Study on the Relationship between Cognitive Dysfunction and Hyperuricemia and Structural Changes of Gray Matter in the Elderly
Objective To analyze the relationship between cognitive dysfunction and hyperuricemia in the elderly,observe the changes in the brain gray matter structure of patients,and explore related brain mechanisms.Methods Prospectively selected 392 elderly patients with cognitive dysfunction who were hospitalized or outpatients in our hospital.According to the classification and diagnostic criteria of cognitive dysfunction and cognitive assessment scale,they were divided into 224 cases of mild cognitive impairment group and 168 cases of dementia group.In addition,182 elderly patients who had a physical examination in this hospital during the same period were selected as the control group.Compare the blood uric acid levels of each group,collect and analyze possible influencing factors.Using voxel-based morphometry to segment the patient's total brain volume,run spm5 in Matlab 6.5 to analyze the correlation between the grading of the Mini Mental State Checklist(MMSE)and the total brain gray matter volume.Results The blood uric acid level of the dementia group[(419.47±32.51)μmol/L]was significantly higher than that of the mild cognitive impairment group[(354.80±27.63)μmol/L]and the control group[(226.48±32.15)μmol/L];the blood uric acid level of the mild cognitive impairment group was significantly higher than that of the control group(all P＜0.01).Multivariate logistic regression analysis showed that age(B=1.821,OR=2.134,95％CI=1.296～4.830,P=0.000),education level(B=1.559,OR=1.607,95％CI=0.971～3.519,P=0.001),and hyperuricemia(B=1.559,OR=1.607,95％CI=0.971～3.519,P=0.001)are independent influencing factors of cognitive dysfunction in the elderly.The risk of cognitive dysfunction in hyperuricemia is 3.641 times higher than that of those with normal uric acid.The brain regions in which the MMSE classification of elderly patients with cognitive impairment is negatively correlated with gray matter volume include:left anterior cingulate gyrus,left medial superior frontal gyrus,bilateral parahippocampal gyrus,bilateral insula,bilateral lingual gyrus,and both sides Cerebellar cortex,left caudate nucleus,right middle temporal gyrus,left posterior cingulate gyrus,left middle occipital gyrus(all P＜0.005);brain areas that are positively correlated include:left middle temporal gyrus,left temporal Lower gyrus,thalamus and lenticular globules on both sides,right dorsolateral superior frontal gyrus,left superior marginal gyrus,right superior occipital gyrus and middle gyrus,and left precuneus(all P＜0.005).Conclusion Hyperuricemia is a risk factor for cognitive dysfunction in the elderly;abnormalities of mood,memory and default network brain gray matter are related to the occurrence and development of cognitive dysfunction in the elderly.
NETL
NSTL
万方数据
维普
