Shen Li, Wei Xiaole, Wang Nan, Lv Haorui, Huang Jing, Zhou Xiaoyan, Cheng Aifang, Ying Changjiang
The First Clinical Medical College, Xuzhou Medical University, Xuzhou, Jiangsu, China.
Department of Genetics, Xuzhou Medical University, Xuzhou, Jiangsu, China.
J Diabetes Investig. 2025 May;16(5):936-944. doi: 10.1111/jdi.70020. Epub 2025 Mar 2.
AIMS/INTRODUCTION: To investigate the predictive value of the biliverdin reductase-A (BVR-A) and the homeostasis model assessment for insulin resistance (HOMA-IR) on mild cognitive impairment (MCI) in patients with type 2 diabetes mellitus, and to establish a nomogram model.
This study included 140 patients with type 2 diabetes mellitus. Based on Montreal Cognitive Assessment (MoCA) scores, participants were categorized into the normal cognitive function (T2DM-NCF) group (65 cases) and the mild cognitive impairment (T2DM-MCI) group (75 cases). Multivariate logistic regression analysis was performed to identify the factors associated with MCI in patients with type 2 diabetes mellitus. A nomogram prediction model was developed using R software for the selected factors, and its predictability and accuracy were verified.
Compared with the T2DM-NCF group, subjects with MCI were older, had a longer duration of diabetes, higher HOMA-IR, lower BVR-A, lower cognitive scores, and lower education levels (all P < 0.05). Multivariate logistic regression analysis showed that duration of diabetes (OR = 1.407, 95% CI: 1.163-1.701), HOMA-IR (OR = 1.741, 95% CI: 1.197-2.53), and BVR-A (OR = 0.528, 95% CI: 0.392-0.712) were significantly associated with the development of MCI in patients with type 2 diabetes mellitus. The C-index of the nomogram was 0.863 (95% CI: 0.752-0.937).
Our findings suggest that BVR-A and HOMA-IR are significantly associated with the development of MCI in patients with type 2 diabetes mellitus. The nomogram incorporating BVR-A and HOMA-IR aids in predicting the risk of developing MCI in these patients.
目的/引言：探讨2型糖尿病患者中胆红素还原酶A（BVR - A）和胰岛素抵抗稳态模型评估（HOMA - IR）对轻度认知障碍（MCI）的预测价值，并建立列线图模型。
本研究纳入140例2型糖尿病患者。根据蒙特利尔认知评估（MoCA）得分，将参与者分为正常认知功能（T2DM - NCF）组（65例）和轻度认知障碍（T2DM - MCI）组（75例）。进行多因素逻辑回归分析以确定2型糖尿病患者中与MCI相关的因素。使用R软件为选定因素建立列线图预测模型，并验证其预测性和准确性。
与T2DM - NCF组相比，MCI患者年龄更大、糖尿病病程更长、HOMA - IR更高、BVR - A更低、认知得分更低且教育水平更低（均P < 0.05）。多因素逻辑回归分析显示，糖尿病病程（OR = 1.407，95%CI：1.163 - 1.701）、HOMA - IR（OR = 1.741，95%CI：1.197 - 2.53）和BVR - A（OR = 0.528，95%CI：0.392 - 0.712）与2型糖尿病患者MCI的发生显著相关。列线图的C指数为0.863（95%CI：0.752 - 0.937）。
我们的研究结果表明，BVR - A和HOMA - IR与2型糖尿病患者MCI的发生显著相关。纳入BVR - A和HOMA - IR的列线图有助于预测这些患者发生MCI的风险。
