老年2型糖尿病患者的炎症因子水平与认知功能障碍的关系  

The relationship between inflammatory factor and cognitive impairment of the elder with type 2 diabetes mellitus

作　　者：杨帆[1] 杨立[1] 许旌[1] 俞金鑫[1] 张洪[1] 

机构地区：[1]南京大学医学院附属鼓楼医院老年科,210008

出　　处：《卒中与神经疾病》2014年第3期169-173,共5页Stroke and Nervous Diseases

摘　　要：目的探讨老年2型糖尿病患者的C反应蛋白、IL-1β等炎症因子水平与认知功能障碍的关系。方法 60岁以上的住院患者120例,其中2型糖尿病组80例,非糖尿病对照组40例,对所有患者应用简易智能精神检查量表(MMSE)进行评分;测量身高、体重、腰围、臀围,计算体重指数(BMI)及腰臀比(WHR);运用ELISA法检测白细胞介素-1β(IL-1β)水平、免疫扩散法检测C反应蛋白(CRP)水平、高压液相色谱法测定糖化血红蛋白(HbA1c)水平、葡萄糖氧化酶法测定空腹血糖(FBG)水平、放射免疫法测定空腹胰岛素(FINS)水平,并计算胰岛素抵抗指数(HOMA-IR)[HOMA-IR=FBG*FINS/22.5];比较各组间BMI、WHR、HbA1c、HOMA-IR、CRP、IL-1β、肝肾功能、血压、血脂等指标及与MMSE评分之间的关系。结果(1)老年2型糖尿病组与老年非糖尿病组在年龄、性别、文化程度、家庭收入、是否吸烟、血压、血脂及肝肾功能等方面比较无明显差异(P>0.05);(2)与非糖尿病组相比,老年2型糖尿病组的BMI、WHR、HbA1c、HOMA-IR、CRP及IL-1β显著升高(P<0.05),而MMSE评分明显低于非糖尿病组(P<0.01);老年2型糖尿病组MMSE评分与WHR、HbA1c、HOMA-IR、CRP和IL-1β呈负相关。结论腹型肥胖、慢性高血糖、胰岛素抵抗及炎症反应可能是老年2型糖尿病患者认知功能障碍的相关因素。Objective To investigate the relationship between inflammatory factor such as C-reactive protein and interleukin-1β and cognitive impairment of the elderly patients with type 2 diabetes mellitus. Methods Collecting 120 patients whom is older than 60 years old ,which includes 80 type 2 diabetes mellitus patients and 40 patients without diabetes mellitus. All the patients are graded by Mini-Mental State Examination, and their height, weight, waistline and hipline are measured. Counting Body Mass Index（BMI） and Weight Hip Rate（WHR）. Detecting interleukin-1β（IL-1β） by ELISA, C-reactive protein（CRP） by immune diffusion method, HbA1c by high pressure liquid chromatography, fasting blood-glucose（FBG） by glucose oxidase method, fasting serum insulin（FINS） by radioimmunoassay, and counting homeostasis model assessment- insulin resistance（HOMA-IR）. Comparing BMI, WHR, HbA1c , HOMA-IR, CRP, IL-1β, liver and kidney function, blood pressure,blood fat and MMSE among each group. Results （1）There is no difference of the age,sex,degree of education,family income,smoking or no,blood pressure,blood fat and liver- kidney function between the group of the elder with type 2 diabetes and the group of the elder without diabetes（P〉0. 05）; there is no difference of the age,sex,course of disease,degree of education,family income, smoking or no, blood pressure, blood fat and liver- kidney function between deficiency of spleen-kidney syndrome group and obstruction by phlegmblood stasis syndrome group（P〉0. 05）. （2）Compared with the group of the elder without diabetes, the level of BMI,WHR, HbA1c, HOMA-IR,CRP and IL-1β in the group of the elder with type 2 diabetes are increased （P〈0. 05）, and the level of MMSE is decreased, which has significant difference（P〈0. 01）. And the level of MMSE in the group of the elder with type 2 diabetes is negatively correlated with WHR, HbA1c, HOMA-IR,CRP and IL-1β. Conclusions Abdominal obesity, chronic hyperglycemia, insulin resistance and infl

关 键 词：老年2型糖尿病 C反应蛋白 白细胞介素-1Β 认知功能障碍 

分 类 号：R587.1[医药卫生—内分泌] R749.24[医药卫生—内科学]