老年2型糖尿病患者的炎症因子水平与认知功能障碍的关系

目的探讨老年2型糖尿病患者的C反应蛋白、IL-1β等炎症因子水平与认知功能障碍的关系。方法60岁以上的住院患者120例，其中2型糖尿病组80例，非糖尿病对照组40例，对所有患者应用简易智能精神检查量表（MMSE）进行评分；测量身高、体重、腰围、臀围，计算体重指数（BMI）及腰臀比（WHR）；运用ELISA法检测白细胞介素-1β（IL-1β）水平、免疫扩散法检测C反应蛋白（CRP）水平、高压液相色谱法测定糖化血红蛋白（HbA1c）水平、葡萄糖氧化酶法测定空腹血糖（FBG）水平、放射免疫法测定空腹胰岛素（FINS）水平，并计算胰岛素抵抗指数（HOMA—IR）HOMA—IR=FBG＊FINS／22．5]；比较各组间BMI、WHR、HbA1C、HOMA—IR、CRP、IL-1β、肝肾功能、血压、血脂等指标及与MMSE评分之间的关系。结果（1）老年2型糖尿病组与老年非糖尿病组在年龄、性别、文化程度、家庭收入、是否吸烟、血压、血脂及肝肾功能等方面比较无明显差异（P〉0．05）；（2）与非糖尿病组相比，老年2型糖尿病组的BMI、WHR、HbA1c、HO—MA—IR、CRP及IL-1β显著升高（P〈0．05），而MMSE评分明显低于非糖尿病组（P〈0．01）；老年2型糖尿病组MMSE评分与WHR、HbA1C、HOMA-IR、CRP和IL-1β呈负相关。结论腹型肥胖、慢性高血糖、胰岛素抵抗及炎症反应可能是老年2型糖尿病患者认知功能障碍的相关因素。

The relationship between inflammatory factor and cognitive impairment of the elder with type 2 diabetes meliitus

Objective To investigate the relationship between inflammatory factor such as C-reactive protein and interleukin-1β and cognitive impairment of the elderly patients with type 2 diabetes mellitus. Methods Collecting 120 patients whom is older than 60 years old ,which includes 80 type 2 diabetes mellitus patients and 40 patients without diabetes mellitus. All the patients are graded by Mini-Mental State Examination, and their height, weight, waistline and hipline are measured. Counting Body Mass Index（BMI） and Weight Hip Rate（WHR）. Detecting interleukin-1β（IL-1β） by ELISA, C-reactive protein（CRP） by immune diffusion method, HbA1c by high pressure liquid chromatography, fasting blood-glucose（FBG） by glucose oxidase method, fasting serum insulin（FINS） by radioimmunoassay, and counting homeostasis model assessment- insulin resistance（HOMA-IR）. Comparing BMI, WHR, HbA1c , HOMA-IR, CRP, IL-1β, liver and kidney function, blood pressure,blood fat and MMSE among each group. Results （1）There is no difference of the age,sex,degree of education,family income,smoking or no,blood pressure,blood fat and liver- kidney function between the group of the elder with type 2 diabetes and the group of the elder without diabetes（P〉0. 05）; there is no difference of the age,sex,course of disease,degree of education,family income, smoking or no, blood pressure, blood fat and liver- kidney function between deficiency of spleen-kidney syndrome group and obstruction by phlegmblood stasis syndrome group（P〉0. 05）. （2）Compared with the group of the elder without diabetes, the level of BMI,WHR, HbA1c, HOMA-IR,CRP and IL-1β in the group of the elder with type 2 diabetes are increased （P〈0. 05）, and the level of MMSE is decreased, which has significant difference（P〈0. 01）. And the level of MMSE in the group of the elder with type 2 diabetes is negatively correlated with WHR, HbA1c, HOMA-IR,CRP and IL-1β. Conclusions Abdominal obesity, chronic hyperglycemia, insulin resistance and inflammatory response may be the related factors of cognitive impairment in the elderly patients with type 2 diabetes mellitus.