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目的:探讨2型糖尿病患者认知功能障碍特点,血清脑源性神经营养因子(brain-derived neurotrophic factor,BDNF)和胰岛素样生长因子-1(insulin-like growth factor-1,IGF-1)水平及其之间的相关性。方法:选取100例2型糖尿病(T2DM)患者和100例正常对照,对其进行多维度神经心理学测试,并收集临床一般资料;采用酶联免疫吸附法测定血清BDNF和IGF-1水平。结果:①T2DM患者空腹血糖(FBG)、糖化血红蛋白(HbA1c)、体重指数(BMI)与正常对照组相比,差异均有统计学意义(P<0.05)。②T2DM患者听觉词语测试-延迟回忆(AVLT-Delay Recall)、听觉词语测试-再认回忆(AVLT-Recognition)和画钟测试(CDT)成绩均明显差于正常对照组,差异有统计学意义(P﹤0.05)。③T2DM患者血浆BDNF[5.95(2.41～6.12)ng/ml]及IGF-1[(110.84±22.14)ng/ml]水平显著低于正常对照组[8.84(1.32～10.41)ng/ml和(129.00±29.41)ng/ml](P﹤0.05)。④AVLT-Delay Recall与BMI呈负相关(r=-0.598,P=0.025);CDT与FBG及HbA1c呈负相关(r=-0.525,P=0.015;r=-0.623,P=0.012);AVLT-Delay Recall与HbA1c呈负相关(r=-0.465,P=0.017)。AVLT-Recognition与BMI呈负相关(r=-0.665,P=0.028)。AVLT-Delay Recall与BDNF及IGF-1呈正相关(r=0.572,P=0.021;r=0.598,P=0.006)。结论:T2DM可导致老年人群认知功能损害,主要表现为记忆、执行功能和视空间结构功能损害更加明显。血糖控制不佳、肥胖、血清BDNF及IGF-1与T2DM患者认知功能障碍密切相关。
Objective: To investigate the characteristics of cognitive dysfunction, serum levels of brain-derived neurotrophic factor (BDNF) and insulin-like growth factor-1 (IGF-1) in type 2 diabetic patients And the correlation between them. Methods: 100 cases of type 2 diabetes mellitus (T2DM) and 100 normal controls were selected and subjected to multidimensional neuropsychological test. General clinical data were collected. Serum levels of BDNF and IGF-1 were measured by enzyme-linked immunosorbent assay. Results: ① There were significant differences in fasting blood glucose (FBG), HbA1c and BMI between patients with T2DM and normal controls (P <0.05). (2) The results of AVLT-Delay Recall, AVLT-Recognition and CDT in T2DM patients were significantly lower than those in normal control group (P <0.05). ③ The levels of plasma BDNF [5.95 (2.41-6.12) ng / ml] and IGF-1 [(110.84 ± 22.14) ng / ml] in T2DM patients were significantly lower than those in the normal controls [8.84 (1.32-10.41) ng / 29.41) ng / ml] (P <0.05). AVLT-Delay Recall was negatively correlated with BMI (r = -0.598, P = 0.025); CDT was negatively correlated with FBG and HbA1c (r = -0.525, P = 0.015; r = -0.623, Delay Recall was negatively correlated with HbA1c (r = -0.465, P = 0.017). AVLT-Recognition was negatively correlated with BMI (r = -0.665, P = 0.028). AVLT-Delay Recall was positively correlated with BDNF and IGF-1 (r = 0.572, P = 0.021; r = 0.598, P = 0.006). Conclusion: T2DM can lead to cognitive impairment in the elderly, which is mainly manifested by impairment of memory, executive function and visual spatial structure. Poor blood glucose control, obesity, serum BDNF and IGF-1 and T2DM patients with cognitive impairment are closely related.