胰岛素抵抗与轻度认知功能障碍的临床研究

Clinical study on insulin resistance and mild cognitive impairment

目的探讨胰岛素抵抗与轻度认知功能障碍的关系。方法选取2018年2月至2019年2月本院收治的胰岛素抵抗患者60例作为病例组,同时选取在本院健康体检者60例作为对照组。记录两组研究对象的一般情况(包括性别、年龄、文化程度、身高、体重、血压等),既往病史(高血压、糖尿病、冠心病等),完成血脂、空腹血糖、空腹胰岛素、糖化血红蛋白及头颅CT或MRI检查,并行蒙特利尔认知评估量表(MoCA)、韦氏成人智力量表(WAIS-RC)、总体衰退量表(GDS)、日常生活能力评定量表(ADL)评估,对比两组研究对象轻度认知功能障碍发生率、胰岛素敏感指数(ISI)、空腹胰岛素(FINS)、空腹血糖(FPG),韦氏量表总分及各分量表分数、蒙特利尔认知评估量表评分,并分析影响轻度认知功能障碍发生的危险因素。结果病例组血脂、血压、受教育程度、年龄、性别方面与对照组相比,差异均无统计学意义(均P>0.05),病例组轻度认知功能障碍发生率35.0%,高于对照组11.7%(P<0.05);病例组ISI、FINS、FPG均高于对照组(均P<0.05);病例组知识、领悟、算术、相似、数字广度、词汇、语言量表总分、数字符号、图形拼凑、操作量表总分、韦氏量表总分、蒙特利尔认知评估量表评分均低于对照组(均P<0.05);高血糖、高胰岛素症、胰岛素抵抗是轻度认知功能障碍发生的独立危险因素(均P<0.05)。结论胰岛素抵抗是轻度认知功能障碍发生的独立危险因素。

Objective To investigate the relationship between insulin resistance and mild cognitive impairment.Methods Sixty patients with insulin resistance admitted to our hospital from February 2018 to February 2019 were selected as the case group,and 60 healthy subjects in our hospital were selected as the control group.The general conditions(including gender,age,educational level,height,weight,blood pressure,etc.),past medical history(hypertension,diabetes,coronary heart disease,etc.)of the two groups were recorded,and blood lipids,fasting blood glucose,fasting insulin,glycosylated hemoglobin,and head CT or MRI examination were completed,the Montreal Assessment Scale(MoCA),Wechsler Adult Intelligence Scale(WAIS-RC),Global Deterioration Scale(GDS),and Assessment of Daily Living Capacity(ADL)were assessed.The incidence of mild cognitive impairment,insulin sensitivity index(ISI),fasting insulin(FINS),fasting blood glucose(FPG),Wechsler scale score and subscale scores,and the Montreal Assessment Scale score were compared between the two groups,and the risk factors affecting the occurrence of mild cognitive dysfunction were analyzed.Results There were no statistically significant differences in blood lipids,blood pressure,educational level,age,or gender between the case group and the control group(all P>0.05).The incidence of mild cognitive impairment in the case group(35.0%)was higher than that in the control group(11.7%)(P<0.05).The levels of ISI,FINS,and FPG of the case group were higher than those of the control group(all P<0.05).The scores of knowledge,comprehension,arithmetic,resemblance,numerical breadth,vocabulary,the total score of language scale,the scores of numeric character,graphic patchwork,the total score of operating scale,the Wechsler scale score and the Montreal assessment scale score in the case group were lower than those in the control group(all P<0.05).Hyperglycemia,hyperinsulinemia,and insulin resistance were independent risk factors for mild cognitive impairment(all P<0.05).Conclusion Insulin resistance is an independent risk factor for mild cognitive impairment.