血脂异常与老年2型糖尿病患者轻度认知功能障碍的相关性

Association between dyslipidemia and mild cognitive impairment in elderly patients with type 2 diabetes mellitus

目的探讨血脂异常对老年2型糖尿病(T2DM)患者轻度认知功能损害(MCI)的影响。方法入选2018年1月至2019年1月在首都医科大学宣武医院老年科治疗的T2DM患者378例。依据认知功能状况分为2组:正常组(n=302)和MCI组(n=76)。采用简易智能评估量表(MMSE)及蒙特利尔认知功能量表(MoCA)进行认知筛查,并收集基线资料以及临床指标。采用SPSS 17.0软件进行数据处理。多因素logistic回归分析MCI的风险因素。结果按年龄中位数(70岁)分层,分析各血脂指标对MCI患病风险影响,结果表明,在>70岁组(n=180)中,MCI者52例,低密度脂蛋白胆固醇(OR=3.01,95%CI 1.37~6.96,P=0.006)和总胆固醇(OR=1.75,95%CI 1.16~2.64,P=0.008)是老年T2DM患者发生MCI的危险因素。按血脂水平高低将人群进一步分层,多因素分析结果显示,总胆固醇≥5.2 mmol/L可使T2DM患者MCI的患病风险增加至2.59倍(P=0.019),低密度脂蛋白胆固醇≥3.4 mmol/L可使T2DM患者MCI患病风险增加至3.24倍(P=0.001)。结论老年T2DM患者MCI的发生可能与增高的总胆固醇和低密度脂蛋白胆固醇水平密切相关。

Objective To investigate the effect of dyslipidemia on mild cognitive impairment(MCI)in the elderly with type 2 diabetes mellitus(T2DM).Methods From January 2018 to January 2019,a total of 378 elderly T2DM patients were selected from our department.According to their cognitive function,they were divided into two groups:normal group(n=302)and MCI group(n=76).Mini-mental state examination(MMSE)and Montreal cognitive assessment(MoCA)were employed for cognitive screening,and baseline data and clinical parameters were collected.SPSS statistics 17.0 was used for data processing.Multivariate logistic regression was used to analyze the risk factors for MCI.Results The analysis with stratification by median age(70 years)showed that,in the group over 70 years old(n=180;52 with MCI),low-density lipoprotein cholesterol(LDL-C)(OR=3.01,95%CI 1.37-6.96,P=0.006)and total cholesterol(TC)(OR=1.75,95%CI 1.16-2.64,P=0.008)were the risk factors for MCI in the elderly T2DM patients.When the patients were further stratified according the level of blood lipid,the results showed that TC≥5.2 mmol/L increased the risk of MCI to 2.59 folds(P=0.019)and LDL-C≥3.4 mmol/L to 3.24 folds(P=0.001)in T2DM patients.Conclusion The occurrence of MCI in the elderly T2DM patients may be closely associated with the increase of TC and LDL-C levels.