【摘要】 目的 探索血浆动脉粥样硬化指数（AIP）与老年人认知功能的关系。方法 采用横断面研究方法，纳入美国全国健康与营养调查（NHANES）2011至2014年年龄>60岁的人群作为研究对象，根据AIP水平将人群分为>-2.158～≤-0.624 AIP组、>-0.624～≤-0.123 AIP组、>-0.123～≤0.309 AIP组、>0.309 AIP组4组。收集人口学资料（包括性别、年龄、种族、受教育程度、婚姻、身高、体质量）、慢性病相关资料（包括心绞痛、肺气肿、抑郁症评分、慢性支气管炎、冠心病、中风病史、高血压、糖尿病）、生活习惯相关资料（包括吸烟、睡眠时间），以及评估认知功能的相关内容[包括阿尔茨海默病联合注册表（CERAD W-L）评分、动物流畅性测试（AFT）评分和数字符号替换测试（DSST）评分]，比较不同AIP水平各组人群上述资料的差异；采用多因素Logistic回归分析影响人群认知功能的因素。结果 共有1 335名参与者纳入分析，多因素线性回归分析提示，在调整所有协变量后的模型3中，>-0.624～≤-0.123 AIP组、>-0.123～≤0.309 AIP组、>0.309 AIP组与>-2.158～≤-0.624 AIP组比较，AIP不是CERAD W-L评分的危险因素（>-0.624～≤-0.123 AIP组P=0.500,>-0.123～≤0.309 AIP组P=0.110,>0.309 AIP组P=0.200）。调整协变量后的加权多因素Logistic回归分析显示，AIP是CERAD W-L评分下降的相关风险因素[优势比（OR）=0.97,95%可信区间（95%CI）为0.950～1.000,P=0.050]。AIP与CERAD W-L评分的限制性立方样条（RCS）曲线提示，CERAD W-L评分对AIP有显著的总体影响（总体P=0.005），但并没有显著的非线性关系（非线性P=0.278）；亚组分析表明，在65～70岁的人群中，受过大学教育或更高教育、已婚且无高血压的人中AIP是CERAD W-L评分下降发生的相关风险因素（OR<1,P<0.05）。结论 AIP是延迟记忆和即时记忆相关的认知功能下降的危险因素，提示AIP能作为预测或评估认知功能的指标。更多还原

【Abstract】 Objective To explore the relationship between atherosclerotic index of plasma(AIP) and cognitive function in older adults. Methods A cross-sectional study method was used to include the National Health and Nutrition Examination Survey(NHANES) 2011 to 2014 population aged > 60 years as study subjects, and the population was divided into >-2.158 to≤-0.624 AIP group, >-0.624 to≤-0.123 AIP group, >-0.123 to≤0.309 AIP group, > 0.309 AIP group 4 groups. Demographic data(including gender, age, race, education, marriage, height, and body mass), chronic disease-related data(including angina pectoris, emphysema, depression score, chronic bronchitis,coronary heart disease, history of stroke, hypertension, and diabetes mellitus), lifestyle-related data(including smoking and sleep duration), and cognitive function assessment [including the United Registry for consortium to establish a registry for Alzheimer’s disease word list(CERAD W-L) score, animal fluency test(AFT) score and digit symbol substitution test(DSST) score], and to compare the differences in the above information between groups with different levels of AIP; and to analyze the factors affecting the cognitive function of the population by using multifactorial Logistic regression. Results A total of 1 335 participants were included in the analysis, and the results of the multivariate linear regression suggested that in model 3 after adjusting for all covariates, no linear relationship existed between AIP and CERAD W-L score for the >-0.624-≤-0.123 AIP group, the >-0.123-≤-0.309 AIP group, and the >-0.309AIP group, compared with the >-2.158-≤-0.624 AIP group have a linear relationship(P = 0.500 for the >-0.624-≤-0.123 AIP group, P = 0.110 for the >-0.123-≤ 0.309 AIP group, and P = 0.200 for the > 0.309 AIP group).Weighted multifactor Logistic regression analyses after adjusting for covariates showed that AIP was a risk correlate for decline in representing immediate and delayed recall CERAD W-L score [odds ratio(OR) = 0.970, 95% confidence interval(95%CI) of 0.950-1.000, P = 0.050]. Restricted Cubic Splines of AIP versus CERAD W-L score restricted cubic spline(RCS) curves suggested a significant overall effect of CERAD W-L score on AIP(overall P = 0.005),but not a significant nonlinear relationship(nonlinear P = 0.278); and subgroup analyses showed that among 65-70 years old who were college-educated or better, married, and free of hypertension, AIP was the most prevalent among CERAD W-L scores. AIP is an associated risk factor for the development of CERAD W-L decline in people(OR < 1,P < 0.05). Conclusion AIP is a risk factor for cognitive decline associated with delayed and immediate memory,suggesting that AIP can be used as a predictor or assessment of cognitive function.更多还原