Department of Endocrinology, First Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang, China.
Department of Neurology, Heilongjiang Provincial Hospital, Harbin, Heilongjiang, China.
PeerJ. 2023 Aug 7;11:e15826. doi: 10.7717/peerj.15826. eCollection 2023.
Cognitive impairment is the main manifestation of diabetes central neuropathy. Currently, there is no effective dementia treatment; early diagnosis and treatment are particularly crucial. Inflammation index fibrinogen-to-albumin ratio (FAR) has been shown to predict complications of type 2 diabetes (diabetic kidney disease and diabetes-related arteriosclerosis), but its relationship with mild cognitive impairment (MCI) in type 2 diabetes (T2D) is undetermined. In this study, we examined the association between the FAR and mild cognitive impairment in type 2 diabetes.
This is a retrospective and cross-sectional study. From January 2022 to December 2022, we have retrieved 328 inpatient medical records for T2D patients hospitalized at the First Hospital of Harbin Medical University from the hospital's electronic system. Subjects' cognitive function was assessed and grouped by the MoCA scales. Subjects' demographic and various laboratory indicators were collected. Using Spearman's bivariate correlation analysis, the FAR and other clinical variables were analyzed for association strength. A multiple linear regression analysis was conducted to determine the independent relationship between FAR and MoCA scores. Multivariate logistic regression was used to analyze the independent relationship between FAR and MCI. The capacity of the FAR to detect MCI was carried using receiver operating characteristic (ROC) analysis.
The included participants' ( = 328; 61.9% male) mean age was 52.62 ± 10.92 years. MoCA scores and MCI prevalence significantly differed ( < 0.05) between the four subgroups of FAR quartiles. The FAR and the MoCA score were significantly negatively correlated in the entire population ( < 0.05). Based on the multiple linear regression analysis, lnFAR and lnMoCA are significantly correlated (β = -0.449, t = -8.21, < 0.05, R2 = 0.469). In multivariate logistic regression analysis, FAR and MCI were independently correlated after adjusting for covariates (OR 95% CI 34.70 [13.90-86.66]). Finally, the analysis of receptor working characteristics shows that the optimal FAR cut-off value was 0.08 (sensitivity: 95.81%, specificity: 84.47%) for detecting MCI in type 2 diabetes.
In type 2 diabetes, the FAR was positive associations with MCI and negative associations with MoCA score. The high FAR was associated with an increased risk of MCI. FAR maybe a appropriate indicator of MCI risk for type 2 diabetes.
认知障碍是糖尿病中枢神经病变的主要表现。目前，尚无有效的痴呆治疗方法；早期诊断和治疗尤为关键。纤维蛋白原与白蛋白比值（FAR）等炎症指标已被证明可预测 2 型糖尿病（糖尿病肾病和糖尿病相关动脉硬化）的并发症，但它与 2 型糖尿病（T2D）轻度认知障碍（MCI）的关系尚未确定。在这项研究中，我们研究了 FAR 与 2 型糖尿病患者轻度认知障碍之间的关系。
这是一项回顾性和横断面研究。我们从哈医大一院电子病历系统中检索了 2022 年 1 月至 2022 年 12 月间 328 例住院 T2D 患者的病历。采用 MoCA 量表评估患者的认知功能并进行分组。收集患者的人口统计学和各种实验室指标。采用 Spearman 双变量相关分析 FAR 与其他临床变量的关联强度。采用多元线性回归分析 FAR 与 MoCA 评分的独立关系。采用多元逻辑回归分析 FAR 与 MCI 的独立关系。采用受试者工作特征（ROC）分析 FAR 检测 MCI 的能力。
纳入的研究对象（n=328；男性占 61.9%）的平均年龄为 52.62±10.92 岁。FAR 四分位组间 MoCA 评分和 MCI 患病率差异有统计学意义（P<0.05）。FAR 与 MoCA 评分在全人群中呈显著负相关（P<0.05）。多元线性回归分析显示，lnFAR 和 lnMoCA 显著相关（β=-0.449，t=-8.21，P<0.05，R2=0.469）。多元逻辑回归分析校正协变量后，FAR 与 MCI 独立相关（OR 95%CI 34.70[13.90-86.66]）。最后，ROC 分析显示，FAR 最佳截断值为 0.08（灵敏度：95.81%，特异性：84.47%），可用于检测 2 型糖尿病的 MCI。
在 2 型糖尿病中，FAR 与 MCI 呈正相关，与 MoCA 评分呈负相关。高 FAR 与 MCI 风险增加相关。FAR 可能是 2 型糖尿病 MCI 风险的一个合适指标。
