老年代谢综合征患者胰岛素抵抗,脑血流灌注及认知功能研究

目的 探究代谢综合征(MetS)及其组分糖尿病或糖耐量异常(DM/IGT)与认知功能的关系.方法 选取华山医院老年病科住院患者90例,其中代谢综合征(MS)伴DM/IGT组28例,MS不伴DM/IGT组30例,非MS组32例.入选对象计算胰岛素抵抗指数(HOMA-IR),进行韦氏智力量表测试及单光子发射型计算机体层摄影(SPECT)脑血流显像.结果 MS组大部分脑区脑区血流灌注明显低于非MS组,MS伴DM/IGT组在左基底节、右顶叶、右颞叶、扣带回血流灌注低于MS不伴DM/IGT组.MS伴DM/IGT组,不伴DM/IGT组,非MS组nQ依次降低.MS组HO-MA-IR高于非MS组,但伴或不伴DM/IGT两组之间无统计学差异.结论 MS增加老年性认知功能减退的危险.MS患者胰岛素抵抗增加及动脉硬化是两大重要致病原因.

Insulin resistance.cerebral blood flow and cognifive function in elderly patients with metabolic syn-drome

Objective To investigate the relationship between Metabolic Syndrome and cognitive impairment in old population.Methods Totally 90 patients hospitalized in Geriatric Department of Huashan Hospital were assigned to 3 groups according to diseases:MetS with DM/IGT,MetS without DM,Normal.All the patients were examined with SPECT and Wais-RC Test.Insulin resistance was estimated by the Insulin Resistance Index of Homeostasis Model Assessment.Results Significant differences were found in perfusions at most lobes in MetS patients with or without DM/IGT and in controls (P<0.05).We found perfusion at left basal ganglia,right parietal,right temporal and cingular gyrus were lower in MetS patients with DM/IGT than those without DM.FIQ declined gradually by groups of normal,MetS without DM/IGT and MetS with DM/IGT.HOMA-IR were higher in both MetS groups than in normal,but showed no different between MetS patients with and without DM/IGT.Conclusions MetS may be the risk factor of aging cognitive impairment.Accelerated cerebrovascular atherosclerosis and increased insulin resistance may contribute to cognitive decline in MetS patients.