老年糖尿病患者β2微球蛋白的影响因素及其与认知功能的相关性

Influencing factors ofβ2 microglobulin and its correlation with cognitive function in elderly patients with diabetes mellitus

目的探讨老年糖尿病患者β2微球蛋白(β2M)的影响因素及其与认知功能的相关性。方法选取2018年5月至2019年5月于宣武医院内分泌科与老年医学科住院诊治的300例老年糖尿病患者为研究对象,收集患者基础临床资料、炎症和生化指标,应用蒙特利尔认知评估量表(MoCA)评估认知功能。根据β2M水平将患者分为高β2M组(n=149)和低β2M组(n=151)。采用SPSS 22.0统计软件进行数据分析。根据数据类型,分别采用t检验、Mann-Whitney U检验或χ^(2)检验进行组间比较。应用Pearson相关性分析和多元线性回归分析β2M与临床指标的相关性。应用logistic回归分析认知功能障碍(CI)的影响因素。结果与高β2M组相比,低β2M组患者年龄、糖尿病病程、白介素6(IL-6)、同型半胱氨酸(HCY)、甘油三酯(TG)、肌酐、尿素氮(BUN)、尿酸水平更低,差异有统计学意义(P<0.05)。多元逐步线性回归方程显示,肌酐、BUN、IL-6、尿酸与β2M呈正相关(P<0.05)。单因素logistic回归分析结果显示,年龄、β2M、合并脑卒中、肌酐、BUN是老年糖尿病患者合并认知障碍的危险因素(P<0.05),多因素logistic回归分析结果显示,年龄、β2M和脑卒中为老年糖尿病患者认知障碍的独立危险因素(P<0.05)。结论老年糖尿病患者β2M水平不仅与肾功能下降相关,还是认知障碍的独立危险因素。

Objective To explore the influencing factors ofβ2 microglobulin(β2M)and its correlation with cognitive function in the elderly patients with diabetes mellitus.Methods A total of 300 elderly diabetic patients hospitalized in the departments of endocri-nology and geriatrics of Xuanwu Hospital from May 2018 to May 2019 were recruited in this study.General clinical data,inflammatory indicators,and results of biochemical tests were collected.The cognitive function was evaluated using Montreal cognitive assessment(MoCA).The patients were divided into high and lowβ2M groups(149 and 151 patients respectively)according toβ2M level.Statistical analyses were performed using SPSS statistics 22.0.Data comparison between two groups was performed using t test,Mann-Whitney U test or Chi-square test depending on data types.The correlation ofβ2M level with clinical indicators was analyzed by Pearson correlation analysis and multiple liner regression analysis.Logistic regression analysis was employed to analyze the affecting factors of cognitive impairment(CI)in the elderly diabetic patients.Results Compared with the highβ2M group,the lowβ2M group had younger age,shorter diabetic duration,and lower levels of interleukin 6(IL-6),homocysteine(HCY),triglyceride(TG),creatine,blood urea nitrogen(BUN)and uric acid(P<0.05).Multiple linear stepwise regression equation showed thatβ2M had positive correlations with creatine,BUN,IL-6 and uric acid(P<0.05).Univariate logistic regression analysis indicated that age,β2M,stroke,creatine and BUN were risk factors for CI in elderly patients with diabetes mellitus(P<0.05).Multivariate logistic regression analysis suggested that age,β2M and stroke were independent risk factors of CI in the elderly patients with diabetes mellitus(P<0.05).Conclusionβ2M in elderly patients with diabetes mellitus is not only associated with declining renal function,but also an independent risk factor of CI.