2型糖尿病患者血清Metrnl水平与认知功能障碍的相关性研究  

Correlation between serum Metrnl level and cognitive impairment in patients with type 2 diabetes mellitus

作　　者：刘翠明 马学芹 唐正和[1] 吴融花 魏娟 LIU Cuiming;MA Xueqin;TANG Zhenghe;WU Ronghua;WEI Juan(Department of Endocrinology,Laigang Hospital Affiliated to Shandong First Medical University,Jinan 271104,China)

机构地区：[1]山东第一医科大学附属莱钢医院内分泌科,济南271104

出　　处：《中国免疫学杂志》2023年第6期1302-1306,共5页Chinese Journal of Immunology

基　　金：济南市卫生健康委员会科技计划项目(2022-2-94)。

摘　　要：目的:探讨2型糖尿病患者血清Metrnl水平与认知功能障碍的相关性。方法:选取2019年7月至2021年6月于山东第一医科大学附属莱钢医院内分泌科住院的2型糖尿病患者150例,根据蒙特利尔认知评估量表(MoCA)评分分为认知功能障碍组(n=78)和认知功能正常组(n=72),选取同期健康体检者为正常对照组(n=65)。测定血清Metrnl、空腹血糖(FPG)、血脂、糖化血红蛋白(HbA1c)、空腹胰岛素、hs-CRP、IL-6、TNF-α、IL-10、MCP-1水平。分析血清Metrnl与临床指标的相关性;Logistic回归分析糖尿病合并认知功能障碍的影响因素,受试者工作特征(ROC)曲线评价Metrnl对糖尿病患者发生认知功能障碍的诊断价值。结果:与正常对照组相比,2型糖尿病患者血清Metrnl水平下降,糖尿病合并认知功能障碍组下降最为明显(P<0.05)。Spearman相关分析显示,Metrnl与葡萄糖目标范围内时间(TIR)、MoCA评分、IL-10呈正相关,与TG、HOMA-IR、IL-6、TNF-α、MCP-1呈负相关(P<0.05)。Logistic回归分析显示,HOMA-IR、HbA1c、MCP-1、TNF-α是2型糖尿病合并认知功能障碍患者的危险因素,Metrnl、TIR为认知功能障碍的保护因素。ROC曲线显示血清Metrnl诊断2型糖尿病发生认知功能障碍的AUC为0.791。结论:血清Metrnl参与免疫炎症、调节糖脂代谢,与MoCA评分呈正相关,是2型糖尿病认知功能障碍的保护因素。Objective:To investigate correlation between serum Metrnl level and cognitive impairment in patients with type 2 diabetes mellitus.Methods:From July 2019 to June 2021,150 patients with type 2 diabetes mellitus who were hospitalized in Department of Endocrinology of Laigang Hospital Affiliated to Shandong First Medical University were divided into cognitive impairment group(n=78)and cognitive normal group(n=72)according to Montreal Cognitive Assessment(MoCA)score.Healthy controls in same period were selected as normal control group(n=65).Serum Metrnl,fasting blood glucose(FPG),blood lipid,glycosylated hemoglobin(HbA1c),fasting insulin,hs-CRP,IL-6,TNF-α,IL-10 and MCP-1 levels were measured.Correlation between serum Metrnl and clinical indexes was analyzed.Logistic regression analysis was used to analyze influencing factors of diabetes mellitus complicated with cognitive impairment.Receiver operating characteristic(ROC)curve was used to evaluate diagnostic value of Metrnl in cognitive impairment of type 2 diabetes.Results:Compared with normal control group,serum Metrnl level was decreased in patients with type 2 diabetes,which decreased most significantly in diabetic mellitus complicated with cognitive impairment(P<0.05).Spearman correlation analysis showed that Metrnl was positively correlated with time within glucose target range(TIR),MoCA score and IL-10,and negatively correlated with TG,HOMA-IR,IL-6,TNF-αand MCP-1(P<0.05).Logistic regression analysis showed that HOMA-IR,HbA1c,MCP-1 and TNF-αwere risk factors in type 2 diabetes mellitus complicated with cognitive impairment.Metrnl and TIR were protective factors in cognitive impairment.ROC curve showed that AUC of serum Metrnl in diagnosing type 2 diabetic cognitive impairment was 0.791.Conclusion:Serum Metrnl is involved in immune inflammation,regulating glucose and lipid metabolism,and positively correlates with MoCA score,which is a protective factor in type 2 diabetic mellitus with cognitive impairment.

关 键 词：Metrnl 认知功能障碍 免疫炎症 2型糖尿病 

分 类 号：R587[医药卫生—内分泌]