摘要
目的基于核苷酸结合寡聚化结构域样受体3/半胱氨酸蛋白酶-1(NLRP3/caspase-1)信号通路探究二甲双胍对2型糖尿病(T2DM)合并脑卒中患者认知功能的改善作用。方法选取2021年2月至2022年5月就诊于邯郸市中心医院的63例T2DM,按照随机数字表法将其分为对照组(n=32)与试验组(n=31),对照组给予钠-葡萄糖共转运蛋白2抑制剂(SGLT-2i)类药物治疗,试验组在对照组基础上给予二甲双胍治疗,两组患者均连续治疗12周。收集患者临床资料,对比治疗前后两组简易精神量表(MMSE)得分、蒙特利尔认知评估量表(MoCA)得分、空腹血糖(FBG)、糖化血红蛋白(HbA1c)、餐后2小时血糖(2 hPBG)、外周单核细胞中NLRP3炎性小体蛋白表达水平、caspase-1蛋白表达水平及血清IL-8、IL-1β水平;采用Pearson线性相关分析治疗后NLRP3、caspase-1、IL-18、IL-1β与FBG的相关性。结果治疗后,试验组MMSE、MoCA得分均增高,且明显高于对照组(P<0.05),试验组FBG、HbA1c、2 h PBG水平低于对照组(P<0.05),试验组NLRP3、caspase-1蛋白水平和IL-18、IL-1β水平较对照组明显更低(P<0.05);经Pearson线性相关分析显示,治疗后NLRP3、caspase-1、IL-18、IL-1β与FBG呈正相关(P<0.05)。结论二甲双胍治疗能够改善T2DM合并脑卒中患者的认知功能,降低血糖水平和炎症反应,这可能与其对NLRP3/caspase-1信号通路的调节作用有关。
Objective To explore the effect of metformin on the improvement of cognitive function in patients with type 2 diabetes mellitus(T2DM)complicated by stroke based on nucleotide-binding oligomerization domain-like receptor protein 3/cysteine-dependent aspartate-directed protease 1(NLRP3/caspase-1)signaling pathway.Methods A total of 63 patients with T2DM in Handan Central Hospital from February 2021 to May 2022 were included and randomly divided into a control group(n=32)and an experimental group(n=31)based on a computer-generated random number table.Both groups were treated with sodium-dependent glucose transporters 2 inhibitor(SGLT-2i),and the experimental group was additionally given metformin.Both groups received continuous treatment for 12 weeks.Clinical data of both groups were collected.Comparative analyses were performed between the two groups before and after treatment for the following parameters:Mini-Mental State Examination(MMSE)scores,Montreal Cognitive Assessment(MoCA)scores,fasting blood glucose(FBG),hemoglobin A1c(HbA1c),2-hour postprandial blood glucose(2hPBG),nucleotide-binding oligomerization domain-like receptor protein 3(NLRP3)inflammasome protein expression levels in peripheral monocytes,cysteine-dependent aspartate-directed protease 1(caspase-1)protein expression levels,and serum interleukin-8(IL-8)and interleukin-1β(IL-1β)levels.The correlation between NLRP3,caspase-1,IL-18,IL-1βand FBG after treatment was analyzed by Pearson linear analysis.Results After treatment,the scores of MMSE and MoCA in the experimental group increased compared with those before treatment,and the scores were higher than those in the control group(P<0.05).Compared to the control group,the experimental group demonstrated lower FBG,HbA1c,and 2hPBG levels(P<0.05),along with reduced protein expression levels of NLRP3 and caspase-1,and serum levels of IL-18 and IL-1β(P<0.05).Pearson linear analysis revealed a positive relationship between NLRP3,caspase-1,IL-18,IL-1βand FBG after treatment(P<0.05).Conclusion Metformin therapy improves cognitive function,reduces hyperglycemia,and attenuates inflammatory responses in T2DM patients complicated by stroke,which may be related to its regulatory effect on the NLRP3/caspase-1 signaling pathway.
作者
马晓伟
王立哲
王相斌
冯文霞
Ma Xiaowei;Wang Lizhe;Wang Xiangbin;Feng Wenxia(Department of Neurology,Handan Central Hospital,Handan 056001,China;Department of Rehabilitation Medicine,Handan Central Hospital,Handan 056001,China)
出处
《成都医学院学报》
2025年第5期782-785,共4页
Journal of Chengdu Medical College
基金
河北省科学技术厅课题(No:20191472)。
关键词
2型糖尿病
二甲双胍
脑卒中
认知功能
核苷酸结合寡聚化结构域样受体3/半胱氨酸蛋白酶-1信号通路
Type 2 diabetes mellitus
Metformin
Stroke
Cognitive function
Nucleotide-binding oligomerization domain-like receptor protein 3/cysteine-dependent aspartate-directed protease 1 signaling pathway
