Pujol Antelm, Sanchis Pilar, Tamayo María I, Godoy Samantha, Calvó Paula, Olmos Asier, Andrés Pilar, Speranskaya Aleksandra, Espino Ana, Estremera Ana, Rigo Elena, Amengual Guillermo J, Rodríguez Manuel, Ribes José Luis, Gomila Isabel, Grases Félix, González-Freire Marta, Masmiquel Lluís
Vascular and Metabolic Diseases Research Group, Endocrinology Department, Son Llàtzer University Hospital, Health Research Institute of the Balearic Islands (IdISBa), 07120 Palma de Mallorca, Spain.
Laboratory of Renal Lithiasis Research, University of Balearic Islands, Research Institute of Heath Science (IUNICS), Health Research Institute of Balearic Islands (IdISBa), 07120 Palma de Mallorca, Spain.
Biomedicines. 2024 Sep 2;12(9):1993. doi: 10.3390/biomedicines12091993.
The effect of liver fibrosis on mild cognitive impairment (MCI) and dementia risk in type 2 diabetes mellitus (T2DM) patients is unclear. Therefore, we performed a prospective cross-sectional study on 219 patients with T2DM and older than 60 years to evaluate the association between liver fibrosis, liver steatosis, and cognitive impairment. The Montreal Cognitive Assessment (MoCA) was used to screen for MCI or dementia. Liver fibrosis was estimated using the non-invasive Fibrosis-4 (FIB-4) score, and liver steatosis was assessed with the hepatic steatosis index. The mean age was 71 ± 6 years, 47% were women and according to MoCA cut-off values, 53.88% had MCI and 16.43% had dementia. A moderate or high risk of advanced fibrosis was significantly higher in patients with MCI or dementia compared to those with normal cognition ( < 0.001). After adjusting for confounders, a FIB-4 score greater than 1.54 was associated with MCI or dementia ( = 0.039). Multivariate analysis identified age over 70.5 years, antiplatelet medication use, and a FIB-4 score above 1.54 as the most relevant risk factors. Liver fibrosis, but not liver steatosis, is associated with MCI or dementia in older T2DM patients, suggesting that FIB-4 score might be a simple biomarker for the detection of cognitive impairment.
肝纤维化对2型糖尿病（T2DM）患者轻度认知障碍（MCI）及痴呆风险的影响尚不清楚。因此，我们对219例年龄大于60岁的T2DM患者进行了一项前瞻性横断面研究，以评估肝纤维化、肝脂肪变性与认知障碍之间的关联。采用蒙特利尔认知评估量表（MoCA）筛查MCI或痴呆。使用无创性Fibrosis-4（FIB-4）评分评估肝纤维化，并用肝脏脂肪变性指数评估肝脂肪变性。平均年龄为71±6岁，47%为女性，根据MoCA临界值，53.88%有MCI，16.43%有痴呆。与认知正常者相比，MCI或痴呆患者出现中重度进展性纤维化的风险显著更高（<0.001）。校正混杂因素后，FIB-4评分大于1.54与MCI或痴呆相关（=0.039）。多变量分析确定年龄大于70.5岁、使用抗血小板药物以及FIB-4评分高于1.54为最相关的危险因素。在老年T2DM患者中，肝纤维化而非肝脂肪变性与MCI或痴呆相关，这表明FIB-4评分可能是检测认知障碍的一个简单生物标志物。
