高Hcy血症对高龄2型糖尿病患者认知功能的影响

摘要

Objective To study the incidence of cognitive impairment in elderly type 2 diabetic patients with hyperhomocysteinaemia. Methods A hundred and twenty-eight patients with type 2 diabetes admitted to Affiliated Hospital of North Sichuan Medical University from May 2010 to October 2012,aged≥70 years were studied.The parameters of Hcy,total glyceride(TG),total cholesterol(TC),low density lipoprotein-C (LDL-C),high density lipoprotein-C (HDL-C),hemoglobin A1c(HbA1c),folic acid(FA)and vitamin B12 (VitB12 )were detected.Their cognitive function was assessed and compared according to the MMSE and ADL.Results HbA1 c,LDL-C,Hcy,FA,VitB12 and systolic blood pressure were risk factors for diabetes and MCI (P <0.05),and MCI incidence of patients with high level of Hcy was significantly higher than those with medium and low level of Hcy(P<0.05).Conclusions Increased serum Hcy level may be an important risk factor for cognitive impairment in elderly type 2 diabetic patients.The incidence of cognitive impairment increases in elderly type 2 diabetic patients with hyperhomocysteinaemia.%目的：探讨高龄2型糖尿病患者合并高同型半胱氨酸（Hcy）血症与认知功能障碍（MCI）的关系。方法选择2010年5月-2012年10月在该院就诊的2型糖尿病患者128例，年龄≥70岁。检测入选病例Hcy水平、血脂、糖化血红蛋白、叶酸、维生素B12、血肌酐等指标；采用简易智能状态检查量表和日常生活能力量表对各组患者进行认知功能评定并比较。结果HbA1c、LDL-C、Hcy、FA、VitB12及收缩压均为糖尿病合并MCI的危险因素（P＜0．05），2型糖尿病患者重度高Hcy血症组MCI发病率较中度及轻度高Hcy血症组明显升高，差异具有统计学意义（P＜0．05）。结论血清Hcy升高是高龄2型糖尿病患者认知功能下降的一个重要危险因素，在高龄2型糖尿病患者中，合并高Hcy血症将会增加MCI的发病率。