老年2型糖尿病合并认知功能障碍患者血清骨钙素检测的意义  

Significance of serum osteocalcin detection in elderly patients with type 2 diabetes and cognitive impairment

作　　者：杨倩 李利娟[1] 任增花 龙威[1] 左晟[1] Yang Qian;Li Lijuan;Ren Zenghua;Long Wei;Zuo Sheng(Department of Geriatrics,Shanghai Jiaotong University Affiliated Sixth People′s Hospital,Shanghai 201306,China)

机构地区：[1]上海交通大学附属第六人民医院老年病科,上海201306

出　　处：《中国临床保健杂志》2022年第1期66-70,共5页Chinese Journal of Clinical Healthcare

基　　金：上海交通大学附属第六人民医院院级项目(DY2019010)。

摘　　要：目的探讨血清骨钙素在老年2型糖尿病(T2DM)合并认知功能障碍患者中的意义,为老年T2DM合并认知功能障碍患者早期干预提供依据。方法选取上海交通大学附属第六人民医院临港院区就诊的150例患者作为研究对象,分为三组:①健康对照组(NC组);②2型糖尿病非认知障碍组(T2DM组);③2型糖尿病合并认知障碍组(CI-T2DM组),三组各50例,比较三组间患者血清骨钙素水平、一般生化指标和认知功能评分情况,并分析影响认知功能的相关因素,采用单因素和多元回归方法分析骨钙素与糖脂代谢及认知功能之间的关系。结果与T2DM组比较,CI-T2DM组中腰围、糖化血红蛋白、内脏脂肪面积均升高,而骨钙素水平与简易精神状态检查量表(MMSE)评分下降;NC组、T2DM组、CI-T2DM组血清骨钙素水平逐渐下降,且组间差异有统计学意义;在老年T2DM人群中,MMSE评分与年龄、腰围、糖化血红蛋白及内脏脂肪面积呈负相关(P<0.05),而与骨钙素水平呈正相关(r=0.374,P<0.001);以骨钙素作为因变量,经多元线性回归分析发现,糖化血红蛋白、内脏脂肪面积、MMSE仍与骨钙素水平相关(P<0.05)。结论骨钙素可能为糖尿病合并认知功能障碍的保护因素。Objective To explore the significance of serum osteocalcin in elderly patients with T2DM and cognitive impairment,and provide evidence for early intervention method in those patients.Methods A total of 150 patients who were admitted to Shanghai Jiaotong University Affiliated Sixth People′s Hospital(Lingang District)were enrolled.Those patients were divided into three groups:①healthy control group(NC group);②type 2 diabetes with normal cognitive function group(T2DM group);③type 2 diabetes with cognitive impairment group(CI-T2DM group),there were 50 cases in each of three groups.The serum osteocalcin level,general biochemical indicators and cognitive function scores were compared among three groups,and the related factors which affect cognitive function were analyzed.And we used single factor and multiple regression methods to analyze the relationship between osteocalcin and glucose-lipid metabolism as well as cognitive function.Results Compared with T2DM group,the waist circumference,glycosylated hemoglobin and visceral fat area were increased in the CI-T2DM group,while the level of serum osteocalcin and MMSE score were decreased;serum osteocalcin level in NC group,T2DM group,and CI-T2DM group gradually decreased,and there were statistical differences among three groups.In elderly patients with type 2 diabetes,MMSE score was negatively correlated with age,waist circumference and glycation hemoglobin as well as visceral fat area(P<0.05),while MMSE score was positively correlated with serum osteocalcin level(r=0.374,P<0.001).Multiple linear regression analysis showed that glycosylated hemoglobin,visceral Fat area and MMSE were still correlated with serum osteocalcin level(P<0.05).Conclusions Serum osteocalcin may be a protective factor for T2DM patients with cognitive impairment.

关 键 词：糖尿病 2型 认知功能障碍 骨钙素 保护因素 老年人 

分 类 号：R58[医药卫生—内分泌]