Yang Xue, Chen Yiqi, Zhang Wenshuo, Zhang Zhen, Yang Xueli, Wang Pengxu, Yuan Huijuan
Department of Education and Training, Diabetes Research Center, Henan Province People's Hospital, Zhengzhou, Henan Province, People's Republic of China.
Department of Endocrinology and Metabolism, Diabetes Research Center, Henan Province People's Hospital, Zhengzhou, Henan Province, People's Republic of China.
Diabetes Metab Syndr Obes. 2020 Oct 29;13:4059-4065. doi: 10.2147/DMSO.S271160. eCollection 2020.
To explore the relationship between inflammatory biomarkers and cognitive dysfunction in patients with type 1 diabetes mellitus (T1DM) and type 2 diabetes mellitus (T2DM).
T1DM patients (n=32), T2DM patients (n=90) and age-matched controls (n=36 and 81, respectively) were included. The 72-hour dynamic blood glucose test and cognitive function, including visuoconstructive function, executive function, learning and memory, attention, language expression ability, and orientation, were analyzed. The head, body and tail grey matter of the hippocampus were analyzed by magnetic resonance spectroscopy. In addition, serum HMGB1, IL-1β, IL-6, and TNF-α concentrations were examined.
HbA1C, MAGE and MODD were higher in T1DM patients than in T2DM patients (p<0.05). MoCA scores and IL-1β and IL-6 levels in patients with T2DM were higher than T1DM patients. NAA/Cr and Cho/Cr of the hippocampus were higher in patients with T1DM than in those with T2DM. Levels of inflammatory factors in T1DM and T2DM patients were higher than in nondiabetic subjects (p<0.05). Regression analysis showed that cognition was associated with MAGE, MODD, NAA/Cr of the left hippocampus and HMGB1 in T1DM patients, after adjustment for age, sex, BMI and other co-variables. In T2DM patients, cognitive impairment was associated with MAGE, NAA/Cr of the left hippocampus, HMGB1 and IL-6, after adjustment for co-variables such as sex, age and BMI.
T2DM patients have more cognitive impairment than T1DM patients. Changes in brain function connections and metabolites may be the structural basis of the differences in cognitive functional impairment. Inflammation is related to cognitive impairment in diabetes patients, especially in T2DM patients.
探讨1型糖尿病（T1DM）和2型糖尿病（T2DM）患者炎症生物标志物与认知功能障碍之间的关系。
纳入T1DM患者（n = 32）、T2DM患者（n = 90）以及年龄匹配的对照组（分别为n = 36和81）。分析72小时动态血糖测试及认知功能，包括视觉构建功能、执行功能、学习与记忆、注意力、语言表达能力和定向力。采用磁共振波谱分析海马头部、体部和尾部灰质。此外，检测血清高迁移率族蛋白B1（HMGB1）、白细胞介素-1β（IL-1β）、白细胞介素-6（IL-6）和肿瘤坏死因子-α（TNF-α）浓度。
T1DM患者的糖化血红蛋白（HbA1C）、血糖波动幅度（MAGE）和平均血糖标准差（MODD）高于T2DM患者（p<0.05）。T2DM患者的蒙特利尔认知评估量表（MoCA）评分以及IL-1β和IL-6水平高于T1DM患者。T1DM患者海马的N-乙酰天门冬氨酸/肌酸（NAA/Cr）和胆碱/肌酸（Cho/Cr）高于T2DM患者。T1DM和T2DM患者的炎症因子水平高于非糖尿病受试者（p<0.05）。回归分析显示，在调整年龄、性别、体重指数（BMI）和其他协变量后，T1DM患者的认知与MAGE、MODD、左侧海马的NAA/Cr以及HMGB1相关。在调整性别、年龄和BMI等协变量后，T2DM患者的认知障碍与MAGE、左侧海马的NAA/Cr、HMGB1和IL-6相关。
T2DM患者比T1DM患者有更多的认知障碍。脑功能连接和代谢物的变化可能是认知功能障碍差异的结构基础。炎症与糖尿病患者的认知障碍有关，尤其是T2DM患者。
