血浆同型半胱氨酸水平与轻度认知功能障碍对老年2型糖尿病患者的影响

目的 分析血浆同型半胱氨酸（Hcy）水平与认知功能障碍对2型糖尿病患者的影响,并探讨影响认知功能的其他因素.方法 2型糖尿病患者80例,根据简易精神状态量表（MMSE）评分将2型糖尿病患者分为认知障碍组（38例）、非认知障碍组（42例）,选择健康对照者30名作为正常对照组.测定3组血浆Hcy、糖化血红蛋白、血脂、尿酸、24 h尿微量白蛋白等指标.结果 糖尿病认知障碍组、糖尿病非认知障碍组、正常对照组血浆Hcy浓度分别为（19.56±5.23）、（16.21 ±3.27）、（14.67 ±4.27）μmol/L,3组差异有统计学意义（F=3.76,P＜0.05）,且糖尿病认知障碍组血浆Hcy水平高于糖尿病非认知障碍组（P＜0.05）与正常对照组（P＜0.01）,糖尿病非认知障碍组高于正常对照组（P＜0.05）;影响患者认知功能的其他因素包括年龄、糖化血红蛋白、体质量指数、糖尿病病程及血浆Hcy水平,与患者MMSE评分呈负相关（r值分别为-0.336、-0.285、-0.226、-0.392、-0.312,P均＜0.05）.结论 年龄、糖尿病病程、糖化血红蛋白、体质量指数均可影响患者的认知功能,Hcy水平升高是2型糖尿病患者认知障碍的一个危险因素.

Effect of plasma homocysteine levels and mild cognitive dysfunction on elderly type 2 diabetes

Objective To investigate the effect of plasma homocysteine （Hcy） levels and cognitive dysfunction on patients with type 2 diabetes and explore the other factors that affect cognitive function.Methods 80 patients with type 2 diabetes were selected as our subjects and they were divided into cognitive impairment group （38 cases）,cognitive normal group （42 cases） according to a simple mental state scale（MMSE） score.The plasma Hcy,glycosylated hemoglobin,blood lipid,uric acid,24 h urine trace albumin were measured.Results Plasma Hcy concentration in diabetic cognitive dysfunction,non cognitive impairment group and normal control group respectively were（19.56 ± 5.23）,（16.21 ± 3.27）,（14.67 ± 4.27） tmol/L,and there was statistically significant difference（F =3.76,P ＜0.05）.The plasma Hcy levels in diabetic cognitive impairment group was higher than that non-cognitive impairment group（P ＜ 0.05） and normal control group （P ＜ 0.01）,The factors impaired cognitive function in patients with other factors included age,glycosylated hemoglobin,body mass index,diabetes duration and plasma Hcy levels,and there were negative correlation with MMSE score （r =-0.336,-0.285,-0.226,-0.392,-0.312 ; all P values were less than 0.05）.Conclusion Patient＇s age,duration of diabetes,glycosylated hemoglobin and BMI can affect cognitive function in patients.Higher Hcy levels in patients with type 2 diabetes is a risk factor for cognitive impairment.