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2 型糖尿病患者炎症生物标志物与认知功能及血糖、血脂谱的相关性:系统评价和荟萃分析。

Correlation between inflammatory biomarkers, cognitive function and glycemic and lipid profiles in patients with type 2 diabetes mellitus: A systematic review and meta-analysis.

机构信息

School of Nursing, Peking University, Beijing 100191, China.

Department of Neurology, The First Medical Center, Chinese PLA General Hospital, Beijing 100853, China.

出版信息

Clin Biochem. 2023 Nov;121-122:110683. doi: 10.1016/j.clinbiochem.2023.110683. Epub 2023 Nov 7.

Abstract

This study aimed to quantitatively estimate the correlation between systemic inflammation with cognitive function, as well as glycemic and lipid profiles in patients with type 2 diabetes mellitus (T2DM). The PubMed, Web of Science, EMBASE, SCOPUS, CNKI, Wanfang, VIP, and CBM databases were searched from its inception until June 2023 (PROSPERO registration: CRD42022356889). We analyzed data extracted from observational studies to quantify the correlations (r) as the pooled effect size and further performed subgroup analyses and sensitivity analyses. A total of 32 studies involving 7,483 patients with T2DM were included. The findings revealed a significant moderate negative correlation between interleukin-6 (IL-6), tumor necrosis factor-α (TNF-α), and C-reactive protein (CRP) levels with Montreal Cognitive Assessment scores. TNF-α levels also had moderate negative correlation with Mini-Mental State Examination scores. For glycemic and lipid profiles, there was a significant moderate positive correlation between CRP and TNF-α levels and glycated hemoglobin (HbA1c), and TNF-α levels were also found to be lowly positively correlated with fasting blood glucose (FBG). CRP levels were found to have a low positive correlation with total cholesterol (TC), and IL-6 levels were found to be lowly positively correlated with triglycerides. The results indicate that elevated levels of IL-6, CRP, and TNF-α are significantly associated with cognitive impairment in patients with T2DM and may serve as inflammatory markers for T2DM with mild cognitive impairment. The CRP and TNF-α levels were more strongly correlated with HbA1c than with FBG and TC. Further research is needed to determine the clinical value of these inflammatory biomarkers and to investigate potential causal mechanisms underlying this association.

摘要

本研究旨在定量评估 2 型糖尿病(T2DM)患者全身炎症与认知功能以及血糖和血脂谱之间的相关性。从建库到 2023 年 6 月,我们检索了 PubMed、Web of Science、EMBASE、SCOPUS、CNKI、万方、VIP 和 CBM 数据库(PROSPERO 注册号:CRD42022356889)。我们分析了从观察性研究中提取的数据,以量化相关性(r)作为汇总效应大小,并进一步进行了亚组分析和敏感性分析。共有 32 项研究纳入了 7483 例 T2DM 患者。研究结果显示,白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)和 C 反应蛋白(CRP)水平与蒙特利尔认知评估评分之间存在显著中度负相关。TNF-α水平与简易精神状态检查评分也存在中度负相关。对于血糖和血脂谱,CRP 和 TNF-α水平与糖化血红蛋白(HbA1c)呈显著中度正相关,TNF-α水平与空腹血糖(FBG)也呈低度正相关。CRP 水平与总胆固醇(TC)呈低度正相关,IL-6 水平与甘油三酯呈低度正相关。结果表明,IL-6、CRP 和 TNF-α水平升高与 T2DM 患者认知障碍显著相关,可能作为轻度认知障碍的 T2DM 的炎症标志物。CRP 和 TNF-α水平与 HbA1c 的相关性强于与 FBG 和 TC 的相关性。需要进一步研究以确定这些炎症生物标志物的临床价值,并探讨这种关联的潜在因果机制。

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