Study On The Relationship Between The Abnormal Lipid Metabolism And Cognitive Impairment

Background and purpose:At present, the population aging has become a serious social problem all over the world, the aging process of rich countries is more than one hundred years, but our country took only 18 years (from 1981 to 1999) to step into an aging society,and is now increasing at a speed of nearly ten million people a year on average, by the middle of this century, the elderly population will develop into one of every three to four, predicts 2020, the proportion of older people will amount to 22%, even up to 31% in 2050, our country will have the most older people of the world. Followed by the pension services, the challenge of old-age security, medical care and so on. The elderly medical and health resources is an important object of consumption. Age-related cognitive impairment is a common neurological degenerative diseases, following cerebrovascular disease. WHO ((World Health Report)) pointed out, the nervous system disease is the leading cause of human health, and dementia are important reasons for endangering health of the elderly.According to the nosology, Alzheimer’s disease (AD) and Vascular dementia (VaD) is one of the most common type of dementia. Generally the cause of the two diseases are different, Alzheimer’s disease is a progressive neural degenerative diseases, metabolic abnormalities and Aβdeposit related to disease, and cerebrovascular disease is the foundation of VaD. In 1996, Petersen put forward mild cognitive impairment (MCI) concept, is considered to be highly stable between normal ageing and dementia,, its characteristics, classification, diagnosis, pathogenesis and outcome is the current hot spot of neuroimaging, elderly epidemiology, molecular biology and drug intervention trial research. In recent years, the study found that high blood pressure, diabetes, hyperlipidemia, is also a risk factor for cognitive impairment, such as hyperlipidemia clinical classification for high cholesterol, high blood triglycerides and mixed hyperlipidemia, low high-density lipoprotein cholesterol, this article through to neurology patients blood lipids, and analysis of the degree of cognitive impairment, to explore various types of hyperlipidemia influence on cognitive impairment process, to focus on drug therapy, prevent the progress of cognitive impairment.Objects and methods:1. Screening for the object of study from the Liaocheng third people’s hospital neurology patients from October 2013 to November 2014 aged 65 and older, gender is not limited, all the patients signed the informed consent, can cooperate to complete determination of neuropsychological scale and other related inspection.Hyperlipidemia diagnosis standard according to China’s regulations on adult dyslipidemia prevention guide (2007 edition) standard:TC≥6.22 mmol/L and TG≤2.26 mmol/L is high cholesterol group; TC≤6.22 mmol/L and TG≥2.26 mmol/L is high blood triglycerides group; TC≥6.22 mmol/L and TG≥2.26 mmol/L, is mixed hyperlipidemia group; HDL—C≤1.55 mmol/L, is low high-density lipoprotein cholesterol group; the patient do not meet the hyperlipidemia diagnosis standard are put into normal blood lipid group.2. The research method:biochemical index determination of all patients were dawn hollow quiet condition, adopt the elbow 2 mL, venous blood serum separation, in our hospital clinical laboratory using automatic biochemical analyzer test total cholesterol, triglycerides, high-density lipoprotein cholesterol.3. Cognitive function assessment all patients to determine relevant neuropsychological scale, done by the professionals, including:simple intelligent status scale check (Chinese Mini-getting the State Examination, CMMSE); The Montreal Cognitive Assessment scale (Montreal Cognitive Assessment, MOCA); Clinical Dementia Scale (Clinical Dementia Rating, CDR) and the decline of the overall Scale (Global Deteriorate Scale, GDS) CDR of rating scales and GDS, we divided into different levels according to the scale of evaluation, based on CDR scale, the score of divided into five grades, respectively as the 1 st level as CDR for CDR= 0.5 level= 0,2,3 for the CDR levels= 1,4 for the CDR= 2,5 for the CDR= 3. According to GDS scale evaluation is divided into three different levels, GDS= 1 or 2 patients respectively as basic cognitive function normal group, GDS= 3,4 or 5 for cognitive impairment group, GDS=6 or 7 to severe cognitive impairment group.4. The statistical analysis of normal distribution of measurement data to x±s, non-normal distribution of measurement data to the median (interquartile range), said all count data expressed as a ratio, use SPSS16.0 statistical software analysis, normal distribution measurement data comparison in group f test and non-normal distribution of measurement data to compare with rank and inspection, count data efficiently using the chi-square test. Take P< 0.05 for the difference was statistically significant.Results1. The patient general condition52 patients with hypercholesterolemia group, aged from 66 to 92, the average (78.1+ 6.3) years old, male 32 cases,20 cases of women; 51 patients with high blood triglycerides group, aged from 67 to 89, the average (77.8+6.1) years old, male 30 cases, women in 21 cases; Mixed hyperlipidemia group 50 cases, aged 65-92, the average (78.3+6.5) years old, male 31 cases,19 cases of women; Low high-density lipoprotein cholesterol group of 51 cases, aged 66～92, the average (77.2±5.3) years old, male 32 cases,19 cases of women; Blood lipids group (control group) 51 cases, aged 66～92, the average (78.1+6.3) years old, male,31 cases,20 cases of women; Five group patients’s basic information is matching, comparable. Compare between five groups:hypercholesterolemia group TC is higher than the control group (P< 0.01), high blood triglycerides group TG is higher than the control group (P< 0.01), mixed hyperlipidemia group TC, TG is higher than the control group (P< 0.01), low density lipoprotein cholesterol group HDL-C is lower than the control group (P< 0.01), the difference is statistically significant.2.1 Hypercholesterolemia CMMSE (P<0.001), MOCA (P=0.003) score is lower. There is statistical significance. CDR scale evaluation comparison between two groups (P= 0.803), GDS scale evaluation (P=0.574), there is no statistically significant difference.2.2 High blood triglycerides group CMMSE (P=0.141), MOCA(P=0.164),there is no statistical significance. CDR scale evaluation comparison between two groups (P= 0.484), GDS scale evaluation (P= 0.635), there was no statistically significant difference.2.3Mixed hyperlipidemia group CMMSE (P< 0.001), MOCA score (P= 0.002)is lower. There is statistical significance. CDR scale evaluation comparison between two groups (P= 0.532), GDS scale evaluation (P= 0.605), there was no statistically significant difference.2.4 Low high-density hyperlipidemia group CMMSE (P< 0.001), MOCA (P< 0.001),the score is lower. There is statistical significance. CDR scale evaluation comparison between two groups (P= 0.794), GDS scale evaluation (P= 0.635), there was no statistically significant difference.Conclusion:The CMMSE,MOCA score of cognitive impairment patients with hypercholesterolemia, mixed hyperlipidemia and low high-density lipoprotein cholesterol is lower than the control group,there is statistical significance, and hypercholesterolemia, mixed hyperlipidemia, low high-density lipoprotein cholesterol are the important risk factors for cognitive impairment.Meaning:Hypercholesterolemia, mixed hyperlipidemia, low HDL cholesterol can lead to different degree of cognitive impairment, and drug intervention should be able to give life to improve the progress of cognitive impairment.