论文部分内容阅读
目的探讨超重及肥胖与T2DM患者认知功能、海马波谱分析的相关性。方法选取2015年1月至2016年1月于河南省人民医院内分泌科住院的T2DM患者90例。根据BMI分为体重正常(NW)组(BMI 18.5~23.9kg/m~2)、超重(OW)组(BMI 24~27.9kg/m~2)和肥胖(OB)组(BMI≥28kg/m~2)。记录一般人体测量学数据和测定相关生化学指标,蒙特利尔认知评估MoCA北京版量表评估受试者认知功能,行磁共振海马波谱成像(1H-MRS)分析海马内代谢物质浓度。结果 OB组MoCA评分低于NW组及OW组[(23.73±1.82)vs(25.03±2.40)vs(25.26±1.14)分,F=15.183,P<0.05],而NW组与OW组比较,差异无统计学意义(P>0.05)。OW组的执行功能评分优于NW组和OB组,NW组的语言功能评分优于OB组,OW组的延迟回忆功能评分优于OB组(P<0.05)。与OW组和NW组比较,OB组右侧N-乙酰天冬氨酸(NAA)/Cr水平降低(F=10.517,P<0.05)。Pearson相关分析显示,T2DM患者的MoCA评分与左侧NAA/Cr、右侧NAA/Cr呈正相关,与BMI、左侧胆碱复合物(Cho)/Cr、HbA1c、FPG呈负相关。多元回归分析结果显示,校正HbA1c、FPG、教育年限、糖尿病病程、年龄、HDL-C影响后,BMI是MoCA评分的独立危险因素(β=-0.272,P<0.05)。结论肥胖的T2DM患者整体认知功能低于体重正常及超重患者,但超重患者执行能力高于体重正常者,海马内NAA水平下降可能是肥胖导致T2DM患者认知功能下降的物质基础。
Objective To investigate the correlation between cognitive function and hippocampal spectral analysis of overweight and obesity and T2DM. Methods From January 2015 to January 2016, 90 patients with T2DM admitted to Department of Endocrinology, Henan Provincial People’s Hospital were enrolled. According to BMI, patients were divided into normal weight (NW) group (BMI 18.5-23.9kg / m 2), OW group (BMI 24-27.9kg / m 2) and obesity group (BMI 28kg / m ~ 2). The general anthropometric data were recorded and the related biochemical indicators were determined. The Montreal Cognitive Assessment MoCA Beijing Scale was used to evaluate the cognitive function of the subjects, and the concentrations of metabolites in the hippocampus were analyzed by 1H-MRS. Results The score of MoCA in OB group was lower than that in NW group and OW group [(23.73 ± 1.82) vs (25.03 ± 2.40) vs (25.26 ± 1.14), F = 15.183, P <0.05] No statistical significance (P> 0.05). The scores of executive function in OW group were better than those in NW and OB groups. The score of language function in NW group was better than OB group. The score of delayed memory function in OW group was better than OB group (P <0.05). Compared with OW group and NW group, the level of N-acetyl-aspartate (NAA) / Cr in the right OB group was decreased (F = 10.517, P <0.05). Pearson correlation analysis showed that MoCA scores of T2DM patients were positively correlated with left NAA / Cr and right NAA / Cr, and negatively correlated with BMI, left Ch / Cho, HbA1c and FPG. Multivariate regression analysis showed that BMI was an independent risk factor for MoCA score (β = -0.272, P <0.05) after adjusting for HbA1c, FPG, education duration, diabetes course, age and HDL-C. Conclusions The overall cognitive function of obese T2DM patients is lower than that of normal weight and overweight patients. However, the executive ability of overweight patients is higher than that of normal weight. The decrease of NAA level in hippocampus may be the material basis of obesity in decreasing the cognitive function of T2DM patients.