血糖变异度对老年代谢综合征患者认知功能障碍的预测价值  

Clinical significance of glycemic variability for prediction of cognitive impairment in elderly patients with metabolic syndrome

作　　者：谢祥红[1] 魏文波 Xie Xianghong;Wei Wenbo(Department of Laboratory Medicine,Chinese People′s Armed Police Corps Hospital in Sichuan Province,Sichuan Leshan 614000,China)

机构地区：[1]中国人民武装警察部队四川省总队医院检验科,四川乐山614000

出　　处：《中国医师进修杂志》2020年第8期696-701,共6页Chinese Journal of Postgraduates of Medicine

摘　　要：目的分析血糖变异度与老年代谢综合征患者认知功能障碍的相关性,为早期诊断认知功能障碍提供参考。方法选择中国人民武装警察部队四川省总队医院2017年12月至2019年3月诊治80例老年代谢综合征患者作为研究组和50例同期体检的健康老年人作为对照组,比较两组一般资料、生化指标等的差异。老年代谢综合征患者入院时采用蒙特利尔认知评估量表(MoCA)测评认知功能,按照MoCA得分将患者分为认知功能障碍组和认知功能正常组。患者入院24 h内进行72 h动态血糖监测,比较两组72 h内平均血糖(GluAve)、血糖标准差(GluSD)、24 h内平均血糖波动幅度(MAGE)、血糖不稳定指数(GLI)、血糖变异系数(GluCV)和其他临床指标的差异。结果与对照组比较,研究组体质量指数(BMI)、收缩压(SBP)、舒张压(DBP)、空腹血糖(FPG)、三酰甘油(TG)、总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)、糖化血红蛋白(HbA1c)明显升高[(25.48 ± 3.86)kg/m2比(22.83 ± 4.60)kg/m2、(139.09 ± 10.17)mmHg(1 mmHg=0.133kPa)比(128.12 ± 7.8)mmHg、(73.00 ± 6.65)mmHg比(69.90 ± 5.99)mmHg、(9.12 ± 1.54)mmol/L比(4.92 ± 0.63)mmol/L、(2.17 ± 0.49)mmol/L比(1.70 ± 0.48)mmol/L、(5.32 ± 0.62)mmol/L比(4.61 ± 0.45)mmol/L、(3.05 ± 0.79)mmol/L比(2.31 ± 0.53)mmol/L、(7.89 ± 1.92)%比(5.30 ± 0.56)%],高密度脂蛋白胆固醇(HDL-C)明显降低[(0.98 ± 0.25)mmol/L比(1.19 ± 0.43)mmol/L],差异有统计学意义(P<0.05)。与认知功能正常组比较,认知功能障碍组病程、HbA1c、GluAve、GluSD、MAGE、GLI、GluCV明显增加[(7.39 ± 1.87)年比(6.50 ± 1.52)年、(8.52 ± 2.21)%比(7.32 ± 1.21)%、(11.6 ± 3.35)mmol/L比(9.84 ± 2.19)mmol/L、(2.98 ± 0.54)mmol/L比(2.17 ± 0.47)mmol/L、(1.19 ± 0.46)mmol/L比(0.71 ± 0.28)mmol/L、95.83 ± 19.77比86.94 ± 15.22、(27.96 ± 10.38)%比(23.02 ± 8.16)%],差异有统计学意义(P<0.05)。老年代谢综合征患者MoCA评分与病程、GluAve、GluSD、MAGE、GLI、GluCObjective To investigate the clinical significance and correlation between blood glucose variability and cognitive impairment in elderly patients with metabolic syndrome.Methods A total of 80 elderly metabolic syndrome patients and 50 healthy controls in Chinese People′s Armed Police Corps Hospital in Sichuan Province from December 2017 to March 2019 were selected as study group and control group respectively,and the difference of general data and biochemical indicators between two groups were compared.The cognitive function of the metabolic syndrome patients was measured by Montreal cognitive assessment scale(MoCA)at admission.The patients were divided into cognitive dysfunction group and normal cognition group according to MoCA score.The glycemic variability was detected by 72-h dynamic monitoring of blood glucose started within 24 h after admission,and the difference of average blood glucose(GluAve),standard deviation of glucose(GluSD),mean amplitude of glycemic excursions in 24 h(MAGE),glycemic index(GLI),glucose variability(GluCV)and other indicators between cognitive dysfunction group and normal cognition group were also compared.Results The levels of body mass index(BMI),systolic blood pressure(SBP),diastolic blood pressure(DBP),fasting plasma glucose(FPG),triglyceride(TG),total cholesterol(TC),low density lipoprotein cholesterin(LDL-C),glycated hemoglobin(HbA1c)were significantly increased in the study group[(25.48±3.86)kg/m2 vs.(22.83±4.60)kg/m2,(139.09±10.17)mmHg(1 mmHg=0.133 kPa)vs.(128.12±7.8)mmHg,(73.00±6.65)mmHg vs.(69.90±5.99)mmHg,(9.12±1.54)mmol/L vs.(4.92±0.63)mmol/L,(2.17±0.49)mmol/L vs.(1.70±0.48)mmol/L,(5.32±0.62)mmol/L vs.(4.61±0.45)mmol/L,(3.05±0.79)mmol/L vs.(2.31±0.53)mmol/L,(7.89±1.92)%vs.(5.30±0.56)%],high density lipoprotein cholesterol(HDL-C)were significantly decreased in the study group[(0.98±0.25)mmol/L vs.(1.19±0.43)mmol/L]compared to the control group,and the differences were statistically significant(P<0.05).The disease course,HbA1c,GluAve,GluSD,MAGE,GLI,GluCV

关 键 词：血糖变异度 代谢综合征 老年人 认知功能障碍 

分 类 号：R589[医药卫生—内分泌] R749.1[医药卫生—内科学]