1,5-脱水葡萄糖醇与轻度认知功能障碍的相关性分析

Correlation analysis of 1,5-anhydroglucitol and mild cognitive impairment

目的探讨血清1,5-脱水葡萄糖醇(1,5-AG)与轻度认知功能障碍的相关性。方法选择2019年11月至12月我院门诊健康体检人群80例,根据MCI诊断标准及蒙特利尔认知评估(MoCA)量表中文版认知功能测试结果,将其分为轻度认知功能障碍(MCI)组(33例)和正常对照(NC)组(47例)。收集两组研究对象的人口学资料、临床资料;测定血糖相关指标,包括1,5-AG、空腹血糖(FPG)、糖化血红蛋白(HbA1c)、餐后2 h血糖(2 h-PPG);用焦虑自评量表(SAS)、老年抑郁量表(GDS)分别评估焦虑、抑郁情绪。采用线性相关分析和多元线性回归分析研究血糖相关指标与MCI的相关性。结果两组研究对象人口学资料、临床资料和SAS、GDS评分差异均无统计学意义(P均>0.05)。MCI组MoCA评分低于NC组(P<0.01),1,5-AG水平低于NC组(P=0.023),FPG和2 h-PPG水平均高于NC组(P=0.041、0.027)。线性相关分析显示,MoCA评分与FPG、2 h-PPG、HbA1c水平呈负相关(P均<0.05),与1,5-AG水平无相关性(P=0.134);其认知域延迟回忆评分与FPG、2 h-PPG、HbA1c水平呈负相关(P均<0.05),与1,5-AG水平呈正相关(P=0.027)。多元线性回归分析显示,FPG是MoCA评分的独立影响因素(β=-0.291,P=0.009),1,5-AG和FPG是延迟回忆评分的独立影响因素(β=0.199、-0.390,P=0.015、0.001)。结论1,5-AG可能是预测认知功能减退的潜在生物学指标,尤其对延迟回忆的影响较突出;MCI个体近期血糖波动大,保持血糖的稳定性或许对预防MCI有益。

Objective To investigate the correlation between serum 1,5-anhydroglucitol(1,5-AG)and mild cognitive impairment(MCI).Methods According to the diagnostic criteria of MCI and the cognitive function test results by Montreal cognitive assessment(MoCA)scale Chinese version,80 volunteers receiving health check in our hospital from Nov.to Dec.,2019 were divided into MCI group(33 cases)and normal control(NC)group(47 cases).The demographic and clinical data were collected,and the blood glucose-related indexes,including 1,5-AG,fasting plasma glucose(FPG),glycosylated hemoglobin(HbA1c)and 2 h-postprandial glucose(2 h-PPG),were measured.Anxiety and depression were assessed by selfrating anxiety scale(SAS)and geriatric depression scale(GDS),respectively.Linear correlation analysis and multiple linear regression analysis were used to study the correlation between the blood glucose-related indexes and MCI.Results There were no significant differences in the demographic data,clinical data,SAS score or GDS score between the two groups(all P>0.05).Compared with the NC group,the MoCA score and the level of 1,5-AG were significantly lower in the MCI group(P<0.01,P=0.023),and the levels of FPG and 2 h-PPG were significantly higher(P=0.041,0.027).Linear correlation analysis showed that the MoCA score was negatively correlated with the levels of FPG,2 h-PPG and HbA1c(all P<0.05),but not with 1,5-AG level(P=0.134);the score of delayed recall,a cognitive domain of MoCA scale,was negatively correlated with the levels of FPG,2 h-PPG and HbA1c(all P<0.05),and positively correlated with the 1,5-AG level(P=0.027).Multiple linear regression analysis showed that FPG was an independent factor of MoCA score(β=-0.291,P=0.009),and 1,5-AG and FPG were independent factors of delayed recall score(β=0.199 and-0.390,P=0.015 and 0.001).Conclusion 1,5-AGmay be a potential biomarker for predicting cognitive impairment,especially for delayed recall;the blood glucose fluctuates greatly in MCI individuals at early stage,and maintaining the stability of blood glucose may be beneficial to the prevention of MCI.