Abstract：
BACKGROUND: Essential trace elements (ETEs) are essential nutrients for keeping the nervous system functioning. Associations between ETEs and cognitive function are still inconclusive and limited.
OBJECTIVE: We aimed to investigate the individual and joint associations between ETEs and cognitive function among older adults.
METHODS: A population (N = 2181) at an average age≥ 65 from Yiwu cohort in China was available for this study. Whole blood chromium (Cr), selenium (Se), manganese (Mn), and copper (Cu) concentrations were measured by inductively coupled plasma mass spectrometry (ICP-MS). Cognitive function was assessed using the Mini-Mental State Examination (MMSE), consisting of five specific cognitive domains: orientation, registry, attention and calculation, recall, and language and praxis. Linear regression, restricted cubic spline (RCS) analysis, and Bayesian kernel machine regression (BKMR) were used to analyze the individual and joint associations between ETEs and cognitive function.
RESULTS: The association between Cr and MMSE score presented an inverted-U shape (Q3 versus Q1: β = 0.774, 95 % CI: 0.297, 1.250; Q4 versus Q1: β = 0.481, 95 % CI: 0.006, 0.956); and Cr was especially associated with the registry, recall, and language and praxis. Per IQR (36.32 μg/L) increase of Se was positively associated with the MMSE score (β = 0.497, 95 % CI: 0.277, 0.717) and all five cognitive domains. The BKMR showed that the dose-response association between Se and cognitive function increased initially and then decreased with increasing Se concentration when fixed the other ETEs in median. ETEs mixture was positively associated with cognitive function, and Se (posterior inclusion probabilities, PIPs = 0.915) was the most important contributor within the ETEs mixture.
CONCLUSIONS: The nonlinear association between Cr and cognitive function suggested further exploration of an appropriate concentration range for ETEs. A positive association between mixed ETEs and cognitive function is a reminder that their joint association should be considered. Further prospective studies or intervention studies are warranted to validate our findings in the future.
OBJECTIVE: We aimed to investigate the individual and joint associations between ETEs and cognitive function among older adults.
METHODS: A population (N = 2181) at an average age≥ 65 from Yiwu cohort in China was available for this study. Whole blood chromium (Cr), selenium (Se), manganese (Mn), and copper (Cu) concentrations were measured by inductively coupled plasma mass spectrometry (ICP-MS). Cognitive function was assessed using the Mini-Mental State Examination (MMSE), consisting of five specific cognitive domains: orientation, registry, attention and calculation, recall, and language and praxis. Linear regression, restricted cubic spline (RCS) analysis, and Bayesian kernel machine regression (BKMR) were used to analyze the individual and joint associations between ETEs and cognitive function.
RESULTS: The association between Cr and MMSE score presented an inverted-U shape (Q3 versus Q1: β = 0.774, 95 % CI: 0.297, 1.250; Q4 versus Q1: β = 0.481, 95 % CI: 0.006, 0.956); and Cr was especially associated with the registry, recall, and language and praxis. Per IQR (36.32 μg/L) increase of Se was positively associated with the MMSE score (β = 0.497, 95 % CI: 0.277, 0.717) and all five cognitive domains. The BKMR showed that the dose-response association between Se and cognitive function increased initially and then decreased with increasing Se concentration when fixed the other ETEs in median. ETEs mixture was positively associated with cognitive function, and Se (posterior inclusion probabilities, PIPs = 0.915) was the most important contributor within the ETEs mixture.
CONCLUSIONS: The nonlinear association between Cr and cognitive function suggested further exploration of an appropriate concentration range for ETEs. A positive association between mixed ETEs and cognitive function is a reminder that their joint association should be considered. Further prospective studies or intervention studies are warranted to validate our findings in the future.
摘要：
背景：必需微量元素（ETEs）是维持神经系统功能的必需营养素。ETEs与认知功能之间的关联仍然不确定且有限。
目的：我们的目的是调查老年人的ETEs与认知功能之间的个体和联合关联。
方法：本研究有来自中国义乌队列的平均年龄≥65岁的人群（N=2181）。全血铬(Cr),硒(Se),锰(Mn),通过电感耦合等离子体质谱法(ICP-MS)测量和铜(Cu)浓度。使用迷你精神状态检查(MMSE)评估认知功能，由五个特定的认知领域组成：取向，注册表，注意和计算，召回，语言和实践。线性回归，约束三次样条(RCS)分析,采用贝叶斯核机回归(BKMR)分析ETEs与认知功能的个体和联合关联。
结果：Cr与MMSE评分之间的关联呈倒U形（Q3与Q1：β=0.774，95％CI：0.297，1.250；Q4与Q1：β=0.481，95％CI：0.006，0.956）；并且Cr与注册表尤其相关，召回，语言和实践。硒的每IQR（36.32μg/L）增加与MMSE评分（β=0.497，95％CI：0.277，0.717）和所有五个认知域呈正相关。BKMR显示，当将其他ETEs固定在中位数时，Se与认知功能之间的剂量反应相关性最初增加，然后随着Se浓度的增加而降低。ETEs混合物与认知功能呈正相关，和Se(后验包含概率，PIPs=0.915)是ETE混合物中最重要的贡献者。
结论：Cr与认知功能之间的非线性关联提示进一步探索ETE的适当浓度范围。混合ETE与认知功能之间的正相关提醒人们，应考虑它们的联合关联。未来需要进一步的前瞻性研究或干预研究来验证我们的发现。
目的：我们的目的是调查老年人的ETEs与认知功能之间的个体和联合关联。
方法：本研究有来自中国义乌队列的平均年龄≥65岁的人群（N=2181）。全血铬(Cr),硒(Se),锰(Mn),通过电感耦合等离子体质谱法(ICP-MS)测量和铜(Cu)浓度。使用迷你精神状态检查(MMSE)评估认知功能，由五个特定的认知领域组成：取向，注册表，注意和计算，召回，语言和实践。线性回归，约束三次样条(RCS)分析,采用贝叶斯核机回归(BKMR)分析ETEs与认知功能的个体和联合关联。
结果：Cr与MMSE评分之间的关联呈倒U形（Q3与Q1：β=0.774，95％CI：0.297，1.250；Q4与Q1：β=0.481，95％CI：0.006，0.956）；并且Cr与注册表尤其相关，召回，语言和实践。硒的每IQR（36.32μg/L）增加与MMSE评分（β=0.497，95％CI：0.277，0.717）和所有五个认知域呈正相关。BKMR显示，当将其他ETEs固定在中位数时，Se与认知功能之间的剂量反应相关性最初增加，然后随着Se浓度的增加而降低。ETEs混合物与认知功能呈正相关，和Se(后验包含概率，PIPs=0.915)是ETE混合物中最重要的贡献者。
结论：Cr与认知功能之间的非线性关联提示进一步探索ETE的适当浓度范围。混合ETE与认知功能之间的正相关提醒人们，应考虑它们的联合关联。未来需要进一步的前瞻性研究或干预研究来验证我们的发现。
