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系统性红斑狼疮患者认知功能障碍与25-羟维生素D的相关性研究

Correlation between cognitive dysfunction and 25-hydroxyvitamin D in patients with systemiclupus erythematosus

    摘要
  • 摘要:
    目的 探讨系统性红斑狼疮(SLE)患者认知功能障碍(CD)与25-羟维生素D25(OH)D水平的相关性。
    方法 选取283例SLE患者作为研究对象, 依据蒙特利尔认知评估量表(MoCA)评分将其分为认知正常组(MoCA评分≥26分)145例和认知障碍组(MoCA评分 < 26分)138例。比较2组患者在人口统计学资料、心理生理学特征、疾病活动度、激素治疗量及25(OH)D水平方面的差异，采用Spearman相关性分析明确MoCA评分与25(OH)D水平的相关性，并采用多因素Logistic回归分析探讨25(OH)D水平与CD患病风险的关联。
    结果 2组患者年龄、抑郁自评量表(SDS)评分、克虏伯疲劳严重程度量表(FSS)评分、激素使用量、职业状态、文化程度、25(OH)D水平比较，差异有统计学意义(P < 0.05); 2组SLE患者MoCA总分及各维度评分的分布差异均有统计学意义(P < 0.05)。Spearman相关性分析显示, CD患者25(OH)D水平与MoCA中抽象思维能力评分(r=0.134, P=0.024)、延迟回忆评分(r=0.167, P=0.005)及总分(r=0.167, P=0.005)均呈正相关。校正人口统计学资料、心理生理学特征、疾病活动度及激素使用量后，多因素Logistic回归分析结果显示, 25(OH)D水平每升高1 ng/mL, 患者CD患病风险降低3%(OR=0.97, 95%CI: 0.95~0.99, P=0.015)。
    结论 SLE患者CD患病风险与25(OH)D水平相关，维持较高水平的25(OH)D可能具有保护作用，临床应定期监测其动态变化并及时干预。

     

    Abstract:
    Objective To explore the correlation between cognitive dysfunction (CD) and the level of 25-hydroxyvitamin D 25(OH)D in patients with systemic lupus erythematosus (SLE).
    Methods A total of 283 SLE patients were selected as the research subjects. According to the scores of the Montreal Cognitive Assessment Scale (MoCA), they were divided into cognitive-normal group (MoCA score≥26 points, 145 cases) and cognitive-impairment group (MoCA score < 26 points, 138 cases). Differences in demographic data, psychophysiological characteristics, disease activity, hormone treatment dosage, and 25(OH)D levels between the two groups were compared. Spearman correlation analysis was used to determine the correlation between MoCA scores and 25(OH)D levels, and multivariate logistic regression analysis was employed to investigate the association between 25(OH)D levels and the risk of CD.
    Results There were significant differences in age, Self-rating Depression Scale (SDS) scores, Fatigue Severity Scale (FSS) scores, dosage of hormone use, occupational status, educational level, and 25(OH)D levels between the two groups (P < 0.05). The distribution differences in total MoCA scores and scores in each dimension between the two groups of SLE patients were also statistically significant (P < 0.05). Spearman correlation analysis showed that the 25(OH)D levels of CD patients were positively correlated with the abstract thinking ability scores (r=0.134, P=0.024), delayed recall scores (r=0.167, P=0.005), and total scores (r=0.167, P=0.005) in the MoCA. After adjusting for demographic data, psychophysiological characteristics, disease activity, and hormone use, multivariate logistic regression analysis revealed that 25(OH)D level for every 1 ng/mL increase, the risk of CD in patients decreased by 3%(OR=0.97, 95%CI, 0.95 to 0.99, P=0.015).
    Conclusion The risk of CD in SLE patients is correlated with 25(OH)D levels. Maintaining a high level of 25(OH)D may have a protective effect. Clinically, its dynamic changes should be regularly monitored and timely interventions should be provided.

     

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