Ghrelin 水平与T2DM 患者认知功能的相关性研究

Association of serum ghrelin level with cognition in T2DM patients

摘要:

目的 探讨血清胃饥饿素（Ghrelin）水平与2 型糖尿病（T2DM）患者认知功能的相关性。方法 选取2015 年6 月-2016 年8 月于唐山工人医院内分泌科就诊的T2DM 患者195 例作为研究对象。收集患者的年龄、性别、教育、病程、体重指数、空腹血糖、糖化血红蛋白、总胆固醇、甘油三酯、高密度脂蛋白及低密度脂蛋白等指标，采用酶联免疫法吸附法检测血清Ghrelin 水平。使用简易精神状态量表（MMSE）和重复性成套神经心理状态测验量表（RBANS）对所用患者的认知功能进行评定。依据MMSE评分结果将患者分为认知功能障碍组和非认知功能障碍组，比较以上两组的一般资料及RBANS 量表认知功能评分有无差异。结果 ①与T2DM 非认知功能障碍组相比，认知功能障碍组患者血清Ghrelin 上升（P <0.05）；②经Logistic 回归分析发现，血清Ghrelin 为T2DM 出现认知功能障碍的保护因素（P <0.05）；③血清Ghrelin 与T2DM 患者RBANS 量表即刻记忆、言语功能、注意力、延时记忆及总分呈正相关（P <0.05）。结论 T2DM 伴认知功能障碍患者血清Ghrelin 水平降低，并且与认知功能呈正相关，提示Ghrelin 可能参与了T2DM 患者认知功能障碍的发生及发展过程。

Abstract:

Objective To investigate the association of serum ghrelin level with cognition in T2DM patients. Methods In this study 195 T2DM patients cared at Tangshan Gongren Hospital from June 2015 to August 2016 were recruited. Data including age, gender, education, duration of illness and BMI were recorded, and clinical parameters including FPG, HbA1c, TC, TG, LDL and HDL were collected. Ghrelin was measured by ELISA. Cognitive performance was assessed by the Mini-mental State Examination (MMSE) and Repeatable Battery for the Assessment of Neuropsychological Status (RBANS). All patients were divided into two groups including cognitive impairment group and non-cognitive impairment group by MMSE. The general data and cognitive function were compared between the two groups. Results Serum ghrelin level in the cognitive impairment group was significantly lower than that of the non-cognitive impairment group. Logistic regression analysis showed that ghrelin was the protective factor of cognition in the T2DM patients (P < 0.05). Serum ghrelin level was positively correlated with RBANS scores excluding visuospatial/constructional score in the T2DM patients, which included immediate memory, language,attention, delayed memory and total scores (P < 0.05). Conclusions T2DM patients with cognitive impairment have low level of serum ghrelin, and serum ghrelin is postively correlated with their cognitive performance, suggesting that serum ghrelin may be involved in cognitive deficit of T2DM patients.