游离脂肪酸与老年2型糖尿病患者轻度认知功能障碍的研究

摘要

目的 探讨游离脂肪酸(FFA)与老年2型糖尿病(T2DM)患者轻度认知功能障碍(MCI)的关系.方法 选择85例老年T2DM患者,应用蒙特利尔认知评估(MoCA)量表评定认知功能,分为T2DM认知功能正常组(T2DM-NC)45例和T2DM认知功能障碍组(T2DM-MCI)40例,另选择糖耐量正常且认知功能正常者35例为对照组(NC).测定3组FFA、糖化血红蛋白(HbA1c)、血脂等.结果 T2DM-MCI组FFA水平(7.45±0.13)mmol/L高于T2DM-NC组(6.32±0.13)mmol/L及NC组(4.56±0.11)mmol/L.T2DM-MCI患者的MoCA评分与糖尿病病程(r=-0.507,P=0.001)、FPG(r=-0.581,P<0.001)、HOMA-IR(r=-0.360,P=0.022)、HbA1c(r=-0.533,P<0.001)、TC(r=-0.358,P=0.023)、TG(r=-0.408,P=0.009)、LDL-C(r=-0.377,P=0.016)、FFA水平(r=-0.566,P<0.001)呈负相关,与HDL-C(r=0.365,P=0.021)呈正相关.多重线性回归分析结果示,FPG(β=-0.290,P=0.015)、HbA1c(β=-0.272,P=0.019)、FFA(β=-0.375,P=0.001)、病程(β=-0.248,P=0.037)是MoCA评分的危险因素.结论 血清FFA是T2DM患者MCI的危险因素.%Objective To explore the relationship between mild cognitive impairment and free fatty acid in older type 2 diabetes mellitus patients.Methods Totally 85 older T2DM patients were divided into T2DM group with normal cognitive function (T2DM-NC group,n=45) and T2DM group with cognitive impairment (T2DM-MCI group,n=40).In addition,a control group with normal glucose tolerance and cognitive function (NC group,n=35) was formed.For all entrants,free fatty acid,HbA1c,blood lipid,etc.were determined.Results The free fatty acid level in T2DM-MCI group (7.45±0.13)mmol/L was higher than that in T2DM-NC group (6.32±0.13)mmol/L and in NC group (4.56±0.11)mmol/L.The MoCA scores of T2DM-MCI patients were negatively correlated with diabetic duration (r=-0.507,P=0.001),FPG (r=-0.581,P<0.001),HOMA-IR (r=-0.360,P=0.022),HbA1c (r=-0.533,P<0.001),TC (r=-0.358,P=0.023),TG (r=-0.408,P=0.009),LDL-C (r=-0.377,P=0.016) and free fatty acid (r=-0.566,P<0.001),but were positively correlated with HDL-C (r=0.365,P=0.021).The result of multiple linear regression analysis shows that FPG (β=-0.29,P=0.015),HbA1c (β=-0.272,P=0.019),FFA (β=-0.375,P=0.001) and duration (β=-0.248,P=0.037) are the risk factors of MoCA scores.Conclusion Free fatty acid is the risk factor of T2DM-MCI patients.