Bai Fengfeng, Li Tao, Li Baozhu, Li Xiaozheng, Zhu Lifeng
Department of Psychiatry, Anding Hospital, Tianjin 300222, People's Republic of China.
Nursing Department, The Second Hospital, Cheeloo College of Medicine, Shandong University, Jinan, Shandong 250033, People's Republic of China.
Diabetes Metab Syndr Obes. 2020 Oct 22;13:3919-3924. doi: 10.2147/DMSO.S274413. eCollection 2020.
Previous studies have reported that patients with diabetes mellitus (DM) have a higher incidence of cognitive decline and an increased risk of developing all types of dementia. The aim was to elucidate the association between serum human epididymal protein 4 and cognitive function in patients with DM.
Serum levels of HE4 were measured in 205 patients with DM. All DM patients were followed up for a median period of 48 months (range=5-49) prospectively. Cox proportional hazard analysis was used to evaluate the predictive value of serum HE4 for predicting cognitive decline (end point).
Multivariate linear regression analysis revealed that serum HE4 was independently associated with MOCA score after adjusting for age, gender, BMI, current smoker, current drinker, admission systolic and diastolic BP, CVD history and laboratory measurements in patients with DM at baseline (Sβ= -0.120; 95% CI, -0.151- -0.069; <0.001). The multivariate Cox proportional hazard analysis revealed that serum HE4 (HR=2.408, 95% CI 1.669-5.238, <0.001) was an independent prognostic factor for cognitive decline in these DM patients.
Our results showed that serum HE4 was significantly and independently associated with cognitive decline and had independent predictive value for cognitive decline in patients with DM. Serum HE4 might enable early recognition of senile dementia among DM patients.
既往研究报道，糖尿病（DM）患者认知功能下降的发生率较高，患各类痴呆症的风险增加。目的是阐明血清人附睾蛋白4与DM患者认知功能之间的关联。
测定205例DM患者的血清HE4水平。对所有DM患者进行前瞻性随访，中位随访时间为48个月（范围=5-49个月）。采用Cox比例风险分析评估血清HE4对预测认知功能下降（终点）的预测价值。
多因素线性回归分析显示，在对DM患者基线时的年龄、性别、BMI、当前吸烟者、当前饮酒者、入院时收缩压和舒张压、心血管疾病史及实验室检查指标进行校正后，血清HE4与蒙特利尔认知评估量表（MOCA）评分独立相关（Sβ=-0.120；95%CI，-0.151--0.069；P<0.001）。多因素Cox比例风险分析显示，血清HE4（HR=2.408，95%CI 1.669-5.238，P<0.001）是这些DM患者认知功能下降的独立预后因素。
我们的结果表明，血清HE4与认知功能下降显著且独立相关，对DM患者的认知功能下降具有独立预测价值。血清HE4可能有助于早期识别DM患者中的老年痴呆症。
