2型糖尿病住院患者伴轻度认知功能障碍与肿瘤坏死因子α-308A／G基因多态性及其他因素的关系

Relationship between polymorphism of tumor necrosis factor alpha gene 308A/G and other factors and mild cognitive impairment in inpatients with type 2 diabetes mellitus

目的探讨2型糖尿病（type2diabetesmellitus，T2DM）住院患者伴轻度认知功能障碍（mildcognitiveimpairment．MCI）与肿瘤坏死因子α（TNF一仅）一308A／G基因多态性及其他因素的关系。方法于2008年5月至2009年3月，选取60例合并MCI的T2DM住院患者作为病例组，120例认知功能正常的T2DM住院患者作为对照组，进行问卷调查、体格检查、实验室检查和认知功能检测。抽取空腹肘正中静脉血2ml，EDTA抗凝，应用聚合酶链反应一限制性片段长度多态性（PCR—RFLP）方法检测TNF—α基因多态性。采用非条件多因素logistic回归模型对T2DM患者合并MCI的相关因素进行多因素分析，计算比值比（OR）及其95％可信区间（95％CI）。结果病例组与对照组的T2DM病程，周围神经病变、高血压、糖化血红蛋白（HbA1C）分布的差异均有统计学意义（P〈0．01）。病例组与对照组TNF—α基因型频率及其等位基因频数差异均有统计学意义（P〈0．05，P〈0．01）。多因素非条件logistic回归分析结果显示，经年龄和文化程度调整后，糖尿病病程（OR=2．458，95％CI：1．365—4．429）、HbA1C≥8．0％（OR=6．620，95％CI：2．351—18．640）、周围神经病变（OR=3．605，95％CI：1．323～9．820）和携带TNF一αA等位基因（OR=5．378，95％CI：1．846—15．666）与T2DM住院患者合并MCI有关。结论病程长、HbA，。高、周围神经病变和携带TNF—dA等位基因可能与T2DM住院患者合并MCI高风险有关。

Objeαive To explore the relationship between polymorphism of tumor necrosis faαor alpha （TNF-c） gene 308A/G and other faαors and mild cognitive impairment （MCI） in inpatients with type 2 diabetes mellitus （T2DM）. Methods During May 2008 to March 2009, 60 T2DM inpatients with MCI and 120 T2DM inpatients without MCI were recruited. The questionnaires, physical examination, laboratory test and cognitive funαion deteαion were conduαed, and the polymorphism of the TNF-α gene-308A/G was deteαed by polymerase chain reaαion-restriαion fragment length polymorphism （PCR-RFLP） for all subjeαs. The related faαors for T2DM patients with MCI were analyzed with the non-condition multiple faαor logistic regression. Odds ratio （OR） and 95% confidence interval （95%CI） were calculated. Results The non-condition multiple faαor logistic regression showed that after adjusting the age and education, the diabetic duration, I-IbAtc 1〉 8.0%, peripheral neuropathy and A allele of TNF-ot gene were related to T2DM inpatients with MCI. The OR values were 2.458 （95%CI： 1.365-4.429）, 6.620 （95%CI： 2.351-18.640）, 3.605 （95%CI： 1.323-9.820）, and 5.375 （95%CI： 1.846-15.666）, respeαively. Conclusion Long diabetic duration, high HbAm level, peripheral neuropathy and A allele of TNF-ot gene may relate to high risk of T2DM inpatients with MCI.