甘油三酯-葡萄糖指数与帕金森病患者认知障碍相关性研究
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国家重点研发计划( 2021YFC2501200)


Correlation of triglyceride-glucose index with cognitive impairment in patients with Parkinsondisease
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    摘要:

    目的 探讨甘油三酯-葡萄糖(TyG)指数与帕金森病(PD)患者认知障碍的相关性。 方法 选择2019 年8 月—2022 年12 月于首都医科大学宣武医院神经内科帕金森组住院治疗的268 例 PD患者临床资料进行回顾性分析。应用蒙特利尔认知评估量表(MoCA)对受试者认知功能进行评估, MoCA < 26 分(文盲加1 分)为认知障碍组(169 例),MoCA≥ 26 分为非认知障碍组(99 例)。收集受试者 一般资料及甘油三酯(TG)、糖化血红蛋白(HBA1c)、空腹血糖(FPG)等化验指标,计算TyG 指数。PD 患 者的运动症状应用运动障碍协会统一帕金森病评定量表第三部分(UPDRS Ⅲ)进行评价,其严重程度采 用修订版 Hoehn-Yahr分期进行评价;生活质量采用39 项帕金森患者生活质量问卷(PDQ-39)评价。采 用多因素 Logistic 回归分析影响PD 认知障碍的相关危险因素,构建认知功能障碍Logistic 回归预测模 型,并绘制受试者工作特征(ROC)曲线,计算最佳模型最佳截断值及相应的敏感度和特异度。结果 单因 素分析结果显示,两组年龄、学历、UPDRS Ⅲ评分、PDQ-39 评分、HBA1c、TyG 指数、尿频占比、糖尿 病占比比较,差异均有统计学意义(均P < 0.05)。多因素Logistic 回归分析结果显示,年龄(OR=1.06, 95%CI=1.02~1.09)、TyG 指数(OR=5.67,95%CI=2.80~11.46)、糖尿病(OR=2.99,95%CI=1.07~8.36)是 PD 患者存在认知障碍的独立影响因素。ROC 曲线结果显示,由年龄、TyG 指数、糖尿病3 个指标构建 模型预测值最佳截断值为0.635,对应的敏感度为0.692,特异度为0.768,ROC 曲线下面积为0.777。 结论 年龄、TyG 指数、糖尿病是PD 认知障碍的独立影响因素,由年龄、TyG 指数和糖尿病构成的预测 模型对PD患者认知功能障碍具有较好的预测价值。

    Abstract:

    Objective To explore the correlation between triglyceride-glucose( TyG) index and cognitive impairment in patients with Parkinson's disease( PD). Methods The clinical data of 268 PD patients in the Parkinson's Group of the Department of Neurology, Xuanwu Hospital of Capital Medical University from August 2019 to December 2022 were selected for retrospective analysis. Montreal Cognitive Assessment( MoCA) was applied to assess the subjects' cognitive function. Patients with MoCA < 26( plus 1 point for illiteracy) were categorized into cognitive impairment group( 169 cases), and those with MoCA ≥ 26 were categorized into non-cognitive impairment group( 99 cases). General information and laboratory parameters such as triglycerides( TG), glycosylated hemoglobin( HBA1c), and fasting plasma glucose( FPG) were collected from the subjects and the TyG index was calculated. The motor symptoms of PD patients were evaluated by the Unified Parkinson's Disease Rating Scale Part Ⅲ( UPDRS Ⅲ) of the Movement Disorders Society, and their severity was evaluated by using the modified Hoehn-Yahr stage. Quality of life of PD patients was evaluated using the 39-item Parkinson's Disease Questionnaire( PDQ-39). Multifactorial Logistic regression was used to analyze the risk factors of cognitive impairment in PD and to construct a Logistic regression prediction model for cognitive impairment. Area under the receiver operating characteristic( ROC) curve was plotted and the optimal model best cut-off values and sensitivities and specificities were calculated. Results Univariate analysis showed that the differences in age, education, UPDRS Ⅲ score, PDQ-39 score, HBA1c, TyG index, urinary frequency, and diabetes mellitus were statistically significant between the two groups( all P<0.05). Multifactorial Logistic regression analysis showed that age[ OR=1.06, 95%CI( 1.02, 1.09)], TyG index[ OR=5.67, 95%CI( 2.80, 11.46)], and diabetes mellitus[ OR=2.99, 95%CI( 1.07, 8.36)] were independent influencing factors of cognitive impairment in patients with PD. The results of the ROC curve showed that the best cutoff value of the prediction model constructed from the three indicators of age, TyG index, and diabetes mellitus was 0.635, with a sensitivity of 0.692, a specificity of 0.768, and an area under the ROC curve of 0.777. Conclusions Age, TyG index, and diabetes mellitus are independent influencing factors of cognitive impairment in PD. A prediction model consisting of age, TyG index and diabetes mellitus has a good predictive performance for cognitive impairment in patients with PD.

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王欣蕾,许保磊,梅珊珊,孙虹,徐希彤,毛薇,许二赫.甘油三酯-葡萄糖指数与帕金森病患者认知障碍相关性研究[J].神经疾病与精神卫生,2025,25(7):480-486
DOI :10.3969/j. issn.1009-6574.2025.07.004.

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  • 在线发布日期: 2025-07-22