餐后2h血糖、游离三碘甲状腺原氨酸及胱抑素C对阿尔茨海默病认知损害的影响

Effects of 2-hour Postprandial Blood Glucose,Free Triiodothyronine and Cystatin C on Cognitive Function of Alzheimer’s Disease

目的探讨餐后2 h血糖(2h P-BG)、游离三碘甲状腺原氨酸(FT_(3))及胱抑素(Cys-C)对阿尔茨海默病(AD)认知损害的影响。方法选取2017至2021年新疆医科大学附属中医医院AD数据库中470例AD患者,根据CDR量表评分将患者分为4组。分别为:轻度认知损害组(a MCI组)136例、轻度痴呆组(Mi-D组)140例、中度痴呆组(Mo-D组)134例和重度痴呆组(SD组)60例。用Spearman相关性分析、有序Logistic回归分析AD患者认知损害的危险因素。结果(1)4组间患者的年龄、高血压病病史、BMI、TT_(3)、TT_(4)、FT_(3)、FT_(4)比较,差异均有统计学意义(均P<0.05)。(2)相关性分析显示:MMSE量表评分与年龄(r=-0.238,P<0.05)、TT_(3)(r=-0.323,P<0.05)、FT_(3)(r=-0.252,P<0.05)、FBG(r=-0.111,P<0.05)呈负相关;与TT_(4)(r=0.141,P<0.05)、FT_(4)(r=0.252,P<0.05)、BMI(r=0.141,P<0.05)呈正相关。(3)多因素Logistics回归分析结果显示,高龄(OR=1.153,95%CI:0.005~0.281)、高2h P-BG(OR=1.085,95%CI:0.029~0.126)、低FT_(3)(OR=16.15,95%CI:-0.642~-4.940)、高Cys-C(OR=1.874,95%CI:0.299~1.702)是AD认知损害的独立危险因素。结论高2h P-BG、低FT_(3)、高Cys-C水平是AD患者认知损害的危险因素。

Aim To analyze the effects of 2-hour postprandial blood glucose(2hP-BG),free triiodothyronine(FT_(3))and cystatin C(Cys-C)on cognitive function in Alzheimer’s disease(AD).Methods 470 AD patients from the Alzheimer’s Disease database of the Hospital of Traditional Chinese Medicine Affiliated to Xinjiang Medical University from 2017 to 2021 were selected.According to the Clinical Dementia Rating(CDR)scores,the patients were divided into a 136-case mild cognitive impairment group(aMCI group),a 140-case mild dementia group(Mi-D group),a 134-case moderate dementia group(Mo-D group)and a 60-case severe dementia group(SD group).Spearman correlation analysis and ordered Logistic regression were used to analyze the risk factors of cognitive aggravation in AD patients.Results①There were statistically significant differences in age,history of hypertension,body mass index(BMI),TT_(3),TT_(4),FT_(3) and FT_(4) in aMCI group,Mi-D group,Mo-D group and SD group(P<0.05).②Correlation analysis showed that MMSE score was negatively correlated with age(r=-0.238,P<0.05),TT_(3)(r=-0.323,P<0.05),FT_(3)(r=-0.252,P<0.05)and FBG(r=-0.111,P<0.05).It was positively correlated with TT_(4)(r=0.141,P<0.05),FT_(4)(r=0.252,P<0.05)and BMI(r=0.141,P<0.05).③Multivariate Logistic regression analysis results showed that advanced age(OR=1.153,95%CI:0.005-0.281),high 2hP-BG(OR=1.085,95%CI:0.029-0.126),low FT_(3)(OR=16.15,95%CI:-0.642--4.940),high Cys-C(OR=1.874,95%CI:0.299-1.702),increased 2hP-BG level,decreased FT_(3) level and decreased Cys-C level were independent risk factors for cognitive function progression in AD patients.Conclusion High 2hPBG,low FT_(3) and high Cys-C are risk factors for cognitive function in AD patients.