Díaz De León González Enrique, Gutiérrez Hermosillo Hugo, Cedillo Rodrígez Javier Armando, Reyes Romero Miguel Arturo, Camacho Luis Abelardo, Palacios Corona Rebeca, Burciaga Nava Jorge Alberto, Ríos Valles José Alejandro, Tamez Pérez Hector Eloy
Servicio de Geriatría, UMAE 21, Instituto Mexicano del Seguro Social, Monterrey, Nuevo León, México; Departamento de Posgrado, Universidad Juárez del Estado de Durango, México.
Departamento de Posgrado, Universidad Juárez del Estado de Durango, México; Centro Médico Nacional del Bajío No. 1, IMSS y Hospital Aranda de la Parra, León Guanajuato, México.
Med Clin (Barc). 2014 Nov 7;143(9):381-5. doi: 10.1016/j.medcli.2013.07.031. Epub 2013 Dec 15.
Cognitive impairment and dementia are common geriatric syndromes in diabetic patients. Inflammation plays a crucial role in the pathophysiology of Alzheimer's disease and cognitive impairment. Cyclooxygenases (COX) 1 and 2 participate in inflammation. The polymorphism c.1-765G>C of the COX2 gene might be protective against cognitive decline in Mexicans with diabetes mellitus through its reduced promotor activity. To determine the association between polymorphism c.1-765G>C of the COX2 gene and cognitive impairment in elderly adults with diabetes.
Case-control study. We included diabetic patients from the Geriatric Clinic of General Hospital No. 17 who were over 65 years and accepted to participate. Cases were patients with a score of 24 or less on the Mini Mental Status Examination (MMSE) and with DSM IV criteria for dementia. Controls were those with MMSE scores of 25 or greater. Results We included 97 patients (50 cases and 47 controls). There were no differences regarding clinical and laboratory characteristics between cases and controls. The frequency of the C allele and the CG genotype was higher in controls than in cases and this difference remained significant in a multivariate analysis with an odds ratio of 0.012 (95% CI 0.001-0.091) and 0.009 (95% CI 0.001-0.076) in the bivariate and multivariate analysis, respectively, using the GG genotype frequency as a reference.
Cognitive impairment in Mexican patients with diabetes is associated with less exposure to the CG genotype of the c.1-765G>C polymorphism of COX2.
认知障碍和痴呆是糖尿病患者常见的老年综合征。炎症在阿尔茨海默病和认知障碍的病理生理学中起关键作用。环氧化酶（COX）1和2参与炎症反应。COX2基因的c.1 - 765G>C多态性可能因其启动子活性降低而对墨西哥糖尿病患者的认知衰退具有保护作用。旨在确定COX2基因c.1 - 765G>C多态性与老年糖尿病患者认知障碍之间的关联。
病例对照研究。纳入了来自第17综合医院老年诊所的65岁以上且同意参与的糖尿病患者。病例为简易精神状态检查表（MMSE）得分24分及以下且符合DSM - IV痴呆标准的患者。对照为MMSE得分25分及以上的患者。结果共纳入97例患者（50例病例和47例对照）。病例组和对照组在临床和实验室特征方面无差异。对照组中C等位基因和CG基因型的频率高于病例组，在多变量分析中，以GG基因型频率为参照，该差异在双变量分析和多变量分析中分别仍具有显著性，比值比分别为0.012（95%置信区间0.001 - 0.091）和0.009（95%置信区间0.001 - 0.076）。
墨西哥糖尿病患者的认知障碍与COX2基因c.1 - 765G>C多态性的CG基因型暴露较少有关。
