School of Medicine, Southeast University, Nanjing, China.
Department of Endocrinology, The Affiliated ZhongDa Hospital of Southeast University, Nanjing, China.
J Alzheimers Dis. 2020;75(3):807-815. doi: 10.3233/JAD-200074.
Metabolic disorders, including insulin resistance, obesity, and hyperlipidemia occur frequently prior to hyperglycemia in patients with type 2 diabetes mellitus (T2DM) and cause mild cognitive impairment (MCI).
We investigated the involvement of resistin in these metabolic abnormalities contributes to MCI in patients with T2DM.
A total of 138 hospitalized patients with T2DM were enrolled and categorized into MCI and non-MCI groups according to the Montreal Cognitive Assessment (MoCA) score. Metabolic indicators and cognitive state were assessed, and plasma resistin levels were determined by ELISA.
The resistin levels and homeostasis model assessment of insulin resistance (HOMA-IR) scores of MCI and gender-stratified subgroups were significantly higher than those of controls without MCI (all p < 0.01). Correlation analysis showed that the resistin level was negatively associated with majority of cognitive domains, e.g., MoCA (r = -0.693, p < 0.001) and Mini-Mental State Examination (r = -0.571, p < 0.001), and was related to HOMA-IR (r = 0.667, p < 0.001) but not to obesity and lipid indices. Multivariable regression analysis indicated that resistin (β= -0.675, p < 0.001) and educational level (β= 0.177, p = 0.003) were independent risk factors of MoCA in patients with T2DM.
High plasma resistin levels portend the insulin resistance-related susceptibility to early cognitive decline in Chinese patients with T2DM. The involvement of this adipokine in other metabolic disorders leading to diabetic MCI and its clinical value for early disease screening must be further studied.
2 型糖尿病（T2DM）患者在出现高血糖之前常发生代谢紊乱，包括胰岛素抵抗、肥胖和血脂异常，导致轻度认知障碍（MCI）。
本研究旨在探讨抵抗素在 T2DM 患者代谢异常导致 MCI 中的作用。
共纳入 138 例住院 T2DM 患者，根据蒙特利尔认知评估（MoCA）评分分为 MCI 组和非 MCI 组。评估代谢指标和认知状态，采用 ELISA 法测定血浆抵抗素水平。
MCI 组和性别分层亚组的抵抗素水平和胰岛素抵抗稳态模型评估（HOMA-IR）评分均显著高于无 MCI 对照组（均 P ＜ 0.01）。相关性分析显示，抵抗素水平与 MoCA（r ＝ －0.693，P ＜ 0.001）和简易精神状态检查（r ＝ －0.571，P ＜ 0.001）等大部分认知域呈负相关，与 HOMA-IR 呈正相关（r ＝ 0.667，P ＜ 0.001），但与肥胖和血脂指数无关。多变量回归分析表明，抵抗素（β ＝ －0.675，P ＜ 0.001）和受教育程度（β ＝ 0.177，P ＝ 0.003）是 T2DM 患者 MoCA 的独立危险因素。
高血浆抵抗素水平预示着中国 T2DM 患者发生与胰岛素抵抗相关的早期认知下降的易感性。该脂肪因子在导致糖尿病性 MCI 的其他代谢紊乱中的作用及其用于早期疾病筛查的临床价值有待进一步研究。
