2型糖尿病轻度认知功能障碍患者MoCA评分与尿白蛋白肌酐比值及足细胞标志蛋白的相关性

The relationship of score of MoCA with urine ACR and PCX in patients with type 2 diabetic mild cognitive impairment

目的 探讨2型糖尿病轻度认知功能障碍(MCI)患者尿白蛋白肌酐比值(ACR)、足细胞标志蛋白(PCX)的变化及其与蒙特利尔认知评估(MoCA)评分的相关性.方法 2型糖尿病患者60例作为对照组,2型糖尿病伴MCI患者60例作为MCI组,记录患者性别、年龄、糖尿病病程、教育年限,测FBG、HbA1c、SBP、DBP、TG、TC、LDL、HDL和尿ACR、PCX,并应用MoCA北京版评估患者认知功能.结果 MCI组糖尿病肾病患者比例显著高于对照组(χ2=73.818,P<0.01);MCI组MoCA评分显著低于对照组(P<0.01),尿PCX、ACR显著高于对照组(P<0.01);MoCA评分与ACR(r=-0.868,P<0.01)和PCX(r=-0.785,P<0.01)均呈负相关;ACR和PCX是MoCA评分的独立危险因素(P<0.01).结论 尿ACR、PCX与2型糖尿病认知功能密切相关,可作为2型糖尿病MCI的筛查指标.

Objective To explore the changes of urine albumin-creatinine ratio ( ACR) and urina-ry podocalyxin (PCX) and the relationship of score of Montreal cognitive assessment (MoCA) with urine ACR and PCX in patients with type 2 diabetic mild cognitive impairment. Methods Sixty patients with type 2 diabetes mellitus were used as the control group, and 60 patients with type 2 diabetic mild cognitive impairment as the mild cognitive impairment ( MCI) group. The sex, age, and course of disease and years of education of patients were recorded, the fasting plasma glucose (FPG), hemoglobin A1c (HbA1c), sys-tolic blood pressure ( SBP) , diastolic blood pressure ( DBP) , triglyceride ( TG) , total cholesterol ( TC) , low density lipoprotein ( LDL) , high-density lipoprotein ( HDL) , and urine ACR and PCX were measured, and the score of MoCA was assessed. Results The patients with type 2 diabetic nephropathy in the MCI group were significantly more than the control group (χ2 =73. 818,P<0. 01). The score of MoCA of the MCI group was significantly lower than the control group (P<0. 01), while urine ACR and PCX were high-er than the control group (P<0. 01). The score of MoCA was inversely associated with the urine ACR (r=-0. 868,P<0. 01) and PCX (r= -0. 785,P<0. 01), and those were the independent risk factors for the score of MoCA ( P<0. 01 ) . Conclusions The urine ACR and PCX were closely related to the cognitive function of type 2 diabetes mellitus, which can be used as the screening indexes of type 2 diabetic mild cog-nitive impairment.