血清GLP-1、hs-CRP与2型糖尿病患者代谢综合征及认知功能的相关分析

Correlation analysis of serum GLP-1 and hs-CRP with metabolic syndrome and cognitive function in patients with type 2 diabetes mellitus

目的探讨血清胰高血糖素样肽1(glucagon-like peptide-1,GLP-1)、超敏C反应蛋白(high-sensitivity C-reactive protein,hs-CRP)与2型糖尿病(type 2 diabetes mellitus,T2DM)患者代谢综合征(metabolic syndrome,MS)及认知功能的相关性。方法选取T2DM患者(观察组)122例与健康体检者(对照组)61例作为研究对象。根据有无MS将观察组分为MS组(T2DM合并MS,81例)与非MS组(单纯T2DM,41例),根据蒙特利尔认知评估量表(Montreal Cognitive Assessment Scale,MoCA)评分将MS组分为认知正常组(MoCA评分≥26分,41例)与认知障碍组(MoCA评分<26分,40例)。比较各组血清GLP-1、hs-CRP、腰围、血脂、血压指标。采用Pearson法分析GLP-1、hs-CRP与MS指标的相关性;采用二元Logistic回归模型分析血清GLP-1、hs-CRP对T2DM合并MS患者认知功能的影响。结果观察组GLP-1、高密度脂蛋白胆固醇(high density lipoprotein cholesterol,HDL-C)、MoCA评分低于对照组,hs-CRP、腰围、收缩压、舒张压、三酰甘油(triacylglycerol,TG)、空腹血糖(fasting blood glucose,FBG)高于对照组(P<0.05)。MS组GLP-1、HDL-C、MoCA评分低于对照组,hs-CRP、腰围、收缩压、舒张压、TG、FBG高于非MS组(P<0.05)。认知障碍组GLP-1、HDL-C、MoCA评分低于对照组,hs-CRP、腰围、收缩压、舒张压、TG、FBG高于认知正常组(P<0.05)。Pearson相关性分析显示,GLP-1与腰围、收缩压、舒张压、FBG呈负相关,与HDL-C呈正相关(P<0.05);hs-CRP与腰围、收缩压、舒张压、TG、FBG呈正相关,与HDL-C呈负相关(P<0.05)。Logistic回归模型分析显示,GLP-1水平降低、hs-CRP水平升高是T2DM合并MS患者认知功能障碍的危险因素(P<0.05)。结论T2DM合并MS患者血清GLP-1水平明显降低,hs-CRP水平明显升高,血清GLP-1水平降低和hs-CRP水平升高是T2DM合并MS患者认知障碍的危险因素。

Objective To investigate the correlation of glucagon-like peptide-1(GLP-1)and high-sensitivity C-reactive protein in serum.hs-CRP)with metabolic syndrome(MS)and cognitive function in patients with type 2 diabetes mellitus(T2DM).Methods A total of 122 T2DM patients(observation group)and 61 healthy physical examinees(control group)were selected as the research subjects.The observation group was divided into MS group(T2DM combined with MS,n=81)and non-MS group(T2DM alone,n=41)according to presence of MS.According to the Montreal Cognitive Assessment Scale(MoCA),MS group was subdivided into cognitive normal group(MoCA score≥26,n=41)and cognitive dysfunction group(MoCA score<26,n=40).Serum GLP-1,hs-CRP,waist circumference,blood lipid and blood pressure were compared among all groups.Pearson method was used to analyze the correlation between GLP-1,hs-CRP and MS index.Binary Logistic regression model was used to analyze the effects of serum GLP-1 and hs-CRP on cognitive function in T2DM patients with MS.Results GLP-1,high density lipoprotein cholesterol(HDL-C)and MoCA scores in the observation group were lower than those in the control group,while hs-CRP,waist circumference,systolic blood pressure(SBP),diastolic blood pressure(DBP),triacylglycerol(TG)and fasting blood glucose(FBG)were higher than those in control group(P<0.05).GLP-1,HDL-C and MoCA scores in MS group were lower than those in control group,while hs-CRP,waist circumference,SBP,DBP,TG and FBG in MS group were higher than those in non-MS group(P<0.05).The GLP-1,HDL-C and MoCA scores in the cognitive dysfunction group were lower than those in the control group,while hs-CRP,waist circum ference,SBP,DBP,TG and FBG in the cognitive dysfunction group were higher than those in the cognitive normal group(P<0.05).Pearson correlation analysis showed that GLP-1 was negatively correlated with waist circumference,SBP,DBP and FBG,but positively correlated with HDL-C(P<0.05).hs-CRP was positively correlated with waist circumference,SBP,DBP,TG,and FBG,and negatively correlated with HDL-C(P<0.05).Logistic regression model analysis showed that decreased GLP-1 level and increased hs-CRP level were risk factors for cognitive dysfunction in T2DM patients with MS(P<0.05).Conclusion Serum GLP-1 level is significantly decreased and hs-CRP level is significantly increased in T2DM patients with MS,and decreased serum GLP-1 level and increased hs-CRP level are risk factors for cognitive dysfunction in T2DM patients with MS.