内脏脂肪面积、低密度脂蛋白胆固醇对老年2型糖尿病患者认知功能障碍的预测价值研究  

Study on the Predictive Value of Visceral Fat Area and Low-Density Lipoprotein Cholesterol on Cognitive Dysfunction in Elderly Patients with Type 2 Diabetes Mellitus

作　　者：朱汝霞[1] 刘春斌 何悠[1] 黄莉婷 梁达一 林媛媛[3] 姚姗姗[1] ZHU Ruxia;LIU Chunbin;HE You;HUANG Liting;LIANG Dayi;LIN Yuanyuan;YAO Shanshan(Department of Geriatrics Ward 1,The First People’s Hospital of Nanning,Nanning,Guangxi 530021,China;Department of Educational Affairs,The First People’s Hospital of Nanning,Nanning,Guangxi 530021,China;Department of Endocrinology,The First People’s Hospital of Nanning,Nanning,Guangxi 530021,China)

机构地区：[1]南宁市第一人民医院老年病科一区,广西南宁530021 [2]南宁市第一人民医院教务部,广西南宁530021 [3]南宁市第一人民医院内分泌科,广西南宁530021

出　　处：《中国医药指南》2025年第9期1-5,共5页Guide of China Medicine

基　　金：广西壮族自治区卫生健康委员会自筹经费科研课题[Z20210973]。

摘　　要：目的研究内脏脂肪面积(eVFA)、低密度脂蛋白胆固醇(LDL-C)对老年2型糖尿病(T2DM)患者合并认知功能障碍的预测效果。方法选择2021年7月至2023年9月南宁市第一人民医院收治的120例老年T2DM患者作为研究对象。根据入选者简易智力状态检查量表(MMSE)得分对其分组,将MMSE得分<27分者纳入老年T2DM合并认知功能障碍组,将MMSE得分≥27分者纳入老年T2DM认知正常组。对比入选者一般资料及eVFA、LDL-C水平,选择Logistic回归分析有差异项,利用Spearman相关分析法计算各因素与老年T2DM合并认知功能障碍的相关性,绘制受试者工作特征(ROC)曲线,计算曲线下面积(AUC)、标准误、最佳界值、敏感度、特异度。结果纳入的120例老年T2DM患者中,MMSE得分<27分者31例(老年T2DM合并认知功能障碍组),占比25.83%;MMSE得分≥27分者89例(老年T2DM认知正常组),占比74.17%。两组年龄、糖尿病病程、eVFA、LDL-C水平对比差异均有统计学意义(P<0.05),且上述指标均为老年T2DM患者合并认知功能障碍的危险因素,均与老年T2DM患者合并认知功能障碍之间呈正相关关系(r=0.606、0.607、0.683、0.673,P<0.05),AUC值分别为0.839、0.825、0.878、0.862,OR值均>1,AUC值均>0.6。结论仍存在13.33%的老年T2DM患者合并认知功能障碍,此现象值得临床广泛关注。年龄、糖尿病病程、eVFA、LDL-C均为导致老年T2DM患者合并认知功能障碍的危险因素,上述因素与老年T2DM患者合并认知功能障碍均存在正相关关系,且eVFA、LDL-C对老年T2DM患者合并认知功能障碍的预测价值相对较高。Objective To study the predictive effect of visceral fat area(eVFA)and low-density lipoprotein cholesterol(LDL-C)on combined cognitive dysfunction in elderly patients with type 2 diabetes mellitus(T2DM).Methods One hundred and twenty elderly T2DM patients admitted to our hospital from July 2021 to September 2023 were selected as study subjects.The enrollees were grouped according to their scores on the Brief Mental Status Examination Scale(MMSE),and those with MMSE scores<27 were included in the elderly T2DM combined cognitive dysfunction group,and those with MMSE scores≥27 were included in the elderly T2DM cognitively normal group.The general information and eVFA and LDL-C levels of the enrolled subjects were compared,logistic regression was selected to analyze the differing items,Spearman correlation analysis was used to calculate the correlation between each factor and the cognitive dysfunction of the elderly T2DM combined,and the working characteristics(ROC)curves of the subjects were plotted,and the area under the curve(AUC),standard error,optimal cut-off value,sensitivity,and specificity were calculated.Results Among the 120 elderly T2DM patients included,31 cases(elderly T2DM combined cognitive dysfunction group)with MMSE score<27,accounting for 25.83%.89 cases(elderly T2DM cognitively normal group)with MMSE score≥27,accounting for 74.17%.The differences between the two groups were statistically significant when comparing age,duration of diabetes mellitus,eVFA,and LDL-C levels(P<0.05),and all of the above indexes were risk factors for combined cognitive dysfunction in elderly patients with T2DM,and all of them showed a positive correlation with the combined cognitive dysfunction in elderly patients with T2DM(r=0.606,0.607,0.683,and 0.673,P<0.05),with AUC values of 0.839,0.825,0.878,0.862,OR>1,and AUC>0.6,respectively.Conclusions Cognitive dysfunction still exists in 13.33%of elderly T2DM patients,a phenomenon that deserves extensive clinical attention.Age,duration of diabetes mellitus,eVFA,and LDL-C ar

关 键 词：内脏脂肪面积 低密度脂蛋白胆固醇 老年2型糖尿病 认知功能障碍 

分 类 号：R587.1[医药卫生—内分泌]