2型糖尿病患者血清Trx、Txnip与认知功能的相关性

摘要：目的  探讨2型糖尿病（T2DM）患者血清硫氧还蛋白（Trx）、硫氧还蛋白互作蛋白（Txnip）水平及Trx活性与认知功能的相关性，为T2DM患者认知功能障碍的防治提供新思路。方法  选取2014～2015年在河北省唐山市工人医院内分泌科住院的T2DM患者100例作为病例组，同时选取正常健康人群90例作为对照组。收集以上所有研究对象的人口学资料（年龄、性别、教育程度、体重指数、病程等）及临床生化指标[空腹血糖（FPG）、糖化血红蛋白（HbA1C）、总胆固醇（TC）、三酰甘油（TG）、高密度脂蛋白（HDL）、低密度脂蛋白（LDL）]，并进行认知功能量表（RBANS）（包括即时记忆、视觉广度、言语功能、注意力、延迟记忆）评分。血清Trx、Txnip水平采用酶联免疫吸附法检测，Trx活性采用胰岛素还原法检测。结果  ①与正常对照组比较，T2DM患者FPG、HbA1C、TG、Trx、Txnip水平升高（P <0.05），Trx活性降低（P <0.05）；②与正常对照组比较，T2DM患者RBANS量表即时记忆、延迟记忆、总分降低（P <0.05）；③在T2DM患者患者中血清Trx、Txnip水平与空腹血糖、糖化血红蛋白呈正相关（P <0.05），Trx活性与Txnip水平呈负相关（P <0.05）；④血清Trx、Txnip水平与RBANS量表延迟记忆、总分呈负相关（P <0.05）；Trx活性与其呈正相关（P <0.05）。结论  血清Trx、Txnip升高，以及Trx活性降低可能是T2DM患者出现认知功能障碍的一个危险因素。

Correlations of serum Trx, Txnip and Trx activity with cognitive function in patients with type 2 diabetes mellitus

Abstract: Objective To explore the relationship between the cognitive function and serum thioredoxin (Trx) and thioredoxin-interacting protein (Txnip) levels, and Trx activity in type 2 diabetic patients, so as to provide new ideas for prevention and treatment of cognitive impairment in these patients. Methods A total of 100 patients with type 2 diabetes mellitus who were hospitalized into Department of Endocrinology, Tangshan Gongren Hospital from 2014 to 2015 were enrolled as case group, at the same time, 90 healthy people were selected as control group. Demographic data (age, gender, education level, BMI, duration of disease, etc.) and clinical biochemical indicators (FPG, HbA1c, TC, TG, HDL and LDL) of all the research objects were collected. The cognitive function scale (RBANS) (including immediate memory, vision span, speech function, attention and delayed memory) scores were evaluated. The serum Trx and Txnip levels were detected by ELISA, the activity of Trx was tested by insulin reduction assay. Results Compared with the control group, FPG, HbA1C, TG, Trx and Txnip levels increased in the case group (P < 0.05), but Trx activity decreased in the case group (P < 0.05). Compared with the control group, RBANS scores including immediate memory, delayed memory and total scores were lowered in the T2DM patients (P < 0.05). In the case group, the serum Trx and Txnip levels were positively associated with fasting blood glucose and glycosylated hemoglobin (P < 0.05), the activity of Trx was negatively correlated with the level of Txnip (P < 0.05). The serum Trx and Txnip levels were negatively correlated with and the activity of Trx was positively correlated with the total RBANS scale score and the delayed memory score (P < 0.05). Conclusions The increased serum Trx and Txnip and decreased Trx activity may be risk factors for cognitive dysfunction in patients with type 2 diabetes mellitus.