2型糖尿病男性患者血清羧化不全骨钙素水平与其认知功能受损的相关性研究

Association of serum undercarboxylated osteocalcin with cognitive deficits in male T2DM patients

摘要:

目的  探讨2型糖尿病（T2DM）男性患者血清羧化不全骨钙素（ucOC）水平与其认知功能受损的相关性。方法  选取唐山工人医院住院的T2DM男性患者71例作为病例组，同时从医院体检中心选取健康男性68例作为对照组，收集以上所有研究对象的一般资料[年龄、教育程度、体重指数（BMI）及病程]及临床生化指标[空腹血糖（FPG）、糖化血红蛋白（HbA1c）、总胆固醇（TC）、三酰甘油（TG）、高密度脂蛋白（HDL）及低密度脂蛋白（LDL）]。用酶联免疫吸附法（ELISA）测定血清ucOC水平，并进行认知功能量表（RBANS）（包括即时记忆、视觉广度、言语功能、注意力和延迟记忆）评分。比较以上两组认知评分是否存在差异；将T2DM组按ucOC中位数水平分为高ucOC组和低ucOC组，对两组的认知评分进行比较。用单因素相关及多元逐步回归分析ucOC与认知评分之间的相关性。结果  ①T2DM组较对照组TC、TG及FPG水平升高，HDL、ucOC水平降低（P <0.05），两组年龄、教育、BMI及LDL差异无统计学意义（P >0.05）；②与对照组比较，T2DM组RBANS量表总分、即时记忆、视觉广度、注意力及延迟记忆评分降低（P <0.05），两组言语功能评分差异无统计学意义（P >0.05）；③在T2DM组中，低ucOC组较高ucOC组RBANS量表总分、即时记忆、言语功能、注意力及延迟记忆评分降低（P <0.05）；④经多元逐步回归分析发现在T2DM组中：ucOC与HbA1c呈负相关（P <
0.05），并且ucOC与RBANS量表总分、即时记忆、言语功能、注意力及延迟记忆评分呈正相关（P <0.05）。结论  T2DM男性患者血清ucOC水平降低可能是其认知功能受损的危险因素之一。

Abstract:

Objective To investigate the association of serum undercarboxylated osteocalcin (ucOC) with cognitive deficits in male T2DM patients. Methods Seventy-one male inpatients in Tangshan Gongren Hospital and 68 male controls without T2DM from the Medical Examination Center were recruited. Data on demographic characteristics (including age, education, duration of illness and BMI) and clinical parameters (including FPG, HbA1c, TC, TG, LDL and HDL) were collected. ELISA was used to measure ucOC. Cognitive performance was assessed by the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS), which consists of five subtests including immediate memory, visuospatial/constructional, language, attention and delayed memory. The scores from the aboved five subtests were scaled together to create a total score. Diffe-rences in RBANS scores were compared between the T2DM group and the control group. The T2DM patients were further divided into two groups according to the average level of ucOC, and the differences in RBANS scores were compared between the two groups. The correlation of osteocalcin with RBANS scores was analyzed. Results Serum TC, TG and FPG were all higher (P < 0.05), and HDL and ucOC were lower (P < 0.05) in the T2DM patients than those in the controls. Age, education, BMI and serum LDL were similar in both groups (P > 0.05).  The total RBANS score and the subtest scores except for that of language were lower in the T2DM patients than in the controls (P < 0.05). In the T2DM group, immediate memory, language, attention, delayed memory and total scores of the patients with ucOC-H were all higher than those of the patients with ucOC-L (P < 0.05). Stepwise regression analysis showed that for the T2DM patients, ucOC was inversely correlated with HbA1c (P < 0.001), but was postively correlated with immediate memory, language, attention and delayed memory scores and total RBANS score (P < 0.05). Conclusions Decreased serum ucOC level may be one of the risk factors for cognitive deficits in male T2DM patients.