血清胱抑素C、尿β_(2)-微球蛋白对中老年2型糖尿病患者认知功能障碍的预测价值

Predictive value of Serum Cystatin C and Urinaryβ_(2)-microglobulin for Cognitive Dysfunction in Middle-aged and Elderly Patients with Type 2 Diabetes Mellitus

目的分析血清胱抑素C、尿β_(2)-微球蛋白指标对中老年2型糖尿病患者认知功能障碍的预测价值。方法回顾性选取2022年1月—2023年12月贵阳白云心血管病医院收治的200例中老年2型糖尿病患者的临床资料,所有患者均完成血清胱抑素C(cystatin C,Cys-C)与尿液β_(2)-微球蛋白(β_(2)-microglobulin,β_(2)-MG)检测,根据认知功能评估结果,将患者分为认知障碍组(n=93)与正常组(n=107)。通过Logistic回归分析2型糖尿病患者出现认知功能障碍的独立危险因素。应用受试者工作特征曲线分析评估血清Cys-C和尿β_(2)-MG在预测认知功能障碍中的诊断效能。结果认知障碍组患者的血清Cys-C、尿液β_(2)-MG分别为(1.18±0.23)mg/L、(5.06±1.04)mg/h,高于正常组的(0.94±0.20)mg/L、(4.13±0.97)mg/h,差异有统计学意义(t=7.688、6.581,P均<0.05)。经多因素Logistic回归分析,血清Cys-C与尿β_(2)-MG高表达是患者出现认知障碍的独立危险因素。尿β_(2)-MG、血清Cys-C联合预测的曲线下面积(0.856)高于血清Cys-C与尿β_(2)-MG单一检测(0.768、0.739)。结论尿β_(2)-MG和血清Cys-C水平在伴有认知障碍的中老年2型糖尿病患者中明显升高,提示这两项指标可能是预测认知障碍的有效标记物。

Objective To evaluate the predictive value of serum cystatin C(Cys-C)and urinaryβ_(2)-microglobulin(β_(2)-MG)levels for cognitive impairment in elderly patients with type 2 diabetes.Methods The clinical data of 200 elderly patients with type 2 diabetes mellitus treated at Guiyang Baiyun Cardiovascular Hospital from January 2022 to December 2023 were retrospectively selected.All cases underwent measurements of serum Cys-C and urinaryβ_(2)-MG.Based on cognitive function assessment results,patients were categorized into a cognitive impairment group(n=93)and a normal group(n=107).Logistic regression was used to analyze independent risk factors for cognitive impairment in patients with type 2 diabetes.Receiver operating characteristic(ROC)curve analysis was used to evaluate the diagnostic performance of Cys-C andβ_(2)-MG in predicting cognitive impairment.Results The serum Cys-C and urinaryβ_(2)-MG levels in the cognitive impairment group were(1.18±0.23)mg/L and(5.06±1.04)mg/h,respectively,which were higher than those in the normal group(0.94±0.20)mg/L and(4.13±0.97)mg/h,the differences were statistically significant(t=7.688,6.581,both P<0.05).Multivariate logistic analysis indicated that elevated Cys-C andβ_(2)-MG levels were independeng risk factors for cognitive impairment.The area under the curve(AUC)for combined prediction ofβ_(2)-MG and Cys-C(0.856)was higher than 0.768 of serum Cys-C and 0.739 of urinaryβ_(2)-MG.Conclusion Elevated levels ofβ_(2)-MG and Cys-C were dindependent observed in elderly patients with type 2 diabetes who have cognitive impairment,suggesting that these markers may be effective for predicting cognitive dysfunction.