血清MCP-1、SAA水平对2型糖尿病伴OSAHS患者早期认知功能损伤的诊断效能

Diagnostic capabilities of serum MCP-1 and SAA levels on early cognitive impairment in patients with type 2 diabetes combined with OSAHS

目的探讨在2型糖尿病伴阻塞性睡眠呼吸暂停低通气综合征(OSAHS)患者早期认知功能损伤中采用血清单核细胞趋化蛋白-1(MCP-1)、血清淀粉样蛋白A(SAA)的诊断效能。方法选取2016年4月至2017年5月诊断明确的2型糖尿病患者123例,分为2型糖尿病伴OSAHS组78例,单纯2型糖尿病组45例,另选择同期37例健康查体者为对照组。对三组血清MCP-1、SAA水平及蒙特利尔认知评估量表(Mo CA)评分进行测定,分析三组对象血清MCP-1、SAA水平差异及其与认知功能的关系,应用ROC曲线分析MCP-1、SAA水平对早期认知功能损伤的诊断效能。结果三组对象一般资料比较无统计学差异(P均>0.05)。与对照组相比,糖尿病伴OSAHS组、单纯2型糖尿病组患者Mo CA总分均降低,且以糖尿病伴OSAHS组最低,差异有统计学意义(P均<0.01);血清MCP-1、SAA水平均增高,且以糖尿病伴OSAH组最高,差异有统计学意义(P均<0.01)。糖尿病伴OSAHS组患者血清MCP-1、SAA水平与Mo CA评分分别成负相关(r=-0.771,P=0.003;r=-0.771,P=0.003)。血清MCP-1、SAA水平预测认知功能障碍的ROC曲线下面积分别为0.773(95%CI:0.691~0.856)、0.771(95%CI:0.689~0.851)。结论 2型糖尿病伴OSAHS患者血清MCP-1、SAA水平与患者认知障碍损伤程度呈正相关,血清MCP-1、SAA水平可以预测认知功能损伤。

Objective To investigate the diagnostic capabilities of serum monocyte chemoattractant protein-1 （ MCP-1 ） and serum amyloid A protein （ SAA ） on early cognitive impairment in patients with type 2 diabetes combined with obstructive sleep apnea hypopnea syndrome （OSAHS）. Methods A total of 123 patients with type 2 diabetes of definitive diagnosis （78 cases of type 2 diabetes combined with OSAHS and 4-5 cases of simple type 2 diabetes） admitted from April 2016 to May 2017 ,and 37 healthy subjects of physical examination in the same period （control group）were selected. The levels of serum MCP-1 and SAA were detected, and the cognitive function was assessed with Montreal cognitive assessment （MoCA） score. The difference of serum MCP-1 and SAA levels in objects of three groups and their associations with cognitive function were analyzed. The receiver operating characteristic curve （ROC curve ） was used to analyze the diagnostic capabilities of MCP-1 and SAA levels for early cognitive impairment. Results There were no significant differences in general data in three groups （ all P 〉 0. 05 ）. Compared with control group, MoCA total scores decreased in both type 2 diabetes combined with OSAHS group and simple type 2 diabetes group, and the MoCA total score in type 2 diabetes combined with OSAHS group was the lowest among three groups （all P 〈 0.01 ）. Compared with control group,serum MCP-1 and SAA levels increased in both type 2 diabetes combined with OSAHS group and simple type 2 diabetes group,and they in type 2 diabetes combined with OSAHS group were the highest among three groups （ all P 〈0. 01 ）. The levels of serum MCP-1 and SAA in type 2 diabetes combined with OSAHS group were negatively correlated with MoCA score（ r = - 0. 771, P = 0. 003 ; r = - 0. 771, P = 0. 003 ） , respectively. The area under the ROC curve for predicting cognitive dysfunction by MCP-1 and SAA levels were 0. 773 （95% CI：0. 691 - 0. 856） and 0. 771 （95% CI：0. 689 - 0. 851 ） ,respectively. Conclusions The levels of serum MCP-1 and SAA in patients with type 2 diabetes combined with OSAHS were positively correlated with the degree of cognitive impairment. The levels of serum MCP-1 and SAA could predict cognitive impairment.