Department of Endocrinology, Suzhou Wujiang District First People's Hospital, Jangsu, China.
Eur Rev Med Pharmacol Sci. 2017 Dec;21(23):5471-5477. doi: 10.26355/eurrev_201712_13937.
To investigate the correlation between the mild cognitive impairment (MCI) and serum level of adiponectin in elderly patients with Type II diabetes mellitus (T2DM), so as to provide evidence for early diagnosis of MCI and effective evaluation of the impairment of cognitive functions, thereby preventing the impairment of cognitive function as early as possible.
Clinical data were collected from 260 T2DM patients (≥ 60 years old) in Endocrine Department and 120 healthy subjects (≥ 60 years old) who underwent physical examination in our hospital between June 2015 and June 2017. According to the evaluation results of MCI, these T2DM patients were further divided into the T2DM + MCI group (n = 138) and the T2DM + NMCI group (n = 122). General data, including gender, age, disease history and body mass index (BMI), and the laboratory indexes, including serum adiponectin, fasting blood glucose (FBG), glycosylated hemoglobin (HbA1c) and blood fat, were collected for statistical analysis in T2DM + MCI group, T2DM + NMCI group and healthy control group.
Comparisons among T2DM + MCI group, T2DM + NMCI group and healthy control group, showed that the serum level of adiponectin in T2DM + MCI group was significantly lower than those in remaining two groups (p < 0.01). Spearman correlation analysis revealed that score of Montreal Cognitive Assessment (MoCA) was positively correlated with the serum level of adiponectin (r = 0.446, p < 0.01). Multivariate linear regression analysis indicated that education (standard β = 0.325, p = 0.003), age (standard β = -0.236, p = 0.016), disease course of hypertension (standard β = -0.242, p = 0.006), disease course of diabetes mellitus (standard β = -0.377, p < 0.001) and the level of adiponectin were correlated with the cognitive impairment. The results of itemized assessment in MoCA scale showed that in T2DM + MCI group, the scores in visuospatial and executive abilities, attention, language and orientation were significantly lower than those in other two groups (p < 0.01). As for the delayed recall, the score in T2DM + MCI group was significantly lower than those in other two groups (p < 0.01), while the score in T2DM + NMCI group was lower than that in the healthy control group (p < 0.01); in terms of the naming ability and abstraction, no statistically significant differences were identified among three groups (p > 0.05).
Age, poor education, disease course of hypertension, disease course of diabetes mellitus and a low level of adiponectin in serum are the risk factors in MCI of T2DM patients. Besides, the level of adiponectin in serum of T2DM patients is correlated with the development of MCI; elderly T2DM patients are afflicted by cognitive impairment, mainly in visuospatial and executive abilities, attention, language, delayed recall and orientation.
探讨老年 2 型糖尿病（T2DM）患者轻度认知功能障碍（MCI）与脂联素血清水平的相关性，为 MCI 的早期诊断及认知功能损害的有效评估提供依据，从而尽早预防认知功能损害。
收集 2015 年 6 月至 2017 年 6 月内分泌科收治的 260 例年龄≥60 岁的 T2DM 患者（T2DM 组）及同期我院体检的 120 例年龄≥60 岁的健康体检者（健康对照组）的临床资料。根据 MCI 评估结果，T2DM 患者进一步分为 T2DM+MCI 组（n=138）和 T2DM+NMCI 组（n=122）。统计 T2DM+MCI 组、T2DM+NMCI 组和健康对照组的一般资料[性别、年龄、疾病史、体质量指数（BMI）]和实验室指标[脂联素、空腹血糖（FBG）、糖化血红蛋白（HbA1c）、血脂]。
T2DM+MCI 组、T2DM+NMCI 组与健康对照组比较，T2DM+MCI 组脂联素血清水平明显低于其余两组（p<0.01）。Spearman 相关分析显示，蒙特利尔认知评估量表（MoCA）评分与脂联素血清水平呈正相关（r=0.446，p<0.01）。多元线性回归分析显示，教育（标准 β=0.325，p=0.003）、年龄（标准 β=-0.236，p=0.016）、高血压病程（标准 β=-0.242，p=0.006）、糖尿病病程（标准 β=-0.377，p<0.001）和脂联素水平与认知损害相关。MoCA 量表分项评估结果显示，T2DM+MCI 组视空间与执行能力、注意力、语言和定向力评分均明显低于其余两组（p<0.01）。延迟回忆评分中，T2DM+MCI 组明显低于其余两组（p<0.01），T2DM+NMCI 组低于健康对照组（p<0.01）；命名能力和抽象能力评分三组间比较，差异无统计学意义（p>0.05）。
年龄、教育程度低、高血压病程、糖尿病病程及血清脂联素水平低是老年 T2DM 患者发生 MCI 的危险因素。此外，T2DM 患者的脂联素血清水平与 MCI 的发生发展相关；老年 T2DM 患者认知功能损害主要累及视空间与执行能力、注意力、语言、延迟回忆和定向力。
