胰岛素抵抗与轻度认知功能障碍关系的临床研究

目的探讨胰岛素抵抗（IR）与轻度认知功能障碍（MCI）的关系；明确IR是否为MCI的独立危险因素。方法102例IR患者进行MMSE、GDS、CMS、ADL等评测；按Petersen标准诊断MCI。结果IR患者MCI发病率高，且重型IR患者高于轻型IR患者、患有糖尿病（DM）的IR患者高于非DM的IR患者、以血糖控制不良者为甚；MCI患者表现IR且空腹胰岛素水平高（P〈0.01）。Logistic回归分析显示受教育程度、空腹胰岛素水平、高血压病、糖化血红蛋白最终进入方程。结论IR患者MCI发生率较高，氓的MCI患者空腹胰岛素水平高；IR影响认知功能的各个环节；IR、高胰岛素水平、高血压病和高血糖是MCI的独立危险因素。

Clinical observation on relationship between insulin resistance and mild cognitive impairment

Objective To investigate the relationship between Insulin Resistance （IN） and Mild Cognitive Impairment （MCI）. Methods 102 clinical IN patients （71 Diabetics and 31Non-diaeits） were collected in study group, and 50 health examinations in controls. The health examinations included neurosychological test, blood routine, fasting plasma glucose and insulin, insulin sensitivity index（ISI）, glycated hemoglob, blood lipid, liver and kidney function, blood pressure, body mass index（BMI）, liver color ultrasonic diagram, electrocardiogram and CT. All the groups were evaluated with MMSE,GDS, CMS and ADL. Those who were selected into the MCI group, accorded with Petersen＇s MCI diagnostic standards. Categorical data was performed by χ2 test and quantitative data by t-test,linear correlation and logistic regression. Results （1）The incidence of MCI of IR patient was higher than non-IR. In IN patient, the severe cases was more than mild cases, and diadetics more than non-diabetics, with more obvious in cases of poor-controled blood glucose; （2）Compare with cases of normal cognitive function,MCI patient had more obvious IR and higher fasting insulin levels （P〈0. 01）; （3）The impairment of cognitive function in IR patient mainly included Directive Memory, Association Study, Image Free Memory, Meaningless Graph Recognition, Human Figure Feature Associated Memory, etc. （P〈0. 05） ; （4） Education level, ISI, high blood glucose, hypertension and glycated hemoglob were variables in the logistic regression equation. Conclusions （ 1 ） The incidence of MCI in IR patient is higher than those in non-IN cases. In IR group, MCI patient have higher fasting insulin level and more serious IR than that in normal cognitive function; （2） IR, high insulin level, hypertension and higher blood glucose are independent risk factors for MCI.