单纯精神分裂症与合并糖尿病患者脑源性神经营养因子与认知功能的相关性分析

Correlation between brain-derived neurotrophic factor and cognitive function in patients with simple schizophrenia and complicated with diabetes mellitus

目的 探讨精神分裂症与合并糖尿病患者脑源性神经营养因子(brain derived neurotrophic factor,BDNF)的水平及其与认知功能的相关性。方法 选取2019年6月至2020年9月北京回龙观医院精神分裂症合并糖尿病(共病组)40例、单纯精神分裂症(精分组)143例、精神正常的糖尿病患者(糖尿病组)221例和周边社区精神正常且非糖尿病人群(正常组)207例,采用酶联免疫吸附法(ELSIA)检测所有研究对象的BDNF水平,采用重复性成套神经心理状态测验(repeatable battery for the assessment of neuropsychological status,RBANS)评估4组研究对象的认知功能,采用Pearson相关分析评估其BDNF和认知功能的相关性。结果 611例研究对象中男385例、女226例,平均年龄(53.8±9.8)岁。4组BDNF水平由低到高依次为糖尿病组(7.74±3.03)ng/ml、精分组(9.99±2.14)ng/ml、共病组(10.04±1.83)ng/ml和正常组(11.71±2.37)ng/ml;与正常组相比,共病组、精分组和糖尿病组的BDNF水平较低,差异有统计学意义(P <0.05)。4组RBANS总分由低到高依次为精分组(72.12±16.15)分、共病组(73.80±14.48)分、糖尿病组(75.81±14.15)分和正常组(80.93±14.34)分;与正常组相比,共病组、精分组和糖尿病组的RBANS总分较低,差异有统计学意义(P <0.05)。4组即刻记忆、言语功能、注意、延时记忆的比较,差异有统计学意义(P <0.05)。精分组中BDNF水平与RBANS总分(r=0.243,P <0.05)、即刻记忆(r=0.299,P <0.05)、注意(r=0.185,P <0.05)呈正相关,糖尿病组中BDNF水平与注意(r=0.135,P <0.05)、延时记忆(r=0.212,P <0.05)呈正相关,正常组BDNF水平与言语功能呈负相关(r=-0.142,P <0.05)。结论 精神分裂症、糖尿病和精神分裂症合并糖尿病患者的BDNF水平较低。精神分裂症合并糖尿病患者的BDNF水平较糖尿病患者偏高,精神分裂症和糖尿病患者的BDNF水平与部分认知功能呈正相关。

Objective To explore the level of brain-derived neurotrophic factor(BDNF) in patients with schizophrenia and complicated with diabetes mellitus and its correlation with cognitive function.Methods Forty patients with schizophrenia complicated with diabetes(comorbid group),143 patients with simple schizophrenia(schizophrenic group),221 diabetic patients with normal mental health(diabetic group) from Beijing Huilongguan Hospital and 207 person with normal mental health and normal blood glucose(normal group) in surrounding communities from June 2019 to September 2020 were selected.The BDNF levels of all the subjects were detected by enzyme-linked immunosorbent assay(ELSIA),and the cognitive function of the four groups was evaluated by repeatable battery for the assessment of neuropsychological status(RBANS).The correlation between BDNF and cognitive function was evaluated by Pearson correlation analysis.Results Among the 611 subjects,there were 385 males and 226 females,with an average age of(53.8 ±9.8) years.The levels of BDNF in the four groups from low to high were(7.74 ± 3.03) ng/ml in the diabetic group,(9.99 ±2.14) ng/ml in the schizophrenic group,(10.04 ± 1.83) ng/ml in the comorbid group and(11.71 ± 2.37) ng/ml in the normal group.Compared with the normal group,the levels of BDNF the comorbid group,schizophrenic group and diabetic group were lower,and the differences were statistically significant(P < 0.05).The total scores of RBANS in the four groups from low to high were(72.12 ± 16.15) score in the schizophrenic group,(73.80 ± 14.48) score in the comorbid group,(75.81 ±14.15) score in the diabetic group and(80.93 ± 14.34) score in the normal group.Compared with the normal group,the total scores of RBANS in the comorbid group,schizophrenic group and diabetic group were lower,and the differences were statistically significant(P < 0.05).There were significant differences in immediate memory,speech function,attention and delayed memory among the four groups(P < 0.05).The levels of BDNF in the schizophrenic group were positively correlated with the total score of RBANS(r = 0.243,P < 0.05),immediate memory(r = 0.299,P < 0.05) and attention(r = 0.185,P <0.05),while the levels of BDNF in the diabetic group were positively correlated with attention(r = 0.135,P < 0.05) and delayed memory(r = 0.212,P < 0.05),while the levels of BDNF in normal group were negatively correlated with speech function(r =-0.142,P < 0.05).Conclusions Patients with schizophrenia,diabetes or schizophrenia complicated with diabetes have lower level of BDNF.The level of BDNF in schizophrenic patients complicated with diabetes is higher than that of the diabetic patients.The levels of BDNF in schizophrenic patients and diabetic patients are positively correlated with some cognitive functions.