目的：研究老年2型糖尿病（T2DM）患者的胱抑素C基因（CST3）多态性与其发生轻度认知功能障碍（MCI）的关系，探讨发生MCI的相关危险因素。方法选取156例老年T2DM患者，分为MCI组和认知功能正常组（NC），均使用简易智力状态量表、蒙特利尔认知评估量表、焦虑自评量表、流行病学调查用抑郁自评量表、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，聚合酶链反应-限制性片段长度多态性分析（PCR-RFLP）CST3基因多态性。结果 A等位基因频率在MCI组与NC组分别为80.4%和90.9%，B等位基因频率在MCI组与NC组分别为19.6%和9.1%，两组比较c2＝7.005，P＝0.008，差异均有统计学意义。在0.05检验水准下，携带B等位基因（OR：2.279，95% CI：1.064～4.882，P＝0.034）与T2DM发生MCI危险性的关联差异有统计学意义。结论携带B等位基因是老年T2DM患者发生MCI的危险因素。检测CST3多态性有利于老年T2DM患者认知障碍的早期诊断。%Objective To investigate the correlation of polymorphism in cystatin C gene (CST3) with mild cognitive impairment (MCI) in the elderly with type 2 diabetes mellitus (T2DM) and to analyze the risk factors for MCI. Methods A total of 156 retired veteran cadres with identified T2DM living in Shanghai were recruited and divided into 2 groups: MCI group and normal cognition (NC) group based on Diagnostic and Statistical Manual of Mental Disorders-Fourth Edition (DSM-Ⅳ). All subjects were evaluated with cognition scores of Mini-Mental State Examination (MMSE), Montreal Cognitive Assessment (MoCA), Self-Rating Anxiety Scale (SAS), Center for Epidemiogical Studies Depression Scale (CES-D), Screening Scale for Parkinson’s disease (SSPD), Activity of Daily Living (ADL), and Global Deterioration Scale (GDS). Polymerase chain reaction restriction fragment length polymorphism (PCR-RFLP) was used to detect the polymorphism of CST3. Results The allele A frequency was 80.4% and 90.9% respectively in T2DM-MCI group and T2DM-NC group, and that of allele B were 19.6% and 9.1% respectively. There were significant differences between the 2 groups (Chi-square=7.005, P=0.008). CST3 B allele carrying was a risk factor for MCI in the T2DM elderly (OR=2.279, 95%CI=1.064 to 4.882, P=0.034). Conclusion CST3 B allele carrying is one of the risk factors for MCI in the T2DM elderly. Detection of CST3 polymorphism is helpful in the early diagnosis of MCI for the elderly people with T2DM.
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