Zhang Haina, Yu Lou, Yun Gai
Department of General Medicine, Shanghai Pudong Hospital, Fudan University Pudong Medical Center, Pudong, Shanghai, 201399, People's Republic of China.
Department of Preventive Treatment, Shanghai Seventh People's Hospital, Shanghai, 200137, People's Republic of China.
Diabetes Metab Syndr Obes. 2023 Jan 15;16:129-137. doi: 10.2147/DMSO.S394099. eCollection 2023.
The study objective was to investigate the serum levels of Klotho in patients with type 2 diabetes mellitus (T2DM) who had moderate cognitive impairment (MCI) and those without MCI and to determine its prediction of MCI in older patients with T2DM.
Patients with diabetes were examined for MCI in 292 cases (using the Montreal Cognitive Assessment: MoCA score). Biomarkers and biochemical parameter data were accumulated.
Comparing T2DM patients with MCI (91 patients) and without MCI (101 patients), patients with MCI considerably reduced serum Klotho levels were observed. In all 292 hospitalized patients, serum Klotho levels were negatively correlated with age (r=-0.184, P=0.002), body mass index (BMI) (r=-0.151, P=0.010), glycosylated hemoglobin (HbA1c) (r=-0.197, P=0.001), creatinine (r=-0.178, P=0.002), and C-reactive protein (CRP) (r=-0.319, P<0.001). On the other hand, it is positively correlated with education (r=0.319, P<0.001) and high-density lipoprotein cholesterol (HDL-C) (r=0.272, P<0.001). Considering the findings of the multivariate logistic regression models, patients with type 2 diabetes who had reduced levels of serum Klotho (OR=0.987, 95% CI=0.980-0.994; P<0.001), lower HDL-C, increased levels of HbA1c, creatinine, and CRP, and limited years of formal education and a longer duration of T2DM, increase the risk of developing MCI.
The results showed that diabetic patients with MCI have lower serum Klotho levels than diabetic patients without MCI. It might be possible to do a more extensive population-based prospective investigation to confirm the correlation between serum Klotho levels and cognitive impairment or dementia.
本研究旨在调查中度认知障碍（MCI）的2型糖尿病（T2DM）患者与无MCI的T2DM患者的血清Klotho水平，并确定其对老年T2DM患者MCI的预测作用。
对292例糖尿病患者进行MCI检查（采用蒙特利尔认知评估：MoCA评分）。收集生物标志物和生化参数数据。
比较有MCI的T2DM患者（91例）和无MCI的T2DM患者（101例），发现有MCI的患者血清Klotho水平显著降低。在所有292例住院患者中，血清Klotho水平与年龄（r = -0.184，P = 0.002）、体重指数（BMI）（r = -0.151，P = 0.010）、糖化血红蛋白（HbA1c）（r = -0.197，P = 0.001）、肌酐（r = -0.178，P = 0.002）和C反应蛋白（CRP）（r = -0.319，P < 0.001）呈负相关。另一方面，它与受教育程度（r = 0.319，P < 0.001）和高密度脂蛋白胆固醇（HDL-C）（r = 0.272，P < 0.001）呈正相关。根据多因素逻辑回归模型的结果，血清Klotho水平降低（OR = 0.987，95%CI = 0.980 - 0.994；P < 0.001）、HDL-C水平较低、HbA1c、肌酐和CRP水平升高、正规教育年限有限以及T2DM病程较长的2型糖尿病患者发生MCI的风险增加。
结果表明，患有MCI的糖尿病患者血清Klotho水平低于无MCI的糖尿病患者。可能有必要进行更广泛的基于人群的前瞻性研究，以证实血清Klotho水平与认知障碍或痴呆之间的相关性。
