摘要
目的探讨老年糖尿病合并认知功能障碍患者血清25-羟维生素D[25(OH)D]、β2微球蛋白(β2-MG)水平及临床意义。方法回顾性分析2019年1月至2022年1月在南京大学医学院附属盐城第一医院就诊的80例老年糖尿病患者的临床资料,根据患者是否存在认知功能障碍分为认知功能障碍组(38例)和认知功能正常组(42例)。比较两组一般资料,检测血脂、血糖、25(OH)D、β2-MG水平。老年糖尿病患者合并认知功能障碍的危险因素采用多因素logistic回归性分析明确;通过受试者操作特征曲线(ROC)分析25(OH)D、β2-MG预测老年糖尿病患者合并认知功能障碍的价值。结果认知功能障碍组高血压、微血管病变、脑白质病变患者的占比及糖化血红蛋白(HbA1c)、胰岛素抵抗指数(HOMA-IR)、β2-MG高于认知功能正常组,25(OH)D低于认知功能正常组(P<0.05)。logistic回归分析显示,高血压(OR=2.714,95%CI:1.258~5.855)、微血管病变(OR=2.542,95%CI:1.176~5.495)、脑白质病变(OR=2.669,95%CI:1.223~5.825)、HbA1c(OR=3.648,95%CI:1.483~8.974)、HOMA-IR(OR=3.841,95%CI:1.520~9.706)、25(OH)D(OR=3.144,95%CI:1.316~7.511)、β2-MG(OR=3.356,95%CI:1.417~7.948)是老年糖尿病患者合并认知功能障碍的影响因素(P<0.05)。经ROC分析,25(OH)D、β2-MG预测老年糖尿病患者合并认知功能障碍的曲线下面积分别为0.753、0.744(P<0.05)。结论25(OH)D、β2-MG水平与认知功能障碍显著相关,监测25(OH)D、β2-MG水平在早期识别老年糖尿病合并认知功能障碍中具有重要的临床意义。
Objective To investigate the serum levels of 25-hydroxyvitamin D(25[OH]D)andβ2 microglobulin(β2-MG)in elderly patients with diabetes mellitus complicated with cognitive dysfunction and their clinical significance.Methods The clinical data of 80 elderly patients with diabetes treated in Yancheng First Hospital Affiliated to Nanjing University School of Medicine from January 2019 to January 2022 were retrospectively analyzed.According to whether the patients had cognitive impairment,they were divided into cognitive impairment group(38 cases)and normal cognitive function group(42 cases).The general data of the two groups were compared,and the levels of blood lipids,blood sugar,25(OH)D,andβ2-MG were detected.Multivariate logistic regression analysis was used to determine the risk factors of cognitive dysfunction in elderly diabetic patients.Receiver operator characteristic curve(ROC)was used to analyze the predictive value of 25(OH)D andβ2-MG in elderly diabetic patients with cognitive dysfunction.Results The proportion of patients with hypertension, microangiopathy, leukoencephalopathy, glycated hemoglobin(HbA1c), insulin resistance index(HOMA-IR) and β2-MG in cognitive impairment group were higher than those in normal cognitive function group, and 25(OH)D was lower than that in normal cognitive function group (P<0.05). Logistic regression analysis showed that hypertension (OR=2.714, 95%CI:1.258-5.855), microangiopathy (OR=2.542, 95%CI:1.176-5.495), white matter lesions (OR=2.669, 95%CI:1.176-5.495), HbA1c (OR=3.648, 95%CI:1.483-8.974), HOMA-IR (OR=3.841, 95%CI:1.520-9.706), 25(OH)D (OR=3.144, 95%CI:1.316-7.511) and β2-MG (OR=3.356, 95%CI:1.417-7.948) were influencing factors for cognitive dysfunction in elderly patients with diabetes mellitus (P<0.05). ROC analysis showed that the areas under the curve of 25(OH)D and β2-MG in predicting cognitive dysfunction in elderly diabetic patients were 0.753 and 0.744, respectively (P<0.05). Conclusion Monitoring the level of 25(OH)D and β2-MG have important clinical significance in early recognition of cognitive impairment in elderly diabetes mellitus.
作者
单湘湘
詹江萍
周建平
任向东
范仁根
SHAN Xiangxiang;ZHAN Jiangping;ZHOU Jianping;REN Xiangdong;FAN Rengen(Department of Geriatrics,Yancheng First Hospital Affiliated to Nanjing University School of MedicineYancheng First People’s Hospital,Jiangsu Province,Yancheng224000,China;Department of Endocrinology,Yancheng First Hospital Affiliated to Nanjing University School of MedicineYancheng First People’s Hospital,Jiangsu Province,Yancheng224000,China;Department of General Surgery,Yancheng First Hospital Affiliated to Nanjing University School of MedicineYancheng First People’s Hospital,Jiangsu Province,Yancheng224000,China)
出处
《中国医药导报》
CAS
2023年第12期82-85,共4页
China Medical Herald
基金
江苏省第五期“333工程”科研资助立项项目(BRA2018251)。
