CAJ | 학술논문

目的：探讨血清胱抑素C（Cys C）水平与老年2型糖尿病患者认知功能障碍的相关性。方法选取老年2型糖尿病患者352例，其中认知功能正常组（NC组）146例、轻度认知功能障碍组（MCI组）112例，阿尔茨海默病组（AD组）94例。采用简易智能状态检查量表（MMSE）、蒙特利尔认知评估量表（MoCA）评定患者认知功能。检测所有患者血糖、血脂、Cys C水平和肝肾功能等，比较3组间临床特征及Cys C水平差异。结果3组间血清Cys C水平差异具有统计学意义（均P＜0.05）。NC、MCI、AD组血清Cys C水平依次升高。相关分析表明，血清Cys C水平与年龄、糖尿病病程、甘油三酯（TG）、血肌酐（Cr）、糖化血红蛋白（HbA1c）呈正相关（r＝0.352，0.199，0.177，0.616，0.368，均P＜0.05），与MMSE分数、MoCA分数、高密度脂蛋白胆固醇（HDL-C）呈负相关（r＝-0.186，-0.237，-0.185，均P＜0.05）。logistic回归分析显示Cys C（P＝0.011，OR＝2.120）、年龄（P＝0.021，OR＝3.401）、病程（P＝0.033， OR＝3.102）、HbA1c（P＝0.010，OR＝2.691）是老年2型糖尿病患者认知功能障碍的独立危险因素。结论血清Cys C水平与老年2型糖尿病患者认知功能障碍相关，老年2型糖尿病患者高血清 Cys C水平提示认知功能障碍患病风险增加。
목적：탐토혈청광억소C（Cys C）수평여노년2형당뇨병환자인지공능장애적상관성。방법선취노년2형당뇨병환자352례，기중인지공능정상조（NC조）146례、경도인지공능장애조（MCI조）112례，아이자해묵병조（AD조）94례。채용간역지능상태검사량표（MMSE）、몽특리이인지평고량표（MoCA）평정환자인지공능。검측소유환자혈당、혈지、Cys C수평화간신공능등，비교3조간림상특정급Cys C수평차이。결과3조간혈청Cys C수평차이구유통계학의의（균P＜0.05）。NC、MCI、AD조혈청Cys C수평의차승고。상관분석표명，혈청Cys C수평여년령、당뇨병병정、감유삼지（TG）、혈기항（Cr）、당화혈홍단백（HbA1c）정정상관（r＝0.352，0.199，0.177，0.616，0.368，균P＜0.05），여MMSE분수、MoCA분수、고밀도지단백담고순（HDL-C）정부상관（r＝-0.186，-0.237，-0.185，균P＜0.05）。logistic회귀분석현시Cys C（P＝0.011，OR＝2.120）、년령（P＝0.021，OR＝3.401）、병정（P＝0.033， OR＝3.102）、HbA1c（P＝0.010，OR＝2.691）시노년2형당뇨병환자인지공능장애적독립위험인소。결론혈청Cys C수평여노년2형당뇨병환자인지공능장애상관，노년2형당뇨병환자고혈청 Cys C수평제시인지공능장애환병풍험증가。
Objective To investigate the correlation of serum cystatin C (Cys C) level with cognitive impairment in the elderly type 2 diabetic (T2DM) patients. Methods A total of 352 T2DM patients hospitalized in Department of Geriatrics from December 2011 to December 2013 were included in this cross-sectional study. Mini-Mental Status Examination (MMSE) and Montreal Cognitive Assessment (MoCA) were applied to evaluate their cognitive function. According to the results, the cohort was divided into normal cognition group (NC, n=146), mild cognitive impairment group (MCI, n=112), and Alzhermer’s disease group (AD, n=94). Their blood glucose, blood lipids, Cys C levels, and liver and kidney function were tested. The clinical features and Cys C levels were compared among the 3 groups. Results There were significant differences in serum Cys C levels among the 3 groups (all P<0.05). The patients in NC group had the lowest serum level of Cys C, followed by those from MCI and AD groups. Spearman correlation analysis showed that the serum level was positively correlated with age, duration of diabetes, triglycerides, serum creatinine, and HbA1c (r=0.352, 0.199, 0.177, 0.616, and 0.368, respectively, all P<0.05), and was negatively correlated with the scores of MMSE, MoCA and high density lipoprotein-cholesterol (r=-0.186,-0.237, and-0.185, respectively, P<0.05). Logistic regression analysis showed that the serum level of Cys C (P=0.011, OR=2.120), age (P=0.021, OR=3.401), diabetes duration (P=0.033, OR=3.102), and HbA1c (P=0.010, OR=2.691) were independent impact factors for diabetic cognitive impairment in the elderly. Conclusion Serum Cys C is correlated with cognitive impairment in the elderly with T2DM. High serum level of Cys C predicts the increasing risk of cognitive impairment in the population.