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目的探讨2型糖尿病(type 2 diabetes mellitus,T2DM)住院患者伴轻度认知功能障碍(mild cognitive impairment,MCI)与肿瘤坏死因子α(TNF-α)-308 A/G基因多态性及其他因素的关系。方法于2008年5月至2009年3月,选取60例合并MCI的T2DM住院患者作为病例组,120例认知功能正常的T2DM住院患者作为对照组,进行问卷调查、体格检查、实验室检查和认知功能检测。抽取空腹肘正中静脉血2 ml,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TNF-α基因多态性。采用非条件多因素logistic回归模型对T2DM患者合并MCI的相关因素进行多因素分析,计算比值比(OR)及其95%可信区间(95%CI)。结果病例组与对照组的T2DM病程,周围神经病变、高血压、糖化血红蛋白(HbA1C)分布的差异均有统计学意义(P<0.01)。病例组与对照组TNF-α基因型频率及其等位基因频数差异均有统计学意义(P<0.05,P<0.01)。多因素非条件logistic回归分析结果显示,经年龄和文化程度调整后,糖尿病病程(OR=2.458,95%CI:1.365~4.429)、HbA1C≥8.0%(OR=6.620,95%CI:2.351~18.640)、周围神经病变(OR=3.605,95%CI:1.323~9.820)和携带TNF-αA等位基因(OR=5.378,95%CI:1.846~15.666)与T2DM住院患者合并MCI有关。结论病程长、HbA1C高、周围神经病变和携带TNF-αA等位基因可能与T2DM住院患者合并MCI高风险有关。
Objective To investigate the relationship between mild cognitive impairment (MCI) and tumor necrosis factor α (TNF-α) -308 A / G polymorphism in hospitalized patients with type 2 diabetes mellitus (T2DM) and other The relationship between factors. Methods From May 2008 to March 2009, 60 patients with T2DM inpatients with MCI and 120 patients with T2DM with normal cognitive function were selected as the control group, and questionnaires, physical examination, laboratory tests and Cognitive function test. 2 ml of fasting elbow middle venous blood and EDTA anticoagulation were collected. The polymorphism of TNF-α gene was detected by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP). Unconditional multivariate logistic regression model was used to analyze multivariable factors associated with MCI in patients with T2DM. The odds ratio (OR) and 95% confidence interval (95% CI) were calculated. Results There were significant differences in T2DM course, peripheral neuropathy, hypertension and HbA1C distribution between case group and control group (P <0.01). The difference of TNF-α genotype frequency and allele frequency in case group and control group were statistically significant (P <0.05, P <0.01). Multivariate non-conditional logistic regression analysis showed that the duration of diabetes (OR = 2.458, 95% CI: 1.365-4.429), HbA1C≥8.0% (OR = 6.620, 95% CI: 2.351-18.640 ), Peripheral neuropathy (OR = 3.605, 95% CI: 1.323-9.820) and TNF-αA allele (OR = 5.378,95% CI: 1.846-15.666) were associated with MCI inpatients with T2DM. Conclusion Long course of disease, high HbA1C, peripheral neuropathy and carrying TNF-αA allele may be associated with high risk of MCI in hospitalized patients with T2DM.