老年糖尿病患者血清8-羟基脱氧鸟苷酸水平与认知功能障碍的相关性研究
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摘要
目的探讨血清8-羟基脱氧鸟苷酸(8-OHdG)水平与老年糖尿病患者认知功能障碍的关系,为防治老年糖尿病合并认知功能障碍提供依据。方法于2014年1月至2015年4月选择南京鼓楼医院老年科收治的114例老年(>65岁)糖尿病患者(T2DM组)和同期30名健康体检者(对照组,NC组)为研究对象。T2DM组患者根据神经认知功能测定,分为认知功能正常组(NC-DM组)42例、轻度认知功能障碍组(MCI-DM组)34例和痴呆组(AD-DM组)38例。对所有研究对象进行体格检查,并测定血清8-OHdG、空腹血糖(FPG)、空腹胰岛素(INS)、总胆固醇(TC)、甘油三酯(TG)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)和糖化血红蛋白(HbA1C)水平。采用SPSS 15.0统计软件进行单因素方差分析和t检验,相关性分析采用Pearson相关分析,糖尿病认知功能障碍发生的危险因素采用多因素logistic回归分析。结果 T2DM组血清8-OHdG水平明显高于NC组,差异有统计学意义(P<0.05,P<0.01)。Pearson相关分析显示,血清8-OHdG水平与FPG、HbA1C呈正相关,有统计学意义(r值分别为0.335、0.230,P<0.01)。多因素logistic回归分析结果显示,8-OHdG、FPG为老年糖尿病认知功能障碍的独立危险因素(OR值分别为1.171和2.847,P<0.01)。结论老年糖尿病患者8-OHdG水平可以反映认知功能损伤的严重程度,老年糖尿病患者认知功能障碍的发生发展与DNA氧化应激有关。
Objective To explore the correlation between serum 8-hydroxydeoxyguanosine( 8-OHdG) level and cognitive impairment in the elderly patients with type 2 diabetes mellitus(T2DM). Methods From January of 2014 to April of 2015,114 elderly inpatients(>65 years old) with T2 DM in the hospital and 30 healthy people(NC group) were selected as the subjects.According to the neurocognitive function,T2DM patients were divided into normal function control group(42 cases NC-DM group),mild cognitive impairment group(34 cases MCI-DM group) and Alzheimer disease group(38 cases AD-DM group).Serum 8-OHdG levels in all groups were determined by ELISA. The correlation of 8-OHdG and the indicators such as fasting blood glucose(FPG),fasting insulin(FINS),total cholesterol(TC),triglyceride(TG),high-density lipoprotein cholesterol(HDL-C),low-density lipoprotein cholesterol(LDL-C),HbA_(1C),BMI,systolic blood pressure(SBP) and diastolic blood pressure(DBP) were analyzed. Risk factors of cognitive impairment in elderly T2DM patients were also analyzed. The t test,ANOVA,Pearson correlation analysis,multivariate logistic regression analysis were used to analyze the data,the used software was SPSS 15. Results The serum 8-OHdG level in T2 DM group was significantly higher than that in NC group(P<0.01). Pearson correlation analysis showed that serum 8-OHdG level was positively correlated with FPG(r =0.335,P <0.01) and HbA_(1C)(r =0.230,P <0.05).Multivariate logistic regression analysis showed that 8-OHdG(OR =1.171,P <0.01) and FPG(OR =2.847,P <0.01) were independent risk factors of cognitive impairment in elderly T2 DM patients. Conclusion In elderly T2DM patients,the 8-OHdG level could reflect the severity of cognitive impairment,and the development of cognitive impairment was closely related to DNA oxidative stress.
Objective To explore the correlation between serum 8-hydroxydeoxyguanosine( 8-OHdG) level and cognitive impairment in the elderly patients with type 2 diabetes mellitus(T2DM). Methods From January of 2014 to April of 2015,114 elderly inpatients(>65 years old) with T2 DM in the hospital and 30 healthy people(NC group) were selected as the subjects.According to the neurocognitive function,T2DM patients were divided into normal function control group(42 cases NC-DM group),mild cognitive impairment group(34 cases MCI-DM group) and Alzheimer disease group(38 cases AD-DM group).Serum 8-OHdG levels in all groups were determined by ELISA. The correlation of 8-OHdG and the indicators such as fasting blood glucose(FPG),fasting insulin(FINS),total cholesterol(TC),triglyceride(TG),high-density lipoprotein cholesterol(HDL-C),low-density lipoprotein cholesterol(LDL-C),HbA_(1C),BMI,systolic blood pressure(SBP) and diastolic blood pressure(DBP) were analyzed. Risk factors of cognitive impairment in elderly T2DM patients were also analyzed. The t test,ANOVA,Pearson correlation analysis,multivariate logistic regression analysis were used to analyze the data,the used software was SPSS 15. Results The serum 8-OHdG level in T2 DM group was significantly higher than that in NC group(P<0.01). Pearson correlation analysis showed that serum 8-OHdG level was positively correlated with FPG(r =0.335,P <0.01) and HbA_(1C)(r =0.230,P <0.05).Multivariate logistic regression analysis showed that 8-OHdG(OR =1.171,P <0.01) and FPG(OR =2.847,P <0.01) were independent risk factors of cognitive impairment in elderly T2 DM patients. Conclusion In elderly T2DM patients,the 8-OHdG level could reflect the severity of cognitive impairment,and the development of cognitive impairment was closely related to DNA oxidative stress.
引文
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[11] Robertson RP.Chronic oxidative stress as a central mechanism for glucose toxicity in pancreatic islet beta cells in diabetes[J]. J Biol Chem,2004,279(41):42351-42354.
[12]鲁燕,陆轶群,李红霞.2型糖尿病患者血清8-羟基脱氧鸟苷酸水平与大血管病变的相关性[J].苏州大学学报(医学版),2007,27(5):736-738.
[13]朱红敏,章军建,杨英.DNA氧化性损伤标志物8-羟基脱氧鸟苷在阿尔茨海默病和血管性痴呆患者血浆中的变化[J].中华老年医学杂志,2013,32(11):1164-1168.
[2]杨立勇,沈喜妹.老年糖尿病认知功能障碍的相关研究进展[J].中华内分泌代谢杂志,2014,30(10):879-881.
[3]张翠林,房辉,徐刚,等.血清单核细胞趋化蛋白-1和血清淀粉样蛋白A水平与2型糖尿病患者认知功能的相关性[J].中国慢性病预防与控制,2015,23(8):605-607.
[4] Currais A,Prior M,Lo D,et a1.Diabetes exacerbates amyloid and neumvascular pathology in aging-accelerated mice[J]. Aging Cell,2012,11(6):1017-1026.
[5] Gabir MM,Hanson RL,Dabelea D,et al. The 1997 American Diabetes Association and 1999 World Health Organization criteria for hyperglycemia in the diagnosis and prediction of diabetes[J].Diabetes Care,2000,23(8):1108-1112.
[6] Folstein MF,Folstein SE,McHugh PR.“Minimental State”,a practical method for grading the cognitive state of patients for the clinician[J].J Psycchiatr Res,1975,12(3):189-198
[7] Nasreddine ZS,Phillips NA,Bedirian V,et al. The Montreal Cognitive Assessment,MOCA;a brief screening tool for mind cognitive impairment[J].J Am Geriatr Soc,2005,53(4):695-699
[8] Black CN,Bot M,Scheffer PG,et al. Sociodemographic and lifestyle determinants of plasma oxidative stress markers 8-OHdG and F2-isoprostanes and associations with metabolic syndrome[J]. Oxid Med Cell Longev,2016,2016:7530820. DOI:10.1155/2016/7530820.
[9] Odegaard AO,Jacobs DR Jr,Sanchez OA,et al.Oxidative stress,inflammation,endothelial dysfunction and incidence of type 2 diabetes[J]. Cardiovasc Diabetol,2016,15:51. DOI:10.1186/s12933-016-0369-6.
[10] Kanauchi M,Nishioka H,Hashimoto T.Oxidative DNA damage and tubulointerstitial injury in diabetic nephropathy[J].Nephron,2002,91(2):327-329.
[11] Robertson RP.Chronic oxidative stress as a central mechanism for glucose toxicity in pancreatic islet beta cells in diabetes[J]. J Biol Chem,2004,279(41):42351-42354.
[12]鲁燕,陆轶群,李红霞.2型糖尿病患者血清8-羟基脱氧鸟苷酸水平与大血管病变的相关性[J].苏州大学学报(医学版),2007,27(5):736-738.
[13]朱红敏,章军建,杨英.DNA氧化性损伤标志物8-羟基脱氧鸟苷在阿尔茨海默病和血管性痴呆患者血浆中的变化[J].中华老年医学杂志,2013,32(11):1164-1168.