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目的探讨老年2型糖尿病(type 2diabetes mellitus,T2DM)患者血清胱抑素C(cystatin C,Cys C)水平与轻度认知损害(mild cognitive impairment,MCI)的关系,并分析MCI发生的相关危险因素。方法老年2型糖尿病患者156例分为MCI组与认知功能正常组;均使用简易智能状态检查量表、蒙特利尔认知评估量表、焦虑自评量表、流调用抑郁自评量表、帕金森病筛查量表、日常生活能力量表、全面衰退量表等进行测验,并检测Cys C、糖化血红蛋白、三酰甘油、总胆固醇和血压等;进行t检验、直线相关及Logistic回归模型分析。结果伴有MCI的老年T2DM患者血清Cys C水平明显升高(P=0.018);血清Cys C与简易智能状态检查量表总分、蒙特利尔认知评估量表总分及视空间与执行功能、命名、注意、语言和延迟回忆得分均存在负相关(P<0.001);Logistic回归分析最终进入方程的是:糖尿病病程、高血压、糖化血红蛋白和Cys C水平。结论老年T2DM患者发生MCI存在多种危险因素,除糖尿病病程、糖化血红蛋白水平、血压水平外,血清Cys C水平升高可能也是其危险因素之一,但有待大样本调查进一步验证。
Objective To investigate the relationship between serum cystatin C (Cys C) and mild cognitive impairment (MCI) in type 2 diabetes mellitus (T2DM) and to analyze the association between the risk of MCI factor. Methods A total of 156 elderly patients with type 2 diabetes mellitus were divided into MCI group and normal cognitive function group. All patients were divided into three groups: MCI, Montreal Cognitive Assessment Scale, Self-Rating Anxiety Scale, Self-rating Depression Scale, The results of T test, linear correlation and Logistic regression model analysis were used to test Cys C, HbA1c, triglyceride, total cholesterol, blood pressure and so on. . Results Serum levels of Cys C were significantly increased in elderly T2DM patients with MCI (P = 0.018). The scores of serum Cys C and simple mental status examination, Montreal Cognitive Assessment Scale total score and visual and executive function, , Note that there was a negative correlation between language and delayed recall score (P <0.001). The logistic regression analysis finally entered the equation: diabetes course, hypertension, glycosylated hemoglobin and Cys C levels. Conclusion There are many risk factors for the occurrence of MCI in senile patients with T2DM. Except for the course of diabetes mellitus, glycosylated hemoglobin and blood pressure, the elevated serum Cys C may be one of the risk factors, but it needs further investigation in large sample.