慢性肾脏病患者认知功能障碍与胰岛素抵抗的相关研究

Relationship Between Cognitive Impairment and Insulin Resistance in Patients with Chronic Kidney Disease

目的探讨慢性肾脏病（chronic kidney disease,CKD）患者认知功能与胰岛素抵抗（IR）的关系。方法将101例CKD3~4期患者分为两组：合并认知功能损害患者组38例,认知功能正常组63例,比较两组间性别、年龄、BMI、TC、TG、CRP、内生肌酐清除率（CCr）、HOMA-IR、颈动脉内膜中层厚度（intima-media thickness,IMT）、收缩压（SBP）和舒张压（DBP）的差别,并进行Logistic回归分析。结果与认知功能正常组相比,慢性肾脏病合并认知功能损害组BMI、TG、FINS、CRP、IMT及HOMA-IR较高（P〈0.05）;Logistic回归分析显示IMT、CCr及HOMA-IR对认知功能障碍的发病具有相关性。结论 HOMA-IR、IMT及CCr是认知功能障碍的独立危险因素。

Objective To explore the relationship between cognitive impairment and insulin resistance in patients with chronic kidney disease（CKD）. Methods One hundred and one cases of 3 -4 CKD patients were divided into two groups：cognitive impairment group and non -cognitive impairment group. The weight, body mass index（ BMI）, fasting serum glucose,insulin, totak cholesterol （ TC ）, triglyceride （ TG）, intima - media thickness （IMT） and CRP were detected. The difference of these indexes and HOMA - IR were compared between cognitive impairment group and non - cogni- tive impairment group. Results Compared with non - cognitive impairment group, the BMI, FPG, TG, CRP, IMT, CCr and HOMA - IR in cognitive impairment group increased markedly （P 〈 0. 05 ）, CCr was lower. The Logistic regression analysis showed that CCr, HOMA - IR, and CRP had an impact on the incidence of cognitive impairment. Conclusions HOMA - IR, CRP and CCr were the independent risk factors for developing cognitive impairment in patients with chronic kidney disease.