2型糖尿病轻度认知功能障碍脾虚型及TOMM40基因等相关因素的研究
发布时间：2018-11-27 16:22
【摘要】：目的： 通过研究中医脾虚证及TOMM40基因(translocase of outer mitochondrial membrane40homolog)rs10524523位点的多态性与2型糖尿病轻度认知功能障碍(mild cognitive impairment, MCI)的关系,进一步明确2型糖尿病MCI的危险因素和发病机理,为中西医结合在2型糖尿病MCI的治疗思路上提供循证依据。 对象与方法： 176例2型糖尿病患者,进行蒙特利尔认知评估表(Montreal Cognitive Assessment, MoCA)、工具性日常生活工具量表(Instrumental Activities of Daily Living, IADL)简易精神状态量表(Mini-mental state examination, MMSE)等量表的评测。同时,检测其TOMM40基因rs10524523的多态性及红细胞、血红蛋白、白蛋白等血生化指标。参照欧洲阿尔茨海默病协会制定的标准(2006)将研究对象分为2型糖尿病MCI组104例和2型糖尿病非MCI组(对照组)72例,2型糖尿病MCI组又根据中医辨证分为脾虚证组56例及非脾虚证组48例,比较各组的基因频率及各项临床数据。 结果： (1)2型糖尿病MCI组和2型糖尿病非MCI组相比较,其糖尿病病程长,HbAlC、CRP、 TG、LDL升高明显,MoCA评分等方面均有显著统计学差异(P0.01)；CHOL水平及T0MM40基因rs10524523缺失基因型分布差异具有统计学意义(x2=4.252P0.05)；在性别、年龄、BMI、HDL、腹围、有无高血压病病史、吸烟史、家族史等方面差异无统计学意义。 (2)2型糖尿病MCI脾虚证组与非脾虚证组相比较,其红细胞、血红蛋白、血清白蛋白等血生化指标均有差异,且有统计学意义(P0.05)；TOMM基因rs10524523缺失基因型的分布差异也具有统计学意义(x2=4.148P0.05)。而在年龄、性别、糖尿病病程、HbAlC、CRP、血脂水平等方面均无统计学差异。 结论： (1)MCI与2型糖尿病患者的病程长短、血脂水平、血糖控制情况与有关。 (2)脾虚是2型糖尿病MCI的发病机制中很重要的一方面。从脾论治、健脾益气是中医治疗2型糖尿病MCI很重要的一方面。 (3)检测TOMM4G基因rs10524523的多态性可以在一定程度上提示2型糖尿病患者认知功能障碍风险。 (4)从脾论治、健脾益气的中医辨证论治法则与西医基因检测方法互补在诊断治疗2型糖尿病MCI方面更能发挥巨大作用。
[Abstract]:Objective: to study the relationship between the polymorphism of rs10524523 locus of spleen deficiency syndrome and TOMM40 gene (translocase of outer mitochondrial membrane40homolog and (mild cognitive impairment, MCI) in type 2 diabetes mellitus. To further clarify the risk factors and pathogenesis of type 2 diabetes mellitus (MCI), to provide evidence-based basis for the treatment of type 2 diabetes mellitus MCI with the combination of traditional Chinese and western medicine. Participants and methods: 176 patients with type 2 diabetes mellitus received Montreal Cognitive Assessment form (Montreal Cognitive Assessment, MoCA),) instrumental Daily living tool scale (Instrumental Activities of Daily Living, IADL), simple Mental State scale (Mini-mental state examination,). MMSE) and other scales. At the same time, the polymorphism of TOMM40 gene rs10524523 and blood biochemical indexes such as erythrocyte, hemoglobin and albumin were detected. According to the European Alzheimer's Association criteria (2006), the subjects were divided into two groups: type 2 diabetes mellitus (MCI) group (104 cases) and type 2 diabetes (non-MCI group) (control group) (72 cases). Type 2 diabetes mellitus MCI group was divided into spleen deficiency syndrome group (56 cases) and non-spleen deficiency syndrome group (48 cases) according to TCM syndrome differentiation. The gene frequency and clinical data of each group were compared. Results: (1) the duration of diabetes was longer, the HbAlC,CRP, TG,LDL was significantly increased and the MoCA score was significantly higher in type 2 diabetes mellitus than that in type 2 diabetes non-MCI group (P0.01). The CHOL level and the genotype distribution of T0MM40 rs10524523 deletion were statistically significant (x2=4.252P0.05), but there were no significant differences in sex, age, BMI,HDL, abdominal circumference, hypertension history, smoking history, family history and so on. (2) compared with non-spleen deficiency syndrome group and type 2 diabetes mellitus MCI spleen deficiency group, the blood biochemical indexes such as erythrocyte, hemoglobin and serum albumin were significantly different (P0.05); The distribution of rs10524523 deletion genotype of TOMM gene was also significantly different (x2=4.148P0.05). However, there were no significant differences in age, sex, course of diabetes, HbAlC,CRP, level of blood lipid and so on. Conclusion: (1) the duration of MCI and type 2 diabetes mellitus, blood lipid level and blood glucose control were related. (2) spleen deficiency is an important aspect in the pathogenesis of type 2 diabetes mellitus (MCI). From the point of view of spleen treatment, invigorating spleen and supplementing qi is one of the important aspects of TCM treatment of type 2 diabetes mellitus (MCI). (3) Detection of TOMM4G gene rs10524523 polymorphism may suggest the risk of cognitive dysfunction in type 2 diabetes mellitus. (4) the rule of TCM differentiation and treatment of invigorating spleen and invigorating qi and the method of gene detection of western medicine can play a more important role in the diagnosis and treatment of type 2 diabetes mellitus (MCI).
【学位授予单位】：福建中医药大学
【学位级别】：硕士
【学位授予年份】：2012
【分类号】：R749.16
本文编号：2361425
[Abstract]:Objective: to study the relationship between the polymorphism of rs10524523 locus of spleen deficiency syndrome and TOMM40 gene (translocase of outer mitochondrial membrane40homolog and (mild cognitive impairment, MCI) in type 2 diabetes mellitus. To further clarify the risk factors and pathogenesis of type 2 diabetes mellitus (MCI), to provide evidence-based basis for the treatment of type 2 diabetes mellitus MCI with the combination of traditional Chinese and western medicine. Participants and methods: 176 patients with type 2 diabetes mellitus received Montreal Cognitive Assessment form (Montreal Cognitive Assessment, MoCA),) instrumental Daily living tool scale (Instrumental Activities of Daily Living, IADL), simple Mental State scale (Mini-mental state examination,). MMSE) and other scales. At the same time, the polymorphism of TOMM40 gene rs10524523 and blood biochemical indexes such as erythrocyte, hemoglobin and albumin were detected. According to the European Alzheimer's Association criteria (2006), the subjects were divided into two groups: type 2 diabetes mellitus (MCI) group (104 cases) and type 2 diabetes (non-MCI group) (control group) (72 cases). Type 2 diabetes mellitus MCI group was divided into spleen deficiency syndrome group (56 cases) and non-spleen deficiency syndrome group (48 cases) according to TCM syndrome differentiation. The gene frequency and clinical data of each group were compared. Results: (1) the duration of diabetes was longer, the HbAlC,CRP, TG,LDL was significantly increased and the MoCA score was significantly higher in type 2 diabetes mellitus than that in type 2 diabetes non-MCI group (P0.01). The CHOL level and the genotype distribution of T0MM40 rs10524523 deletion were statistically significant (x2=4.252P0.05), but there were no significant differences in sex, age, BMI,HDL, abdominal circumference, hypertension history, smoking history, family history and so on. (2) compared with non-spleen deficiency syndrome group and type 2 diabetes mellitus MCI spleen deficiency group, the blood biochemical indexes such as erythrocyte, hemoglobin and serum albumin were significantly different (P0.05); The distribution of rs10524523 deletion genotype of TOMM gene was also significantly different (x2=4.148P0.05). However, there were no significant differences in age, sex, course of diabetes, HbAlC,CRP, level of blood lipid and so on. Conclusion: (1) the duration of MCI and type 2 diabetes mellitus, blood lipid level and blood glucose control were related. (2) spleen deficiency is an important aspect in the pathogenesis of type 2 diabetes mellitus (MCI). From the point of view of spleen treatment, invigorating spleen and supplementing qi is one of the important aspects of TCM treatment of type 2 diabetes mellitus (MCI). (3) Detection of TOMM4G gene rs10524523 polymorphism may suggest the risk of cognitive dysfunction in type 2 diabetes mellitus. (4) the rule of TCM differentiation and treatment of invigorating spleen and invigorating qi and the method of gene detection of western medicine can play a more important role in the diagnosis and treatment of type 2 diabetes mellitus (MCI).
【学位授予单位】：福建中医药大学
【学位级别】：硕士
【学位授予年份】：2012
【分类号】：R749.16
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