中老年2型糖尿病认知功能障碍患者血清IGF-1的水平研究

发布时间：2018-06-26 00:09

本文选题：2型糖尿病 + 蒙特利尔认知评估　；参考：《山东大学》2012年硕士论文

【摘要】：目的：探讨2型糖尿病认知功能障碍的特点血清胰岛素样生长因子-1(insulin-like growth factor-1, IGF-1)水平与其之间的相关性,并进一步分析影响认知功能的其他因素如胰岛素抵抗、血糖控制程度、血脂代谢和血压等。方法：选择本院内分泌科2011年12月-2012年3月份入院2型糖尿病病人78例,根据蒙特利尔认知评估量表(MoCA)测评,将2型糖尿病患者分为糖尿病认知障碍组(39例)、糖尿病非认知障碍组(39例)。对所有入选患者收集临床一般资料包括一般情况、既往病史、用药情况及生活习惯等,采用酶联免疫吸附法(enzyme-linked immunosorbent assay, ELISA)测定血清IGF-1水平,并山东省立医院化验室统一测定空腹胰岛素、C肽、空腹血糖、糖化血红蛋白、血脂,同时记录体重指数、血压等指标,HOMA-IR模型计算胰岛素抵抗指数。对评定和记录的结果进行记录整理,剔除不符合要求者或中途退出检查者。所有数据SPSS18.0进行统计分析。结果：2011年11月年至2012年3月共筛选出符合条件T2DM患者78例,其中糖尿病认知障碍者39例、糖尿病非认知障碍者39例,其中单纯T2DM18例,T2DM仅合并高血压者14例,T2DM仅合并血脂异常者20例；T2DM同时合并高血压和血脂异常者26例。 1.2型糖尿病认知障碍组与非认知障碍组比较,体重指数、血压、高密度脂蛋白、糖尿病病程以及空腹血糖和C肽、糖尿病并发症累及系统数差异无统计学意义,教育程度、低密度脂蛋白、总胆固醇、甘油三酯、胰岛素抵抗指数(HOMA-IR)、空腹胰岛素、糖化血红蛋白、血清IGF-1水平差异有统计学意义(P0.05)。 2.糖尿病认知障碍组血清IGF-1水平低于糖尿病非认知障碍组(P0.05)。 3.2型糖尿病患者的MoCA评分与LDL、TC、TG、HbAlc、HOMA-IR、空腹胰岛素呈负相关(r分别=-0.411、-0.498、-0.414、-0.452、-0.539、-0.449,P均0.05),与受教育年限、IGF-1呈正相关(r=0.579、0.491,P均0.05)。 4.两组患者MoCA量表中在视结构空间与语言、抽象、延迟记忆、定向、总分等项检查结果比较差异具有统计学意义(均P0.05),在命名、注意方面差异无统计学意义(均P0.05)。结论： 1.T2DM可导致中老年人群认知功能损害,记忆、执行功能和视空间结构功能损害更加明显。 2.教育程度低下、血糖控制不佳、胰岛素抵抗及血脂代谢紊乱与2型糖尿病认知障碍密切相关。 3.血清IGF-1水平下降是2型糖尿病患者认知功能下降的一个危险因素。
[Abstract]:Objective: to investigate the relationship between the level of serum insulin-like growth factor-1 (IGF-1) and cognitive impairment in type 2 diabetes mellitus, and to analyze other factors influencing cognitive function such as insulin resistance and blood glucose control. Metabolism of blood lipids and blood pressure. Methods: 78 patients with type 2 diabetes mellitus admitted to our hospital from December 2011 to March 2012 were assessed with the Montreal Cognitive Assessment scale (MoCA). Type 2 diabetic patients were divided into diabetic cognitive impairment group (39 cases) and diabetic non-cognitive disorder group (39 cases). General clinical data including general information, past medical history, drug use and living habits were collected from all patients. Serum IGF-1 levels were measured by enzyme-linked immunosorbent assay (Elisa). The fasting insulin C peptide, fasting blood glucose, glycosylated hemoglobin, blood lipids, body mass index and blood pressure were measured in laboratory of Shandong Provincial Hospital. HOMA-IR model was used to calculate insulin resistance index. Record the results of the evaluation and record, and eliminate those who do not meet the requirements or exit the check. All data were analyzed by SPSS 18.0. Results: from November 2011 to March 2012, 78 patients with T2DM were selected, including 39 patients with diabetic cognitive impairment and 39 patients with diabetes non-cognitive impairment. Among them, there were only 18 cases of T2DM with hypertension and 14 cases of T2DM with dyslipidemia. There were 20 cases of T2DM complicated with hypertension and 26 cases of dyslipidemia. The body mass index (BMI), blood pressure (BP) of type 1.2 diabetic cognitive impairment group were compared with those of non-cognitive disorder group. High density lipoprotein (HDL), course of diabetes, fasting blood glucose and C peptide, diabetic complications involved no significant difference in the number of system, education, low density lipoprotein, total cholesterol, triglyceride, There were significant differences in insulin resistance index (HOMA-IR), fasting insulin, glycosylated hemoglobin and serum IGF-1 levels (P0.05). The level of serum IGF-1 in diabetic cognitive impairment group was lower than that in diabetic non-cognitive impairment group (P0.05). The MoCA score of type 3.2 diabetic patients was negatively correlated with the level of HbAlcl HOMA-IRR and fasting insulin (r = -0.411 ~ -0.498U -0.445 ~ -0.452- 0.539- 0.449p 0.05), and positively correlated with the years of education and IGF-1 (r = 0.579n 0.491g, P < 0.05). There were significant differences in visual structure space and language, abstraction, delayed memory, orientation, total score between the two groups (P0.05), but there was no significant difference in naming and attention (P0.05). Conclusion: 1. T2DM can lead to cognitive impairment, memory, executive function and visual spatial structure impairment. 2. 2. Low level of education, poor control of blood glucose, insulin resistance and dyslipidemia were closely related to cognitive impairment of type 2 diabetes mellitus. The decrease of serum IGF-1 level is a risk factor for cognitive impairment in type 2 diabetes mellitus.
【学位授予单位】：山东大学
【学位级别】：硕士
【学位授予年份】：2012
【分类号】：R587.1;R749.2

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