2型糖尿病男性患者血清硫酸脱氢表雄酮水平与认知功能的相关性

Association of serum dehydroepiandrosterone sulfate with cognition in male T2DM patients

目的探讨2型糖尿病（T2DM）男性患者血清硫酸脱氢表雄酮（DHEA-S）水平与认知功能的相关性。方法选取唐山工人医院住院的T2DM男性患者99例作为病例组，同时从健康体检中心选取男性健康人群97例作为对照组。收集其人口学资料及临床检验指标，采用放免法检测血清DHEA-S水平。用RBANS量表对所有人进行认知功能评定。结果（1）T2DM患者较正常人DHEA．S[（2．66±0．78对4．02±1．24）μmol／L，P〈0．01]水平明显降低；（2）与正常人相比，T2DM患者RBANS量表即时记忆（79．24±17．47对86．25±15．21，P〈0．01）、视觉广度（83．98±17．98对97．24±11．51，P〈0．01）、注意力（96．04±14．65对101．45±13．93，P〈0．01）、延迟记忆（89．28±11．74对97．41±9．41，P〈0．01）评分以及总分（85．85±11．46对94．60±10．91，P〈0．01）明显降低；（3）与T2DM高DHEA．S组相比，低DHEA．S组患者RBANS量表延迟记忆（84．53±12．23对93．94±9．18，P〈0．01）评分及总分（80．33±10．91对91．26±9．25，P〈0．01）明显降低；（4）T2DM伴认知功能障组患者较认知功能对照组DHEA-S水平（2．314-0．79对2．90±0．67．P〈0．01）明显降低。（5）DHEA．S与RBANS量表延迟记忆（r偏=0．252，P=0．019）评分和总分（r偏=0．258，P=0．016）呈正相关。结论2型糖尿病男性患者血清DHEA-S水平及认知功能评分均降低．且DHEA-S水平与其认知功能评分呈正相关．提示血清DHEA-S可能参与了其认知功能受损的发生发展。

Objective To investigate the association of serum dehydroepiandrosterone sulfate （DHEA-S） with the cognition in male type 2 diabetes mellitus （T2DM） patients. Methods 99 male patients cared at Tangshan Gongren Hospital and another 97 male healthy controls without T2DM from the medical examination center were recruited. Data on demographic characteristics and clinical parameters were collected, DHEA-S was measured by radioimmunologic assay. Cognitive performance was assessed by the Repeatable Battery for the Assessment of Neuropsychological Status（RBANS）. Results （ 1 ） Serum DHEA-S levels were lower in male T2DM patients than that of controls[ （2.66 ± 0.78 vs 4.02 ± 1.24 ） μmol/L, P〈0.01 ] ; （ 2 ） Compared with controls, RBANS scores including immediate memory（79.24 ± 17.47 vs 86.25 ± 15.21, P〈0.01 ）, visuospatial/constructional （ 83.98 ± 17.98 vs 97.24 ± 11.51, P〈 0.01 ）, attention （ 96.04± 14.65 vs 101.45 ± 13.93, P〈 0.01 ）, delayed memory （ 89.28± 11.74 vs 97.41 ± 9.41, P〈0.01 ） , and total scores（ 85.85 ± 11.46 vs 94.60 ± 10.91, P〈0.01 ） were all lower in male T2DM patients; （3） RBANS scores including delayed memory （84.53 ±12.23 vs 93.94 ± 9.18, P〈 0.01 ） and total scores（ 80.33± 10.91 vs 91.26 ± 9.25, P〈0.01 ） in T2DM patients with low-level DHEA-S（ DHEA- S-L） were all lower than those of patients with high-level DHEA-S ; （ 4 ） Male T2DM patients with cognitive impairment had lower levels of DHEA-S than patients without cognitive impairment （ 2.31 ± 0.79 对2.90 ± 0.67, P〈0.01 ） ; （ 5 ） In male T2DM patients, DHEA-S was positively correlated with delayed memory （ r = 0. 252, P = 0. 019 ） and total scores （r = 0. 258, P = 0. 016 ）. Conclusion Male T2DM patients are with lower serum DHEA-S levels and worse cognitive performance, and serum DHEA-S was positively correlated with their cognitive performance, suggesting that serum DHEA-S may be involved in the cognitive deficits of male T2DM patients.