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目的:观察晚期糖基化终末产物(AGEs)在2型糖尿病(T2DM)认知功能障碍患者血清中的表达,探讨其临床意义。方法:78例T2DM患者根据MoCA评分分为糖尿病认知障碍组和糖尿病非认知障碍组,同期选择40例门诊健康体检者作为对照组。比较各组一般临床资料、血清AGEs表达水平及MoCA评分,并分析血清AGEs水平与MoCA评分之间的相关性。结果:糖尿病认知功能障碍组和糖尿病非认知功能障碍组空腹血糖和HbA1c均明显高于对照组(P<0.05),且糖尿病认知功能障碍组糖尿病病程、空腹血糖和HbA1c均明显高于糖尿病非认知功能障碍组(P<0.05),而3组在其他方面比较差异无统计学意义(P>0.05);糖尿病认知功能障碍组和糖尿病非认知功能障碍组MoCA评分明显低于对照组(P<0.05),而血清AGEs水平明显高于对照组(P<0.05),且糖尿病认知功能障碍组MoCA评分下降和血清AGEs水平升高较糖尿病非认知功能障碍组更为显著(P<0.05);血清AGEs水平与MoCA评分之间呈负相关性关系(r=-0.376、P<0.05)。结论:血清AGEs升高是T2DM患者发生认知功能障碍的一个重要危险因素。
Objective: To observe the expression of advanced glycation end products (AGEs) in the serum of patients with cognitive dysfunction of type 2 diabetes mellitus (T2DM) and to explore its clinical significance. Methods: 78 cases of T2DM patients were divided into diabetic cognitive impairment group and non-cognitive diabetic group according to MoCA score. 40 outpatients were selected as control group in the same period. The clinical data of all groups, serum AGEs expression level and MoCA score were compared. The correlation between serum AGEs level and MoCA score was analyzed. Results: The levels of fasting blood glucose and HbA1c in diabetic cognitive impairment group and non-cognitive dysfunction group were significantly higher than those in control group (P <0.05). The duration of diabetes, fasting blood glucose and HbA1c in diabetic cognitive dysfunction group were significantly higher than those in control group (P <0.05), but there was no significant difference among the other three groups (P> 0.05). The MoCA score of diabetes cognitive impairment group and diabetes non-cognitive dysfunction group was significantly lower than that of diabetes cognitive impairment group (P <0.05), while serum AGEs level was significantly higher in the control group (P <0.05). The decrease of MoCA score and the increase of serum AGEs level in diabetic cognitive dysfunction group were more significant than those in non-cognitive dysfunction group (P <0.05). There was a negative correlation between serum AGEs level and MoCA score (r = -0.376, P <0.05). Conclusion: Increased serum AGEs is an important risk factor for cognitive dysfunction in T2DM patients.