中国8个长寿地区65岁及以上老年人血锰内暴露水平与认知功能受损的关联性研究

王振旭; 李丹丹; 周锦辉; 顾珩; 吕跃斌; 赵峰

doi:10.13421/j.cnki.hjwsxzz.2021.02.006

中国8个长寿地区65岁及以上老年人血锰内暴露水平与认知功能受损的关联性研究

Association between Blood Manganese Exposure and Cognitive Impairment in the Elderly Aged 65 Years Older in Eight Longevity Areas of China

摘要

摘要:
目的探讨中国长寿地区≥65岁老年人血锰内暴露水平与认知功能受损发生风险的关系。
方法选取2017年中国老年人口健康影响因素跟踪调查中8个长寿地区的2 423名老年人，通过问卷调查获得调查对象的人口学变量、行为生活方式及健康状况，同时使用简易精神状态量表（MMSE）评定调查对象的认知功能，收集空腹静脉血，以电感耦合等离子体质谱法（ICP-MS）检测血锰水平。根据老年人的血锰暴露水平四分位数将其分为4组，分别是Q₁组（< 8.69 μg/L）、Q₂组8.69~10.71）μg/L、Q₃组10.71~13.39）μg/L和Q₄组（≥ 13.39 μg/L）。采用多因素Logistic回归模型分析总样本人群和不同年龄组老年人血锰内暴露水平与认知功能受损的风险。
结果共673例老年人发生认知功能受损，患病率为27.78%，Q₁、Q_2、Q₃和Q₄组的认知功能受损的患病率分别是21.9%（132/603）、27.2%（165/607）、31.8%（193/607）和30.2%（183/606），差异有统计学意义（P < 0.05）。多因素Logistic回归模型分析结果显示，在总样本人群和≥100岁年龄组的老年人中，相对于Q₁组，Q₃组老年人认知功能受损风险均增加，OR（95%CI）值分别为1.46（1.04~2.05）和2.41（1.06~5.48）；（65~79）岁年龄组的老年人中，相对于Q₁组，Q₃组和Q₄组老年人认知功能受损风险均增加，OR（95%CI）值分别为3.61（1.22~10.69）和3.10（1.06~9.05）。
结论中国8个长寿地区的（65~79）岁和100岁及以上老年人对高血锰更为易感，可能增加认知功能受损的风险。

Abstract:
Objective To investigate the relationship between the level of blood manganese exposure and the risk of cognitive impairment in the elderly aged 65 years and older in longevity areas in China.
Methods A total of 2 423 elderly people from eight longevity areas were selected from 2017 follow-up survey on health influencing factors of the elderly population in China. A questionnaire survey was conducted to investigate their demographic variables, behavior and lifestyle, and health status. At the same time, mini-mental state examination (MMSE) was used to assess the cognitive function of the respondents. The fasting venous blood was collected, and inductively coupled plasma mass spectrometry was used to determine the blood manganese level. According to the quartiles of blood manganese exposure, the elderly were divided into four groups: Q₁ group (< 8.69 μg/L), Q₂ group (8.69-10.71 μg/L), Q₃ group (10.71-13.39 μg/L), and Q₄ group (≥ 13.39 μg/L). A multivariate logistic regression model was employed to analyze the level of blood manganese exposure and the risk of cognitive impairment in all respondents and elderly people of different ages.
Results A total of 673 (27.78%) elderly people had cognitive impairment. The prevalence rates of cognitive impairment in the Q₁, Q₂, Q₃ and Q₄ groups were 21.9% (132/603), 27.2% (165/607), 31.8% (193/607), and 30.2% (183/606), respectively, with a significant difference among the groups (P < 0.05). The multivariate logistic regression model analysis showed that in all respondents and the elderly aged 100 years and older, the risk of cognitive impairment in Q₃ group was increased compared with the Q₁ group (OR=1.46 and 2.41, 95%CI: 1.04-2.05 and 1.06-5.48); in the elderly aged 65 to 79 years, the risk of cognitive impairment in Q₃ and Q₄ groups was increased compared with the Q₁ group (OR=3.61 and 3.10, 95%CI: 1.22-10.69 and 1.06-9.05).
Conclusion The elderly aged 65 to 79 years and 100 years and older are more vulnerable to high level of blood manganese in the eight longevity areas, which may increase the risk of cognitive impairment.

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