血清β-淀粉样蛋白及可溶性糖基化终末产物受体与新诊断2型糖尿病患者认知功能损害的关系  

Relationship Between Cognitive Impairment of Patients With Newly Diagnosed T2DM and Aβ1-42 and sRAGE

作　　者：周莉 房辉[2] 徐刚[3] 张翠林 李玉凯[4] 关如花 杨莹[4] 张雅中[2] 田金莉[2] 许静[2] 甄艳凤[2] 

机构地区：[1]华北理工大学,河北省唐山市063000 [2]唐山工人医院内分泌二科 [3]唐山工人医院烧伤整形科 [4]河北医科大学

出　　处：《中国全科医学》2016年第2期150-153,共4页Chinese General Practice

摘　　要：目的通过观察2型糖尿病患者血清β-淀粉样蛋白(Aβ)1-42、可溶性糖基化终末产物受体(sRAGE)水平变化,探讨2型糖尿病患者认知功能损害的可能机制。方法选取2014年3—12月于唐山工人医院内分泌二科诊断为2型糖尿病的患者66例为病例组,另同期选取本院体检中心体检健康者50例为对照组。采用自制调查表收集受试者临床资料,采用可重复的成套神经心理状态测量(RBANS)量表评价受试者认知功能,该量表包括即刻记忆、视觉广度、言语功能、注意力、延迟记忆5个分测验,根据受试者不同年龄查表转化为量表分,再统一转化为标准分。抽取受试者空腹肘静脉血5 ml,采用酶联免疫吸附(ELISA)法测定血清Aβ1-42及sRAGE水平。结果病例组RBANS量表即刻记忆、视觉广度、言语功能、注意力、延迟记忆评分及标准分均低于对照组,差异有统计学意义(P<0.05)。病例组Aβ1-42水平高于对照组,sRAGE水平低于对照组,差异均有统计学意义(P<0.05)。病例组患者年龄与RBANS量表各分测验评分及标准分均呈负相关(P<0.05);受教育年限与即刻记忆、视觉广度、注意力、延迟记忆评分及标准分呈正相关,与言语功能评分呈负相关(P<0.05);Aβ1-42水平与RBANS量表各分测验评分及标准分均呈负相关(P<0.05);sRAGE水平与即刻记忆、言语功能、注意力、延迟记忆评分及标准分呈正相关(P<0.05),与视觉广度评分无直线相关性(P>0.05)。调整年龄、受教育年限后,病例组患者Aβ1-42水平与即刻记忆、注意力、延迟记忆评分及标准分呈负相关(r=-0.464、-0.418、-0.384、-0.696,P<0.05);sRAGE水平与即刻记忆、延迟记忆评分及标准分呈正相关(r=0.422、0.394、0.566,P<0.05)。结论 2型糖尿病患者存在认知功能损害,其发生机制可能与血清Aβ1-42水平升高及sRAGE水平降低有关。Objective To investigate the change of the levels of Aβ1-42 and sRAGE in T2DM patients and the possible mechanism of cognitive impairment of T2DM patients. Methods We enrolled 66 T2DM patients who were diagnose in the Second Department of Endocrinology, Tangshan Gongren Hospital from March 2014 to December 2014. And 50 healthy people who received physical examination in the same hospital were selected as control group. Using self - designed questionnaire, the clinical data of subjects were collected, and the cognitive function of the subjects was evaluated by RBANS scale. The scale included 5 subtests on instant memory, visual breadth, verbal function, attention and delayed memory. According to the age of the subjects, the scale scores were obtained by table look - up and were transferred to standard score. From each subject, 5 ml of fasting venous blood was extracted, and ELISA was employed to determine the levels of Aβ1-42 and sRAGE. Results Case group was lower than control group in the scores of instant memory, visual breadth, verbal function, attention, delayed memory and standard score of RBANS scale （P 〈0. 05 for all）. Case group was higher in Aβ1-42 level and lower in sRAGE level than control group （ P 〈 0.05 ）. In case group, age had negative correlation with the scores of RBANS subtests and standard score （ P〈 0. 05） ; education years had positive correlation with the scores of instant memory, visual breadth, attention, delayed memory and standard score, and had negative correlation with verbal function （ P 〈 0. 05 ） ; Aβ1-42 level had negative correlation with the scores of RBANS subtests and standard score （P 〈 0. 05 ） ; sRAGE level had positive correlation with the scores of instant memory, verbal function, attention and delayed memory and standard score （ P 〈 0. 05 ） , and had no correlation with visual breadth （P 〉0. 05）. After the adjustment of age and education years, the Aβ1-42 level of patients in case group had negative correlation with the scores

关 键 词：糖尿病 2型 认知障碍 β淀粉样肽类 糖基化终产物 高级 

分 类 号：R587.1[医药卫生—内分泌]