Jin Qi-hui, Li Tian-lang, Chen Huai-hong, Liu Zhao, Li Xiao-chun, Xu Lei, Wang Shuang
Department of Geriatrics, College of Medicine, Zhejiang University, Hangzhou, China.
Zhonghua Yi Xue Za Zhi. 2011 Jul 26;91(28):1949-52.
To explore the relationship between fasting plasma level of total homocysteine (tHcy) and mild cognitive impairment in senile patients with type 2 diabetes mellitus.
A total of 88 senile type 2 diabetics with mild cognitive impairment treated at our hospital from July 2008 to November 2010 were recruited into the MCI group while 52 senile type 2 diabetics into the DNC group. And the control group was composed of 36 healthy elders. The parameters of tHcy, total glyceride (TG), total cholesterol (TC), low density lipoprotein-C (LDL-C), high density lipoprotein-C (HDL-C), creatinine (Cr), hemoglobin A1c (HbA1c), fasting plasma glucose (FPG), 2 h plasma glucose (2 hPG), fasting insulin (FINS), homeostasis model of insulin resistance (HOMA-IR), folic acid (FA) and vitamin B(12) (VitB(12)) were detected.
The patients had a higher level of tHcy in the MCI group than those in the NCM and control groups [(11.3 ± 1.8) vs (9.8 ± 1.5) and (8.1 ± 1.1) µmol/L; P < 0.01]. ROC curve showed that tHcy level had some value of predicting the occurrence of mild cognitive impairment in senile patients with type 2 diabetes mellitus (AUC 0.825, 95%CI 0.758-0.893, P < 0.01). Logistic regression analysis showed that tHcy, SBP, HbA1c, 2 h PG, FINS, LDL-C, HOMA-IR, FA and VitB(12) [OR value: 3.64, 1.68, 1.10, 1.05, 0.81, 1.42, 0.83, 0.74, 0.86 (P < 0.05 or 0.01)] were independent risk factors of mild cognitive impairment in senile diabetic patients.
Such factors as tHcy, SBP, HbA1c, FPG, 2 hPG, FINS, LDL-C, HOMA-IR, FA and VitB(12) induce senile patients with type 2 diabetes mellitus to suffer mild cognitive impairment. But tHcy level may play an important role in senile diabetic patients with mild cognitive impairment.
探讨老年2型糖尿病患者空腹血浆总同型半胱氨酸（tHcy）水平与轻度认知功能障碍之间的关系。
选取2008年7月至2010年11月在我院治疗的88例患有轻度认知功能障碍的老年2型糖尿病患者作为MCI组，52例老年2型糖尿病患者作为DNC组。对照组由36例健康老年人组成。检测tHcy、总甘油三酯（TG）、总胆固醇（TC）、低密度脂蛋白胆固醇（LDL-C）、高密度脂蛋白胆固醇（HDL-C）、肌酐（Cr）、糖化血红蛋白（HbA1c）、空腹血糖（FPG）、餐后2小时血糖（2hPG）、空腹胰岛素（FINS）、胰岛素抵抗稳态模型评估（HOMA-IR）、叶酸（FA）和维生素B12（VitB12）等指标。
MCI组患者的tHcy水平高于NCM组和对照组[（11.3±1.8） vs （9.8±1.5）和（8.1±1.1）μmol/L；P<0.01]。ROC曲线显示，tHcy水平对预测老年2型糖尿病患者轻度认知功能障碍的发生具有一定价值（AUC 0.825，95%CI 0.758 - 0.893，P<0.01）。Logistic回归分析显示，tHcy、收缩压（SBP）、HbA1c、2hPG、FINS、LDL-C、HOMA-IR、FA和VitB12[OR值：3.64、1.68、1.10、1.05、0.81、1.42、0.83、0.74、0.86（P<0.05或0.01）]是老年糖尿病患者轻度认知功能障碍的独立危险因素。
tHcy、SBP、HbA1c、FPG、2hPG、FINS、LDL-C、HOMA-IR、FA和VitB12等因素可导致老年2型糖尿病患者发生轻度认知功能障碍。但tHcy水平在老年糖尿病轻度认知功能障碍患者中可能起重要作用。
