a protective factor. The area under the ROC curve of serum 25(OH)D, Hcy, uric acid and the three integrated predictive models for diagnosis of MCI were 0.834, 0.870, 0.683 and 0.921 respectively, and the best cut-off values of the three were 15.60 ng/mL, 15.48 μmol/L and 288.30 μmol/L, respectively. Conclusion： The serum 25(OH)D, Hcy, uric acid levels and the three integrated predictive models can be regarded as predictors of MCI in elderly patients with hypertension, and the three integrated predictive models have more advantages than single variables in predicting the occurrence of MCI in elderly patients with hypertension.
［Key words］25-hydroxyvitamin D; homocysteine; uric acid; hypertension; mild cognitive impairment; elder
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. [J]. Journal of Jiangsu University(Medicine Edition), 2023, 33(02): 174-179,184. |
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