2型糖尿病认知功能障碍患者血清IL-6、TNF-α的水平

摘要

目的 探讨2型糖尿病(DM)患者认知功能障碍与血清白介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)水平之间的关系,并分析影响认知功能的其他因素.方法 选取2型糖尿病患者(112例)的年龄、性别、受教育程度无明显差异(P＞0.05)的正常对照组(100例).根据蒙特利尔认知评估量表(MoCA)测评,将2型糖尿病患者分为糖尿病认知障碍组(32例)、糖尿病非认知障碍组(80例).用ELISA法测定血清IL-6和TNF-α水平,并测定空腹血糖、糖化血红蛋白、血脂、体重指数、血压等指标.结果 2型糖尿病认知障碍组与非认知障碍组比较,糖尿病病程、空腹血糖、糖化血红蛋白、胰岛素治疗、体重指数差异有统计学意义(P＜0.05);糖尿病认知障碍组血清IL-6和TNF-α水平高于糖尿病非认知障碍组(P＜0.01)及正常对照组(P＜0.01);2型糖尿病患者的MoCA评分与年龄、糖尿病病程、空腹血糖、HbA1c、LDL、TC、BMI及血清IL-6、TNF-α水平呈负相关(r分别=-0.349、-0.438、-0.415、-0.397、-0.193、-0.259、-0.221、-0.938、-0.881,P均＜0.05),与受教育年限呈正相关(r =0.192,P＜0.05).结论 血清IL-6和TNF-α水平升高是2型糖尿病患者认知功能下降的一个重要危险因素,提示炎症反应可能参与了糖尿病认知功能障碍的发病.%Objective To determine the relationship between serum IL-6 and TNF-ct levels and cognitive impairment in type 2 diabetic patients,and to analyze the factors that influence cognitive function. Methods 112 type 2 diabetic patients were selected as the investigation object, and 100 normal participants whose age, sex and educated degree had no significant differences with type 2 diabetic patients were selected as the control group ( P > 0. 05 ). According to the Montreal Cognitive Assessment ( MoCA ) scores, type 2 diabetic patients were divided into two groups, one group including 32 cases with cognitive impairment, the other one with 80 patients with non-cognitive impairment. Serum levels of IL-6 and TNF-α were measured by enzyme linked immunosorbent assay in all subjects. Fasting blood glucose, HbAl c, blood lipids, BMI, blood pressure and other biochemical indicators were measured in all subjects. Result Compared with the non-cognitive impairment group and diabetic course, fasting blood glucose, HbAl C, insulin treatment and BMI were significantly different in the cognitive impairment group ( P < 0. 05 ). The levels of serum IL-6 and TNF-a in the cognitive impairment group were higher than those in the non-cognitive impairment group and the control group( P <0. 01 ). MoCA scores of patients with type 2 diabetes negatively correlated with age, duration of diabetes, fasting blood glucose ,HbAlc, low-density lipoprotein, total cholesterol , body mass index, and serum levels of IL-6 and TNF-α( r = -0. 349, -0. 438, -0. 415,-0. 397,-0. 193,-0. 259, -0.221 ,-0. 938,-0. 881 ,all P <0. 05 ). And MoCA scores of patients with type 2 diabetes positively correlated with educated degree (r =0. 192, P <0. 05). Conclusion Increased serum IL-6 and TNF-a levels may be an important risk factor for cognitive impairment in type 2 diabetic patients. It is suggested that inflammatory reaction may be involved in the pathogenesis of diabetic cognitive impairment.