口服维生素D辅助银杏叶片对老年2型糖尿病合并轻度认知功能障碍患者的影响

Effects of oral vitamin D supplemented with Ginkgo biloba tablets on elderly patients with type 2 diabetes mellitus and mild cognitive impairment

目的 探讨口服维生素D(VitD)辅助银杏叶片对老年T2DM合并轻度认知功能障碍患者的影响。方法 选取2020年6月至2021年11月于长沙市第一医院内分泌代谢科治疗的T2DM老年患者136例,随机分为对照组(Con)和观察组(Obs),每组各68例。Con组常规降糖治疗+银杏叶片(40 mg,Tid),Obs组常规降糖治疗+银杏叶片(40 mg,Tid)+VitD(800 U,Qd)。比较两组治疗前后蒙特利尔认知评估量表(MoCA)评分、胰岛素抵抗指数(HOMA-IR)、血清25羟基维生素D3[25(OH)D3]、TNF-α和脑源性神经营养因子(BDNF)。结果 两组治疗后MoCA评分、血清25(OH)D3及BDNF升高,且Obs组高于Con组(P<0.05)。两组治疗后HOMA-IR、TNF-α降低,且Obs组低于Con组(P<0.05)。Pearson相关分析显示,MoCA评分与25(OH)D3、BDNF呈正相关(P<0.05),与年龄、HbAlc、HOMA-IR及TNF-α呈负相关(P<0.05)。多元线性回归分析显示,年龄、HbA1c、25(OH)D3及TNF-α是MoCA评分的影响因素。结论 口服VitD辅助银杏叶片可改善老年T2DM合并轻度认知功能障碍患者的认知功能。

Objective To investigate the effect of oral vitamin D supplemented with Ginkgo biloba tablets on cognitive function in elderly patients with type 2 diabetes mellitus(T2DM)and mild cognitive impairment.Methods 136 elderly T2DM patients hospitalized in the Department of Endocrinology and Metabolism of Changsha First Hospital from June 2020 to November 2021 were selected,and randomly divided into control group(Con)and observation group(Obs),with 68 cases in each group.The Con group was treated with conventional hypoglycemic therapy+Ginkgo biloba tablets(40 mg,Tid).The Obs group received conventional hypoglycemic therapy+Ginkgo biloba leaves extract tablets(40 mg,Tid)+vitamin D(800 U,Qd).The Montreal cognitive assessment(MoCA)score,homeostasis model assessment for insulin resistance(HOMA-IR),serum 25-hydroxyvitamin D3[(25(OH)D3)],tumor necrosis factor-α(TNF-α)and brain-derived neurotrophic factor(BDNF)levels were compared between the two groups before and after treatment.Results MoCA score,serum 25(OH)D3 and BDNF increased after treatment in both groups,which was more significant in Obs group than in Con group(P<0.05).HOMA-IR and TNF-αdecreased after treatment in both groups,which was more significant in Obs group than in Con group(P<0.05).Pearson correlation analysis showed that MoCA score was positively correlated with 25(OH)D3 and BDNF(P<0.05),and negatively correlated with age,HbA1c,HOMA-IR and TNF-α(P<0.05).Multiple linear regression analysis showed that age,HbA1c,25(OH)D3 and TNF-αwere the influence factors of MoCA score.Conclusion Oral vitamin D supplementation with Ginkgo biloba tablets can improve cognitive function in elderly patients with T2DM and mild cognitive impairment.