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目的探讨2型糖尿病(T2DM)伴轻度认知功能减退(MCI)与载脂蛋白Eε4(ApoEε4)等位基因等因素的关系。方法于2008-2009年选取60例T2DM伴MCI的患者作为病例组,120例认知功能正常的T2DM患者作为对照组,进行问卷调查、体格检查、实验室检查和认知功能检测;抽取空腹静脉血,EDTA抗凝,应用聚合酶链反应-限制性片段长度多态性(PCR-RFLP)方法检测ApoE基因多态性。采用多因素非条件logistic回归模型对T2DM伴MCI的危险因素进行分析。结果病例组与对照组性别、吸烟、饮酒、糖尿病家族史、高血压家族史、胰岛素治疗、体质指数、空腹血糖、餐后2 h血糖的差异均无统计学意义(P>0.05);但病例组的平均年龄、糖尿病病程高于对照组,病例组糖化血红蛋白(HbA1C)≥8.0%者及文化程度较低者的比例均高于对照组,差异均有统计学意义(P<0.01)。病例组中携带ApoEε4等位基因者的比例高于对照组,差异有统计学意义(P<0.01)。多因素非条件logistic回归分析结果显示,年龄(OR=1.148,95%CI:1.078~1.224)、T2DM病程(OR=1.132,95%CI:1.058~1.210)、文化程度(OR=0.500,95%CI:0.329~0.762)、HbA1C≥8.0%(OR=3.214,95%CI:1.453~7.109)和携带ApoEε4等位基因(OR=4.276,95%CI:1.736~10.534)与T2DM患者合并MCI的高危险有关。结论年龄大、糖尿病病程长、文化程度低、HbA1C高和携带ApoEε4等位基因可能与T2DM合并MCI有关。
Objective To investigate the relationship between type 2 diabetes mellitus (T2DM) with mild cognitive impairment (MCI) and apolipoprotein Eε4 (ApoE ε4) alleles. Methods Sixty patients with T2DM with MCI were selected as the case group from 2008 to 2009, and 120 normal T2DM patients with normal cognitive function were selected as the control group. Questionnaires, physical examination, laboratory tests and cognitive function tests were performed. Fasting venous Blood and EDTA anticoagulation were performed. ApoE gene polymorphism was detected by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP). Multivariate non-conditional logistic regression model was used to analyze the risk factors of T2DM with MCI. Results There was no significant difference in gender, smoking, alcohol consumption, family history of diabetes, family history of hypertension, insulin therapy, body mass index, fasting blood glucose and 2 h postprandial blood glucose between case group and control group (P> 0.05) The mean age and duration of diabetes were higher in the control group than those in the control group. The cases with HbA1C≥8.0% and the lower education level were all higher than those in the control group (P <0.01). The proportion of patients carrying ApoEε4 allele in the case group was higher than that in the control group, the difference was statistically significant (P <0.01). Multivariate non-conditional logistic regression analysis showed that age (OR = 1.148, 95% CI: 1.078-1.224), T2DM duration (OR = 1.132, 95% CI: 1.058-1.210) CI: 0.329 ~ 0.762), HbA1C≥8.0% (OR = 3.214, 95% CI: 1.453 ~ 7.109) and carrying ApoEε4 allele (OR = 4.276,95% CI: 1.736-10.534) Dangerous. Conclusion Age, long duration of diabetes, low education level, high HbA1C and carrying ApoEε4 allele may be associated with T2DM with MCI.