2型糖尿病认知功能障碍与BDNF、胰岛素抵抗的相关性研究

Correlations of Brain-derived Neurotrophic Factor(BDNF),Insulin Resistance and Cognitive Disorders Caused by Type Ⅱ Diabetes Mellitus

目的探讨2型糖尿病患者的胰岛素抵抗水平、血清脑源性神经营养因子(BDNF)与认知功能障碍的相关性。方法本研究选取健康人群和2型糖尿病患者共100名,分T2DM组(n=56)和对照组(n=44),同时检测血糖、糖化血红蛋白、空腹胰岛素、胆固醇、甘油三酯、BDNF等指标,并计算胰岛素抵抗指数及进行认知功能评估。结果 T2DM组与对照组相比,体重指数、收缩压、舒张压、空腹血糖、糖化血红蛋白、甘油三酯、低密度脂蛋白、高密度脂蛋白均升高(P<0.05);T2DM组的认知功能(视觉、注意力、视空间、语言和延时记忆)得分均明显低于对照组(P<0.05),T2DM组的血BDNF低于对照组(P<0.01),血BDNF下降与认识功能降低存在明显关联性;以T2DM组的BDNF、HOMA-IR与MoCA认知功能评分结果进行多元线性回归分析,结果提示三者存在明显统计相关性(P<0.01)。结论胰岛素抵抗、BDNF可能参与了2型糖尿病患者认知功能障碍的发病过程。

Objective To explore the correlations of insulin resistance,brain-derived neurotrophic factor(BDNF)and cognitive disorder of type II diabetics.Methods We enrolled 44 healthy people as control group and 56 patients with type II diabetes in the study.The levels of fasting blood glucose(FBG),glycated hemoglobin(HbA1C),fasting insulin(FI),cholesterol,triglyceride(TG)and BDNF,and insulin resistance index,evaluated cognitive functions in both groups were detected and compared between the groups.Results Compared with the control group,the levels of BMI,systolic and diastolic pressures,FBG,HbA1C,TG,low density lipoprotein(LDL)and high density lipoprotein(HDL)in the T2DM group were all significantly increased(P<0.05).Thescores of cognitive function(vision,attention,visual space,language and delayed memory)in the T2DM group were significantly lower than those of the control group(P<0.05).The level of BDNF in T2DM group was lower than that of the control group(P<0.01).Multiple linear regression showed significantly statistical correlations among levels of BDNF,HOMA-IR and scores of MoCA cognitive function in the T2DM group(P<0.01).Conclusion Insulin resistance and BDNF may be involved in the pathogenesis of congnitive dysfunction in patients with type 2 diabetes.