摘要
目的 探讨血清β-淀粉样蛋白1-42(Aβ1-42)、胰高血糖素样肽-1(GLP-1)与2型糖尿病患者认知功能障碍的相关性,并分析2型糖尿病患者认知功能障碍发生的危险因素.方法 回顾性选取2020年6月至2023年6月青岛市胶州中心医院收治的80例2型糖尿病认知功能障碍患者作为研究对象,将其作为认知功能障碍组,另选取同期来本院体检的80例单纯2型糖尿病无认知功能障碍患者作为非认知功能障碍组.比较两组患者一般临床情况,并比较其Aβ1-42、GLP-1表达水平.采用Logistic回归分析分析2型糖尿病患者认知功能障碍发生的危险因素.采用简易智能精神状态检查量表(MMSE)评分将80例2型糖尿病认知功能障碍患者分为3个亚组,MMSE＜10分为重度组(n=21),MMSE 10～20分为中度组(n=25),MMSE＞20分为轻度组(n=34).比较3组患者血清Aβ1-42、GLP-1表达水平.采用Spearman相关分析方法分析Aβ1-42、GLP-1与2型糖尿病认知功能障碍严重程度的相关性.结果认知功能障碍组患者年龄、糖尿病病程、合并高血脂患者比率、空腹血糖、糖化血红蛋白、餐后2 h血糖水平分别为(59.30±3.57)岁、(8.64±1.91)年、31.25％、(9.18±2.75)mmol/L、(11.91±0.72)％、(14.27±3.73)mmol/L,均高于非认知功能障碍组[(50.21±3.42)岁、(5.72±1.87)年、15.00％、(7.87±1.58)mmol/L、(8.73±0.57)％、(10.83± 2.84)mmol/L],教育程度为(6.74±1.53)年,低于非认知功能障碍组[(8.35±2.63)年],差异均有统计学意义(P＜0.05).认知功能障碍组患者Aβ1-42水平为(566.28±113.19)pg/mL,高于非认知功能障碍组[(353.59±65.78)pg/mL],GLP-1水平为(19.85±4.25)pmol/L,低于非认知功能障碍组[(23.24±3.34)pmol/L],差异均有统计学意义(P＜0.05).Logistic回归分析结果表明:糖尿病病程、合并高血脂、糖化血红蛋白、Aβ1-42、GLP-1为2型糖尿病患者认知功能障碍发生的独立危险因素(P＜0.05).不同严重程度认知功能障碍患者Aβ1-42、GLP-1水平比较差异显著,重度组Aβ1-42水平高于轻度组和中度组,GLP-1水平低于轻度组和中度组,差异均有统计学意义(P＜0.05).Spearman相关分析结果显示:Aβ1-42与认知功能障碍严重程度呈正相关(r=0.586,P＜0.05),而GLP-1与知功能障碍严重程度呈负相关(r=-0.579,P＜0.05).结论 糖尿病病程、合并高血脂、糖化血红蛋白、Aβ1-42、GLP-1水平可作为2型糖尿病患者认知功能障碍发生的中亚危险因素,且β1-42、GLP-1与认知功能障碍严重程度具有明显相关性.
Abstract
Objective To explore the correlation between serum β-amyloid 1-42(Aβ1-42),glucagon-like peptide-1(GLP-1)and cognitive dysfunction in patients with type 2 diabetes,and to analyze the risk factors of cognitive dysfunction in patients with type 2 diabetes.Methods Eighty patients with cognitive impairment of type 2 diabetes in Qingdao Jiaozhou Central Hospital from June 2020 to June 2023 were ret-rospectively selected as the research object,and they were divided into cognitive impairment group,and another 80 patients with simple type 2 dia-betes without cognitive impairment who came to our hospital for physical examination in the same period were selected and divided into non cogni-tive impairment group.The general clinical conditions,the levels of Aβ1-42,GLP-1 of the two groups were compared.The risk factors of cog-nitive dysfunction in patients with type 2 diabetes was analyzed using Logistic regression analysis.Then 80 patients with cognitive impairment in pa-tients with type 2 diabetes were assessed with the simplified intelligent mental state examination scale(MMSE)and divided into three subgroups,21 patients with MMSE＜10 were divided into severe group,25 patients with MMSE 10～20 were divided into moderate group,and 34 patients with MMSE＞20 were divided into mild group.The levels of serum Aβ1-42,GLP-1 in the three groups were compared.The correlation be-tween Aβ1-42,GLP-1 and the severity of cognitive dysfunction in type 2 diabetes was analyzed using Spearman correlation analysis method.Results Age,duration of diabetes,ratio of patients with hyperlipidemia,fasting blood glucose,glycosylated hemoglobin,and postprandial blood glucose levels in the cognitive impairment group were(59.30±3.57)years,(8.64±1.91)years,31.25％,(9.18±2.75)mmol/L,(11.91 ±0.72)％,and(14.27±3.73)mmol/L,respectively,which were higher than those in the non cognitive impairment group[(50.21±3.42)years old,(5.72±1.87)years old,15.00％,(7.87±1.58)mmol/L,(8.73±0.57)％,(10.83±2.84)mmol/L],the education level was(6.74±1.53)years,which was lower than that in the non cognitive impairment group[(8.35±2.63)years],and the differences were statisti-cally significant(P＜0.05).The level of Aβ1-42 in the cognitive impairment group was(566.28±113.19)pg/mL,which was higher than that in the non cognitive impairment group[(353.59±65.78)pg/mL],and the level of GLP-1was(19.85±4.25)pmol/L,which was lower than that in the non cognitive impairment group[(23.24±3.34)pmol/L],the differences were statistically significant(P＜0.05).The results of Logistic regression analysis showed that diabetes duration,hyperlipidemia,hemoglobin A1c,Aβ1-42,and GLP-1 were independent risk fac-tors for the occurrence of cognitive dysfunction in type 2 diabetic patients(P＜0.05).Aβ1-42 and GLP-1 levels in patients with different se-verity,Aβ1-42 was higher in severe than mild and moderate groups,and GLP-1 was lower than mild and moderate groups(P＜0.05).Spearman correlation analysis showed that Aβ1-42 was positively associated with the severity of cognitive dysfunction(r=0.586,P＜0.05),while GLP-1 was negatively correlated with the severity of known dysfunction(r=-0.579,P＜0.05).Conclusion The course of diabetes,combined with hyperlipidemia,hemoglobin A1c,Aβ1-42 and GLP-1 levels can be used as subrisk factors for the occurrence of cognitive dys-function in type 2 diabetic patients,and β 1-42 and GLP-1 have obvious correlation with the severity of cognitive dysfunction.
维普
万方数据