血清β淀粉样蛋白1-42水平与老年2型糖尿病患者认知功能关系研究  

Relationship between serum amyloid β1-42 level and cognitive function in elderly patients with type 2 diabetes

作　　者：张利红[1] 王引娣 吴冠吉[2] 王翔[1] 王芳[1] ZHANG Lihong;WANG Yindi;WU Guanji;WANG Xiang;WANG Fang(Department of Endocrinology,Xi’an Central Hospital,Xi’an 710004,China)

机构地区：[1]西安市中心医院内分泌科,陕西西安710004 [2]西安市中心医院心血管内科,陕西西安710004

出　　处：《陕西医学杂志》2021年第9期1077-1080,1085,共5页Shaanxi Medical Journal

基　　金：陕西省重点研发计划项目(2017SF-080)。

摘　　要：目的:检测老年2型糖尿病患者血清β淀粉样蛋白1-42(Aβ1-42)的水平,并分析其与2型糖尿病患者认知功能的关系。方法:收集2型糖尿病患者118例作为糖尿病组,其中合并高血压者64例,无高血压者54例。收集同期健康体检者35例作为对照组。采用酶联免疫吸附(ELISA)检测血清Aβ1-42及胰岛素样生长因子1(IGF-1)水平。采用全自动生化分析仪检测血糖、肾功能、总胆固醇(TC)、甘油三酯(TG)、高密度脂蛋白(HDL)、低密度脂蛋白(LDL)、同型半胱氨酸(Hcy)等生化指标。使用色谱法测定糖化血红蛋白(HbA1c)。采用蒙特利尔认知评估(MoCA)对研究对象进行评分。比较两组一般资料及生化指标。比较糖尿病组合并高血压与未合并高血压患者一般资料、生化指标、MoCA评分及慢性并发症发生情况。分析MoCA评分与年龄、Aβ1-42的相关性,以及Aβ1-42、高血压与认知功能障碍的关系。结果:糖尿病组与对照组体重指数(BMI)、HbA1c、Aβ1-42、IGF-1、HDL、LDL、Hcy比较有统计学差异(均P<0.05)。合并高血压与未合并高血压患者年龄、BMI、尿蛋白、Hcy、Aβ1-42比较有统计学差异(均P<0.05)。合并高血压患者MoCA总分低于未合并高血压患者(P<0.05)。合并高血压患者冠心病、脑血管病变、糖尿病肾病发生情况高于未合并高血压患者(均P<0.05)。未合并高血压患者Aβ1-42与MoCA评分呈正相关(r=0.470,P=0.032),合并高血压患者年龄与MoCA评分呈负相关(r=-0.703,P<0.01)。Aβ1-42水平升高,认知功能障碍风险降低(OR=0.991,95%CI:0.984~0.998,P=0.019)。结论:Aβ1-42水平与老年2型糖尿病患者认知功能存在相关性,其水平降低可能是老年糖尿病患者发生认知功能障碍的危险因素。高血压可能是加重糖尿病合并认知功能障碍的危险因素。Objective:To detect the level of serumβ-amyloid 1-42(Aβ1-42)in elderly patients with type 2 diabetes,and to analyze its relationship with the cognitive function of patients with type 2 diabetes.Methods:118 patients with type 2 diabetes were collected as the diabetes group,including 64 patients with hypertension and 54 patients without hypertension.35 cases of healthy physical examination during the same period were collected as the control group.ELISA was used to detect serum Aβ1-42 and IGF-1 levels.Automatic biochemical analyzer was used to detect blood sugar,kidney function,TC,TG,HDL,LDL,Hcy.HbA1c was detected by chromatography.The study subjects were scored by using MoCA scale.The two groups of general information and biochemical indicators were compared.The general data,biochemical indicators,MoCA score and the occurrence of chronic complications between diabetes patients combined with hypertension and those without hypertension were compared.The correlation between MoCA score and age,Aβ1-42,and the relationship between Aβ1-42,hypertension and cognitive dysfunction was analyzed.Results:There were statistical differences in BMI,HbA1c,Aβ1-42,IGF-1,HDL,LDL,and Hcy between the diabetes group and the control group(all P<0.05).There were statistical differences in age,BMI,urine protein,Hcy,Aβ1-42 between patients with hypertension and those without hypertension(all P<0.05).The total score of MoCA in patients with hypertension was lower than that of patients without hypertension(P<0.05).The incidence of coronary heart disease,cerebrovascular disease and diabetic nephropathy in patients with hypertension was higher than those of patients without hypertension(all P<0.05).There was positive correlation between Aβ1-42 and MoCA score in patients without hypertension(r=0.470,P=0.032),and the age of patients with hypertension was negatively correlated with MoCA score(r=-0.703,P<0.01).The level of Aβ1-42 increased,and the risk of cognitive dysfunction decreased(OR=0.91,95%CI:0.984-0.998,P=0.019).Conclusion:There is

关 键 词：2型糖尿病 β淀粉样蛋白1-42 高血压 认知功能 蒙特利尔认知评估 

分 类 号：R587.1[医药卫生—内分泌]