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β细胞功能与葡萄糖代谢异常患者认知障碍的相关性。

Association of β-cell function and cognitive impairment in patients with abnormal glucose metabolism.

机构信息

Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.

Department of Neurology, Beijing Sanbo Brain Hospital, Capital Medical University, Beijing, China.

出版信息

BMC Neurol. 2022 Jun 23;22(1):232. doi: 10.1186/s12883-022-02755-6.

Abstract

BACKGROUND

Insulin has been demonstrated to play an important role in the occurrence and development of Alzheimer's disease, especially in those with diabetes. β cells are important insulin-producing cells in human pancreas. This study aimed to investigate the association between β-cell dysfunction and cognitive impairment among patients over 40-year-old with abnormal glucose metabolism in Chinese rural communities.

METHODS

A sample of 592 participants aged 40 years or older from the China National Stroke Prevention Project (CSPP) between 2015 and 2017 were enrolled in this study. Abnormal glucose metabolism was defined when hemoglobin Alc ≥ 5.7%. Cognitive function was assessed by the Beijing edition of the Montreal Cognitive Assessment scale. Homeostasis assessment of β-cell function was performed and classified into 4 groups according to the quartiles. A lower value of HOMA-β indicated a worse condition of β-cell function. Multivariate logistic regression was used to analyze the association between β-cell function and cognitive impairment.

RESULTS

In a total of 592 patients with abnormal glucose metabolism, the average age was 60.20 ± 7.63 years and 60.1% patients had cognitive impairment. After adjusting for all potential risk factors, we found the first quartile of β-cell function was significantly associated with cognitive impairment (OR: 2.27, 95%CI: 1.32-3.92), especially at the domains of language (OR: 1.64, 95%CI: 1.01-2.65) and abstraction (OR: 2.29, 95%CI: 1.46-3.58).

CONCLUSIONS

Our study showed that worse β-cell function is associated with cognitive impairment of people over 40-year-old with abnormal glucose metabolism in Chinese rural communities, especially in the cognitive domains of abstraction and language.

摘要

背景

胰岛素已被证明在阿尔茨海默病的发生和发展中起重要作用,尤其是在糖尿病患者中。β细胞是人类胰腺中重要的胰岛素产生细胞。本研究旨在探讨中国农村社区中葡萄糖代谢异常的 40 岁以上人群中,β细胞功能障碍与认知障碍之间的关系。

方法

本研究纳入了 2015 年至 2017 年中国国家卒中预防项目(CSPP)中年龄在 40 岁或以上的 592 名参与者。当血红蛋白 Alc≥5.7%时,定义为异常葡萄糖代谢。认知功能采用北京版蒙特利尔认知评估量表进行评估。根据四分位数对β细胞功能的稳态评估进行分类。HOMA-β值越低,β细胞功能越差。采用多变量逻辑回归分析β细胞功能与认知障碍之间的关系。

结果

在 592 名葡萄糖代谢异常的患者中,平均年龄为 60.20±7.63 岁,60.1%的患者有认知障碍。在调整所有潜在的危险因素后,我们发现β细胞功能的第一四分位数与认知障碍显著相关(OR:2.27,95%CI:1.32-3.92),特别是在语言(OR:1.64,95%CI:1.01-2.65)和抽象(OR:2.29,95%CI:1.46-3.58)方面。

结论

我们的研究表明,β细胞功能越差与中国农村社区葡萄糖代谢异常的 40 岁以上人群的认知障碍有关,尤其是在抽象和语言认知领域。

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