BDNF Val66Met基因多态性与老年糖尿病患者认知功能损害的相关性  

Association of BDNF Val66Met gene polymorphism with cognitive impairment in elderly diabetic patients

作　　者：刘佳[1] 罗鸿宇[1] 王洁妤[1] 张丽[1] 但小娟[2] 杨伟[1] Liu Jia;Luo Hongyu;Wang Jieyu;Zhang Li;Dan Xiaojuan;Yang Wei(Department of Geriatrics,Xuanwu Hospital,Capital Medical University,Beijing 100053,China)

机构地区：[1]首都医科大学宣武医院老年科,北京100053 [2]首都医科大学宣武医院神经内科,北京100053

出　　处：《疑难病杂志》2020年第3期232-236,共5页Chinese Journal of Difficult and Complicated Cases

基　　金：北京市保健科研课题(京17-13);北京市医院管理局青年人才培养“青苗”计划(QML20180805)~~

摘　　要：目的分析脑源性神经营养因子(BDNF)Val66Met基因多态性对老年糖尿病患者认知功能损害的影响。方法收集2018年1月-2019年5月首都医科大学宣武医院老年科诊治糖尿病患者(年龄≥65岁)592例,采用简易智能评估量表(MMSE)对患者进行认知功能评估,其中认知功能损害(CI)组189例,认知正常组403例,采集患者临床资料和生化资料,进行BDNF基因分型检测,分析BDNF Val66Met基因多态性与老年糖尿病患者认知功能损害的相关性。结果CI组风险等位基因A高于认知正常组(χ^2/P=4.396/0.036);等位基因A携带者在定向力、延迟回忆及语言能力3个认知域的分值显著低于非携带者(t/P=3.063/0.012、2.642/0.034、2.941/0.020);线性回归分析显示,每拷贝A等位基因与MMSE、定向力和延迟回忆有显著相关性(β/P=-0.096/0.011、-0.155/<0.001、-0.134/0.001);多因素Logistic分析显示,糖尿病病程、空腹血糖、HbA1C、低密度脂蛋白胆固醇(LDL-C)是糖尿病认知功能障碍的危险因素[OR(95%CI)=1.036(1.014~1.059)、1.082(1.004~1.166)、1.253(1.057~1.486)、1.116(1.022~1.554),P均<0.05],而受教育时间和口服二甲双胍是认知功能障碍的保护因素[OR(95%CI)=0.877(0.812~0.947)、0.502(0.297~0.849),P均<0.05],糖尿病人群BDNF Val66Met A等位基因携带者患认知功能障碍疾病风险是非携带者的1.696倍(95%CI 1.119~2.569,P=0.013)。结论老年糖尿病人群认知功能损害可能与BDNF Val66Met基因多态性密切相关。Objective To analyze the effect of brain-derived neurotrophic factor(BDNF)Val66 Met gene polymorphism on cognitive impairment in elderly diabetic patients.Methods Five hundred and ninety-two diabetic patients(aged≥65 years)were collected from January 2018 to May 2019 in the Department of Geriatrics,Xuanwu Hospital,Capital Medical University.The cognitive function of the patients was assessed by MMSE,including 189 patients in CI group and 403 patients in normal cognitive group.Clinical and biochemical data were collected and BDNF genotyping was performed to analyze the relationship between BDNF Val66 Met gene polymorphism and cognitive impairment in elderly diabetic patients.Results The risk allele A in the CI group was higher than that in the cognitively normal group(χ^2/P=4.396/0.036);the scores of allele A carriers in the three cognitive domains of orientation,delayed recall and language ability were significantly lower than those of Carriers(t/P=3.063/0.012,t/P=2.642/0.034,t/P=2.941/0.020).Linear regression analysis showed that each copy of the A allele was significantly correlated with MMSE,orientation,and delayed recall(β/P=-0.096/0.011,β/P=-0.155/<0.001,β/P=-0.134/0.001).Multivariate logistic analysis showed that the duration of diabetes,fasting blood glucose,HbA1 C,and low-density lipoprotein cholesterol(LDL-C)were risk factors for cognitive impairment in diabetes[OR(95%CI)=1.036(1.014 to 1.059),1.082(1.004 to 1.166),1.253(1.057 to 1.486),1.116(1.022 to 1.554),P<0.05].Time of education and oral metformin are protective factors of cognitive dysfunction[OR(95%CI)=0.877(0.812 to 0.947),0.502(0.297 to 0.849),P<0.05].The carriers of the BDNF Val66 Met A allele in the diabetic population were 1.696 times more likely to suffer from cognitive dysfunction than non-carriers(95%CI 1.119 to 2.569,P=0.013).Conclusion The cognitive impairment in the elderly with diabetes may be closely related to the BDNF Val66 Met gene polymorphism.

关 键 词：老年人 糖尿病 2型 认知功能障碍 脑源性神经营养因子 基因多态性 Val66Met基因 

分 类 号：R587.2[医药卫生—内分泌] R749.2[医药卫生—内科学]