血硒与老年人认知功能受损的关系：基于美国国家健康与营养调查数据库的分析-现代医学

血硒与老年人认知功能受损的关系：基于美国国家健康与营养调查数据库的分析

单位：1. 南京医科大学公共卫生学院, 江苏南京 211166;
2. 苏州大学医学部公共卫生学院, 江苏苏州 215006;
3. 苏州市疾病预防控制中心, 江苏苏州 215131

分类号：R161.7;R151

出版年·卷·期（页码）：2025·53·第八期（1248-1253）

摘要：

目的：通过美国国家健康与营养调查(NHANES)数据库，研究60岁以上老年人血硒浓度与认知功能受损之间的关系。方法: 横断面研究使用数据来自2011—2014年NHANES中的1 829名老年人。认知功能通过数字符号替代测试(DSST)进行评估；采用电感耦合等离子体质谱法测定血中的硒(Se)的浓度；Logistic回归和限制性立方样条模型分析血硒与认知功能受损之间的关联。结果：控制各混杂因素影响后，与血硒浓度的最低四分位数相比，其他三个四分位数的OR值(95% CI)分别为0.53(0.31,0.9)、0.49(0.31,0.77)和0.53(0.35,0.78)(P-trend＜0.05)。限制性立方样条分析结果显示，血硒浓度与认知障碍之间存在非线性的负相关关系；分层分析结果显示，除年龄、吸烟状态和高血压外，血硒浓度与认知障碍之间的关联在各层之间均一致。结论：在美国老年人中，较低的血硒水平与老年人认知功能受损增加有关，提示增加硒摄入对于预防和控制认知功能受损可能具有重要意义。

Objective: To investigate the relationship between blood selenium concentration and cognitive impairment in elderly individuals aged ≥60 years old using the National Health and Nutrition Examination Survey(NHANES) database in the United States. Methods: This cross-sectional study used the data from a nationally representative sample of 1 829 older adults from the 2011—2014 National Health and Nutrition Examination Survey(NHANES). Cognitive function was measured by the Digit Symbol Substitution Test(DSST). Selenium(Se) in whole blood was determined using inductively coupled plasma mass spectrometry. Logistic regression model and restricted cubic spline model were used to analyse the association between blood selenium and impaired cognitive function. Results: After controlling for the influence of various confounding factors, the OR(95% CI) for the other three quartiles compared to the lowest quartile of selenium was 0.53(0.31, 0.90), 0.49(0.31, 0.77), and 0.53(0.35, 0.78)(P for trend＜0.05). Results from restricted cubic spline analysis indicated a non-linear inverse association between blood selenium concentrations and cognitive impairment in older adults, which were consistent with the results of hierarchical analysis. Hierarchical analysis showed that the association between blood selenium concentration and cognitive impairment was consistent across all layers, except for age, smoking status, and hypertension. Conclusion: It is concluded that lower blood selenium is associated with cognitive impairment among the elderly adults, which underscores the necessity of increasing the intake of selenium for the prevention and control of cognitive impairment.

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