维生素C对老年2型糖尿病患者轻度认知功能障碍的影响及机制研究

Research on Mechanism and Effect of Vitamin C on Mild Cognitive Impairment in Type 2 Diabetes Mellitus Patients

目的探讨维生素C对老年2型糖尿病(T2DM)患者轻度认知功能障碍(MCI)的影响及可能机制。方法将患有MCI的老年T2DM患者随机分为对照组(30例)和试验组(30例)。对照组给予常规降糖治疗;试验组在常规治疗基础上加用维生素C0.2g,3次/d,疗程1年。于治疗前后分别采用简易精神状态量表(MMSE)、蒙特利尔认知量表(MoCA)评定两组患者的认知功能,并检测两组患者的氧化应激相关指标血清8-异前列腺素F2α(8-iso-PGF2α)。结果治疗前对照组患者的MMSE评分为(26.7±1.0)分,MoCA评分为(24.9±1.6)分;试验组患者的MMSE评分为(26.0±0.6)分,MoCA评分为(25.2±1.1)分,两组比较差异均无统计学意义(t值分别为-0.511和-0.625,P均>0.05)。治疗后对照组患者的MMSE及MoCA评分分别为(26.3±1.2)分和(26.2±1.4)分,试验组患者的MMSE及MoCA评分分别为(28.0±1.1)分和(28.3±1.2)分,两组比较差异均有统计学意义(t值分别为5.566和6.067,P均<0.01)。试验组患者血清8-iso-PGF2α水平治疗前为(50.8±21.9)ng/L,治疗后为(31.5±12.4)ng/L;对照组患者血清8-iso-PGF2α水平治疗前为(49.5±19.9)ng/L,治疗后为(46.7±21.2)ng/L,治疗前两组患者血清8-iso-PGF2α水平间差异无统计学意义(t=0.455,P>0.05),治疗后两组患者血清8-iso-PGF2α水平间差异有统计学意义(t=3.184,P<0.01)。结论维生素C能明显改善老年T2DM患者的MCI,具体机制可能与减轻氧化应激有关。

Objective To investigate the effects and possible mechanism of Vitamin C on mild cognitive impairment（MCI） in type 2 diabetes mellitus（T2DM） patients.Methods Senile T2DM patients with MCI were randomly divided into control group（30 cases） and experimental group （30 cases）.Patients from control group were given routine treatment,while patients from experimental group took additional Vitamin C 0.2g,3/d despite the routine treatment,with the course of treatment lasting one year.MMSE Scale and MoCA Scale were used and 8-iso-PGF2α was tested before and after the treatment respectively.Results Before treatment,there were no significant differences between control group and treatment group in MMSE scale,MoCA scale test and serum 8-iso-PGF2α 〔with MMSE （26.7±1.0） score,MoCA （24.9±1.6） score and 8-iso-PGF2α（49.5±19.9 ）ng/L in control group,and MMSE （26.0±0.6） score,MoCA （25.2±1.1）score and 8-iso-PGF2α（50.8±21.9） ng/L in treatment group,t=-0.511,-0.625 and 0.455,all P0.05〕;after treatment,significant differences was found between the two groups 〔with MMSE （26.3±1.2） score,MoCA （26.2±1.4）score and 8-iso-PGF2α（46.7±21.2） ng/L in control group,and MMSE （28.0±1.1）score,MoCA（28.3±1.2） score and 8-iso-PGF2α（31.5±12.4） ng/L in treatment group,t= 2.095,2.014 and 3.184,（all P0.01）〕.Conclusion Vitamin C could ameliorate the MCI of Senile T2DM patients,probably by alleviating oxidative-stress.