老年2型糖尿病患者血清BGP、ghrelin、YKL-40水平与胰岛素抵抗及认知功能损害的关系研究  

Relationship between Serum Levels of BGP,Ghrelin and YKL-40 and Insulin Resistance and Cognitive impairment in Elderly Patients with Type 2 Diabetes Mellitus

作　　者：王建军[1] 朱晓燕 余云华 王小玲 李玺[3] WANG Jian-jun;ZHU Xiao-yan;YU Yun-hua;WANG Xiao-ling;LI Xi(Second Department of Cadre ward,900 Hospital of the Joint Service Support Force of Chinese People's Liberation Army,Fuzhou.Fujian,350025,China;Department of Tuberculosis,Meifeng hospital,900 Hospital of the loint Service Support Force of Chinese People's Liberation Arny,Fuzhou,Fujian,350003,China;Department of Geriatrics,The Second Afiliated Hospital of Xi'an Jiaotong LUniversity,Xi'an,Shanxi,710004,China)

机构地区：[1]中国人民解放军联勤保障部队第900医院干部病房二科,福建福州350025 [2]中国人民解放军联勤保障部队第900医院梅峰院区结核科,福建福州350003 [3]西安交通大学附属第二医院老年病科,陕西西安710004

出　　处：《现代生物医学进展》2021年第7期1324-1327,1332,共5页Progress in Modern Biomedicine

基　　金：福建省自然科学基金项目(2017J01327)。

摘　　要：目的:研究老年2型糖尿病(T2DM)患者血清骨钙素(BGP)、生长激素释放多肽(ghrelin)及人软骨糖蛋白-39(YKL-40)水平与胰岛素抵抗及认知功能损害的关系。方法:选择2018年1月~2019年12月我院收治的老年T2DM患者100例记作病变组,选择同期于我院进行体检的老年健康志愿者100例作为对照组。比较两组血清BGP、ghrelin及YKL-40水平,血糖、血脂、胰岛素抵抗相关指标及简易智力状态检查量表(MMSE)评分情况,并分析各指标的相关性。结果:病变组血清BGP、ghrelin水平低于对照组,而YKL-40水平高于对照组(P<0.05)。病变组空腹血糖(FPG)、糖化血红蛋白(HbA1c)水平及胰岛素抵抗指数(HOMA-IR)均高于对照组,而空腹胰岛素(FINS)水平低于对照组(P<0.05)。病变组除语言、延迟记忆评分与对照组对比差异无统计学意义(P>0.05),其他各项MMSE评分均低于对照组(P<0.05)。经Pearson相关性分析可得:老年T2DM患者血清BGP、ghrelin水平和FPG、HbA1c、HOMA-IR均呈负相关,与FINS及MMSE评分均呈正相关(P<0.05);而血清YKL-40水平和FPG、HbA1c、HOMA-IR均呈正相关,与FINS及MMSE评分均呈负相关(P<0.05)。结论:老年T2DM患者的血清BGP、ghrelin存在明显低表达,而血清YKL-40水平呈明显高表达,且上述血清学指标水平均与胰岛素抵抗和认知功能损害密切相关。Objective:To study the relationship between serum osteocalcin(BGP),growth hormone releasing peptide(ghrelin)and human cartilage glycoprotein-39(YKL-40)levels and insulin resistance and cognitive impairment in elderly patients with type 2 diabetes mellitus(T2 DM).Methods:100 elderly patients with T2 DM who were admitted to our hospital from January 2018 to December2019 were seelected as the lesion group.Another 100 healthy elderly volunteers who underwent physical examination in our hospital at the same time were selected as the control group.The levels of BGP,ghrelin and YKL-40,blood glucose,blood lipid and insulin resistance,cognitive impairent and simple mental state examination scale(MMSE)score were compared between the two groups,and correlation analysis was performed.Results:The serum BGP and ghrelin level of the lesion group were lower than those of the control group,while the levels of YKL-40 was higher than that of the control group(P<0.05).Fasting blood glucose(FPG),glycosylated hemoglobin(HbA1 c)and insulin resistance index(HOMA-IR)levels in the lesion group were higher than those in the control group,while fasting insulin(fins)levels were lower than those in the control group(P<0.05).There was no significant difference between the pathological group and the control group except for the scores of language and delayed memory(P>0.05),Other MMSE scores were lower than those of the control group(P<0.05).According to Pearson correlation analysis,serum BGP,ghrelin,FPG,HbA1 c and HOMA-IR were negatively correlated with fins and MMSE scores(P<0.05),while serum YKL-40 was positively correlated with FPG,Hb A1 c and HOMA-IR,and negatively correlated with fins and MMSE scores(P<0.05).Conclusion:Serum BGP and ghrelin are significantly lower in elderly T2 DM patients,while serum YKL-40 is significantly higher,and the above serological indexes are closely related to insulin resistance and cognitive impairment.

关 键 词：老年 2型糖尿病 骨钙素 生长激素释放多肽 人软骨糖蛋白-39 胰岛素抵抗 认知功能 

分 类 号：R587.1[医药卫生—内分泌]