老年2型糖尿病患者血清骨钙素水平与认知功能障碍的相关性研究

Correlation between serum osteocalcin level and cognitive dysfunction in elderly patients with type 2 diabetes mellitus

目的探讨老年2型糖尿病(type 2 diabetes mellitus,T2DM)患者血清骨钙素水平与认知功能障碍的关系,为老年T2DM合并认知功能损害患者早期诊断、早期干预提供依据。方法选取2017年6月至2018年6月于安徽省立医院就诊的98例患者作为研究对象,其中2型糖尿病组45例,正常对照组53例,比较两组受试者血清骨钙素水平和一般生化指标以及认知功能评分情况,并分析影响认知功能的危险因素以及与骨钙素之间的关系。结果老年T2DM患者血清骨钙素水平低于对照组(P<0. 01),且认知功能评分低于对照组(P=0. 025),而胰岛素抵抗指数(homeostatic model assessment of insulin resistance,HOMA-IR)高于对照组(P=0. 041)。在老年T2DM患者中,简易精神量表(mini-mental state examination,MMSE)分值与骨钙素水平呈正相关(r=0. 364,P=0. 014),与HOMA-IR呈负相关(r=-0. 426,P=0. 004),骨钙素水平与分项得分中记忆力、注意力和计算力、执行能力呈正相关,与画钟试验(clock drawing test,CDT)呈正相关;多元回归分析发现血清骨钙素水平与MMSE呈独立相关(P<0. 05)。结论老年T2DM患者认知功能损害可能与骨钙素水平相关。

Objective To investigate the relationship between serum osteocalcin level and cognitive dysfunction in elderly patients with type 2 diabetes mellitus( T2 DM),and to provide evidence for early diagnosis and early intervention in elderly patients with T2 DM and cognitive impairment. Methods A total of 98 patients who were admitted to Anhui Provincial Hospital from June 2017 to June 2018 were enrolled,including 45 patients with type 2 diabetes and 53 patients with normal control. The serum osteocalcin level and general biochemical indicators as well as cognitive function scores were compared between the two groups,and relevant factors affecting cognitive function were also analyzed. Finally,we also analyzed the relationship between osteocalcin and cognitive function. Results Serum osteocalcin level in elderly T2 DM patients was lower than that in the control group( P<0. 01),and the cognitive function score was lower than that in the control group( P= 0. 025),while the HOMA-IR( homeostatic model assessment of insulin resistance) was higher than that in the control group( P = 0. 041). In elderly patients with T2 DM,MMSE score was positively correlated with serum osteocalcin level( r = 0. 364,P = 0. 014),while it was negatively correlated with the HOMA-IR( r =-0. 426,P= 0. 004). There was a positive correlation between serum osteocalcin level and memory,attention and calculative ability,as well as executive ability in the score,respectively. In addition,serum osteocalcin level was positively correlated with the clock drawing test( CDT),as well as independently correlated with MMSE score( P<0. 05). Conclusion Cognitive impairment in elderly T2 DM patients may be associated with serum osteocalcin level.