血清维生素A、E与2型糖尿病老年人认知功能的分析

Correlation between serum vitamin A and vitamin E and cognitive function in aging subjects with type 2 diabetes mellitus

目的探讨血清维生素A、维生素E浓度与2型糖尿病(type 2 diabetes mellitus,T2DM)老年人认知功能的相关性。方法募集社区60岁以上T2DM老年人500例。同时募集年龄、性别、受教育程度与T2DM患者相匹配的非糖尿病60岁以上健康居民500例作为对照组。采用自行设计调查表对研究对象进行社会人口学、生活方式、疾病史等因素调查。应用蒙特利尔认知评估量表(Montreal Cognitive Assessment,MoCA)对被调查者的认知功能进行评估。采集被调查者的空腹静脉血,用于检测空腹血糖(fasting blood glucose,FBG)、血总胆固醇(total cholesterol,TC)、三酰甘油(triglyceride,TG)、低密度脂蛋白胆固醇(low density lipoprotein-cholesterol,LDL-C)和高密度脂蛋白胆固醇(high density lipoprotein-cholesterol,HDL-C)等生物化学指标。高效液相色谱法对血清中维生素A(vitamin A,VA)和维生素E(vitamin E,VE)进行检测。采用SPSS 20.0对数据进行统计分析。结果T2DM组中,认知功能正常者血清VA浓度(0.59μg/mL)高于患有轻度认知功能障碍(mild cognitive impairment,MCI)者(0.50μg/mL),差异有统计学意义(P<0.01);认知功能正常者血清VE含量(12.22μg/mL)高于MCI患者(11.40μg/mL),但差异无统计学意义(P>0.05)。糖尿病患者血清VA浓度与MoCA总分及各项评分(除定向功能外)均呈正相关;较高浓度的血清VA浓度与低浓度相比,患糖尿病的风险降低(OR<1,P<0.05)。结论本研究观察到较高的血清VA浓度与更好的认知功能有关,所以较高的血清VA浓度可能作为T2DM老年人认知功能的一种保护性因素;而血清VE浓度与老年人认知功能尚不能得出存在关联性的结论。

Objective To investigate the correlation between serum vitamin A and vitamin E levels and cognitive function in aging subjects in older adults with type 2 diabetes mellitus(T2DM).Methods A total of 500 T2DM patients were recruited from Communities.And 500 age,gender and education level matched non-diabetic healthy adults were recruited as normal control subjects.A self-designed questionnaire was used to investigate socio-demography,lifestyle,disease history and other factors.Montreal Cognitive Assessment(MoCA)scale was used to assess the cognitive function.Fasting venous blood was collected for biochemical parameters including fasting blood glucose(FBG),total blood cholesterol(TC),triglycerides(TG),low density lipoprotein-cholesterol(LDL-C)and high density lipoprotein-cholesterol(HDL-C)levels.The serum levels of vitamin A(VA)and vitamin E(VE)were detected by high performance liquid chromatography(HPLC).SPSS 20.0 was used to statistically analyze the data.Results Among the T2DM group,the serum VA level of those with normal cognitive function(0.59μg/mL)was higher than that of those with mild cognitive impairment(MCI)(0.50μg/mL),and the difference was statistically significant(P<0.01).The serum VE level of those with normal cognitive function(12.22μg/mL)were higher than those with MCI(11.40μg/mL),but the difference was no statistically significance(P>0.05).Serum VA levels in T2DM group were positively correlated with the total MoCA score and all scores(except the orienting function);and higher concentrations of serum VA levels were associated with a reduced risk of developing diabetes compared with lower levels(OR<1,P<0.05).Conclusion In this study,we found that higher serum VA levels were associated with better cognitive function.Thus,higher serum VA levels may act as a protective factor for cognitive function in elderly with T2DM.However,there is no association between serum VE level and cognitive function in the elderly.