糖尿病临床研究

　　【摘要】目的 探讨T2DM患者轻度认知障碍(MCI)与海马体积及血清抵抗素的关系。方法 用蒙特利尔认知评估(MoCA)量表测评认知功能，选择T2DM+MCI组25例，单纯T2DM组35例，以及正常对照(NC)组25例。行磁共振海马成像，测定HbA1c及血清抵抗素水平。结果 T2DM+MCI组海马体积[左侧(2.42±0.31)，右侧(2.44±0.35)cm3]<其他两组(P <0.05);抵抗素(15.36±0.22)ng/ml高于其他两组(P<0.05)。相关分析显示，MoCA评分与海马体积呈正相关(左侧r=0.858, P<0.01;右侧r=0.537, P=0.006)，抵抗素与海马体积呈负相关(左侧r=-0.550, P=0.004，右侧r=-0.519, P=0.008);多元回归分析显示，抵抗素(β=-0.559, P<0.01)、HbA1c (β=-0.442, P=0.003)是MoCA评分的影响因素。结论 T2DM合并MCI与海马体积缩小相关;HbA1c及抵抗素是T2DM合并MCI的危险因素。

　　【关键词】糖尿病，2型;轻度认知障碍;蒙特利尔认知评估;海马体积;抵抗素

　　[Abstract] Objective To explore the relationships of mild cognitive impairment (MCI)with hippocampal volume and resistin. Methods Cognitive function was assessed with MoCA(Beijing Version)scale. 25 T2DM patients with MCI(T2DM+MCI group), 35 T2DM patients without MCI (T2DM group) and 25 subjects as normal control (NC group) were compared. All the subjects underwent magnetic resonance imaging(MRI)to calculate hippocampal volumes. Glycosylated hemoglobin(HbA1c) and serum resist in were also determined. Results In MCI group versus T2DM group and NC group, the bilateral hippocampal volumes left [ (2.42±0.31)，right (2.44±0.35)cm3]were significantly decreased in (all P<0.05), while the level of resistin was higher in MCI group (15.36±0.22) ng/ml(all P<0.05). In MCI group, MoCA scores were positively correlated with bilateral hippocampal volumes (r=0.858, P<0.01 for the left, and r=0.537, P=0.006 for the right), while resistin was negatively correlated with bilateral hippocampal volumes (r=-0.550, P=0.004 for the left, and r=-0.519, P=0.008 for the right).Multiple regression analysis suggested that serum resistin (β=-0.559, P<0.01) and HbA1c (β=-0.442, P=0.003) were the influencing factors of MoCA scores. Conclusion MCI in T2DM is associated with the reduction of hippocampal volumes. HbA1c and resistin may be the risk factors for diabetic cognitive impairment.

　　[Key words]Diabetes mellitus, type 2; Mildcognitive impairment (MCI); Montreal Cognitive Assessment (MoCA); Hippocampal volume;Resistin