老年2型糖尿病患者血清胱抑素C水平与轻度认知损害的相关性

目的探讨老年2型糖尿病(type 2diabetes mellitus,T2DM)患者血清胱抑素C(cystatin C,Cys C)水平与轻度认知损害(mild cognitive impairment,MCI)的关系,并分析MCI发生的相关危险因素。方法老年2型糖尿病患者156例分为MCI组与认知功能正常组;均使用简易智能状态检查量表、蒙特利尔认知评估量表、焦虑自评量表、流调用抑郁自评量表、帕金森病筛查量表、日常生活能力量表、全面衰退量表等进行测验,并检测Cys C、糖化血红蛋白、三酰甘油、总胆固醇和血压等;进行t检验、直线相关及Logistic回归模型分析。结果伴有MCI的老年T2DM患者血清Cys C水平明显升高(P=0.018);血清Cys C与简易智能状态检查量表总分、蒙特利尔认知评估量表总分及视空间与执行功能、命名、注意、语言和延迟回忆得分均存在负相关(P<0.001);Logistic回归分析最终进入方程的是:糖尿病病程、高血压、糖化血红蛋白和Cys C水平。结论老年T2DM患者发生MCI存在多种危险因素,除糖尿病病程、糖化血红蛋白水平、血压水平外,血清Cys C水平升高可能也是其危险因素之一,但有待大样本调查进一步验证。

Association of serum cystatin C and risk of mild cognitive impairment in elderly patients with type 2 diabetes mellitus

ObjectiveTo investigate the association of serum Cystatin C level and mild cognitive impairment(MCI) in elderly people with type 2 diabetes mellitus(T2DM) and to analyze the risk factors for MCI. MethodsA total of 156 elderly people with type 2 diabetes mellitus were divided into two groups: MCI and normal cognition(NC) group. All subjects were evaluated with cognition scores of Mini-mental state examination(MMSE), Montreal Cognitive Assessment(MoCA), Self-Rating Anxiety Scale(SAS), Center for Epidemiogical Studies Depression Scale(CES-D), Screening Scale for Parkinson disease (SSPD), Activity of Daily Living(ADL), and Global Deterioration Scale(GDS). CystatinC, HbA1c, triglyceride(TG), total cholesterol(TC), and blood pressure were examined. Independent t-test, correlations and logistic regression analysis were performed. ResultsThe elderly diabetic patients complicated with MCI showed a higher level of serum Cystatin C than those in NC group (P=0.018). Cystatin C was negatively correlated with the score of MMSE, and score, visuospatial/executive, naming, attention, language and delayed recall of MOCA (P<0.001). Logistic regression analysis showed that diabetes duration, hypertension, HbA1c and Cystatin C were the variables of the equation. ConclusionMultiple risk factor including the higher level of serum Cystatin C may induce MCI in elderly T2DM people, but larger sample study is needed for further verification.