老年2型糖尿病患者轻度认知功能障碍与体质量指数的关系  

Endocrine DiseaseRelationship between mild cognitive impairment and body mass index in older adult patients with type 2 diabetes mellitus

作　　者：张锐 吴都[1] 陈乐辉[1] Zhang Rui;Wu Du;Chen Lehui(Department of Internal Medicine,Wuyunshan Sanatorium,Hangzhou 310008,Zhejiang Province,China)

机构地区：[1]杭州市五云山疗养院内科,310008

出　　处：《中国基层医药》2021年第4期481-486,共6页Chinese Journal of Primary Medicine and Pharmacy

基　　金：浙江省杭州市科技发展计划项目 (20170533B77)。

摘　　要：目的:探讨老年2型糖尿病患者轻度认知功能障碍(MCI)与体质量指数(BMI)的关系。方法:选取杭州市五云山疗养院2016年1月至2019年5月诊治的2型糖尿病患者327例为2型糖尿病组,其中合并MCI的患者73例为MCI组,未合并MCI的患者254例为非MCI组。选取同期在该院体检的老年健康志愿者100例为对照组。比较各组性别、年龄、受教育年限、家庭月收入、BMI、生活习惯(饮酒、吸烟)及实验室检查指标的差异,使用logistics回归分析判断影响2型糖尿病患者合并MCI的影响因素,使用受试者工作特征(ROC)曲线评估BMI对老年2型糖尿病患者合并MCI的预测价值。结果:2型糖尿病组的年龄、家庭月收入、合并糖尿病家族史比例、BMI、空腹血糖(FBG)、糖化血红蛋白(HbA1c)、低密度脂蛋白胆固醇(LDL-C)分别为(73.10±9.56)岁、8926元、189/327例、(24.18±2.64)kg/m 2、(6.96±0.88)mmol/L、(7.10±0.84)%、(7.32±0.84)mmol/L,均高于对照组的(68.28±8.21)岁、6715元、13/100例、(22.30±1.74)kg/m 2、(4.51±0.72)mmol/L、(5.62±0.68)%、(7.04±0.67)mmol/L,差异均有统计学意义(t=4.554,χ^(2)=18.601、61.654,t=6.668,t=25.360、16.077、3.049,均P<0.05)。2型糖尿病患者中,MCI组家庭月收入<5000元的比例、糖尿病家族史、BMI、HbA1c分别为29/73例、60/73例、(24.92±2.43)kg/m 2、(7.54±0.88)%,非MCI组分别为70/254例、129/254例、(23.77±2.59)kg/m 2、(6.92±0.81)%,两组差异均有统计学意义(χ^(2)=6.144、22.927,t=3.389、5.652,均P<0.05)。多因素logistics回归分析结果显示:BMI、HbA1c是影响老年2型糖尿病患者合并MCI的影响因素(OR=0.274、0.192,均P<0.05);家庭月收入、糖尿病家族史与老年2型糖尿病患者发生MCI的关系不明显(OR=-0.154、0.093,均P>0.05)。ROC曲线分析显示:当BMI值为24.49 kg/m 2时,约登指数最大(0.510),对应的灵敏度为83.86%、特异度为67.12%。ROC曲线下面积为0.766[95%CI(0.699~0.832)]。结论:BMI是老年2型糖尿病患者Objective To investigate the relationship between mild cognitive impairment(MCI)and body mass index(BMI)in older adult patients with type 2 diabetes mellitus(T2DM).Methods A total of 327 patients with T2DM who received treatment in Wuyunshan Sanatorium from January 2016 to May 2019 were included in the T2DM group.Patients in theT2DM group were subdivided into an MCI group(n=73)and a non-MCI group(n=254)according to whether they had MCI.An additional 100 older adult volunteers who concurrently received physical examination were included in the control group.Sex,age,years of education,monthly family income,body mass index,living habits(drinking,smoking)and laboratory indexes were compared among the groups.The influential factors of MCI in patients with T2DM were analyzed by logistic regression model.The predictive value of BMI for MCI in older adult patients with T2DM was evaluated by receiver operating characteristic(ROC)curve.Results Age,monthly family income,the proportion of patients with a history of diabetes mellitus,BMI,fasting blood glucose,glycosylated hemoglobin(HbA1C),low-density lipoprotein cholesterol(LDL-C)in the T2DM group were(73.10±9.56)years old,8926 yuan RMB,189/327,(24.18±2.64)kg/m2,(6.96±0.88)mmol/L,(7.10±0.84)%,(7.32±0.84)mmol/L,respectively,which were higher than those in the control group[(68.28±8.21)years old,6715 yuan RMB,13/100,(22.30±1.74)kg/m2,(4.51±0.72)mmol/L,(5.62±0.68)%,(7.04±0.67)mmol/L,t=4.554,χ^(2)=18.601,61.654,t=6.668,t=25.360,16.077,3.049,all P<0.05].In the MCI group,the proportion of patients having a monthly family income<5000 yuan RMB,the proportion of patients having a history of diabetes mellitus,BMI,HbA1c value were 29/73,60/73,(24.92±2.43)kg/m2,(7.54±0.88)%,respectively,while they were 70/254,129/254,(23.77±2.59)kg/m2,(6.92±0.81)%,respectively in the non-MCI group.There were significant differences in these indexes between MCI and non-MCI groups(χ^(2)=6.144,22.927,t=3.389,5.652,all P<0.05).Multivariate logistic regression analysis showed that BMI and HbA

关 键 词：糖尿病 2型 认知障碍 人体质量指数 血糖 血红蛋白A 糖基化 年龄因素 收入 老年人 回归分析 

分 类 号：R587.2[医药卫生—内分泌]