High Plasma Resistin Levels Portend the Insulin Resistance-Associated Susceptibility to Early Cognitive Decline in Patients with Type 2 Diabetes Mellitus.
High Plasma Resistin Levels Portend the Insulin Resistance-Associated Susceptibility to Early Cognitive Decline in Patients with Type 2 Diabetes Mellitus.
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DOI：
10.3233/jad-200074
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发表时间：
2020-04
期刊：
影响因子：
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通讯作者：
Chenchen Wang;Xi Huang;S. Tian;Rong Huang;Dan Guo;Hongyan Lin;Jiaqi Wang;Shaohua Wang
中科院分区：
文献类型：
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作者：
Chenchen Wang;Xi Huang;S. Tian;Rong Huang;Dan Guo;Hongyan Lin;Jiaqi Wang;Shaohua Wang
背景：代谢紊乱，包括胰岛素抵抗、肥胖和高脂血症，在2型糖尿病（T2DM）患者中经常发生在高血糖之前，并导致轻度认知障碍（MCI）。目的：研究抵抗素在T2DM患者MCI代谢异常中的作用。方法选取138例住院T2DM患者，根据蒙特利尔认知评估（MoCA）评分分为轻度认知损伤组和非轻度认知损伤组。评估代谢指标和认知状态，ELISA检测血浆抵抗素水平。结果MCI组和性别分层亚组的抵抗素水平和胰岛素抵抗稳态模型评估（HOMA-IR）评分均显著高于无MCI的对照组（p < 0.01）。相关分析显示，抵抗素水平与MoCA （r = -0.693, p < 0.001）和Mini-Mental State Examination （r = -0.571, p < 0.001）等大部分认知域呈负相关，与HOMA-IR （r = 0.667, p < 0.001）相关，与肥胖和脂质指标无关。多因素回归分析显示，抵抗素（β= -0.675, p < 0.001）和文化程度（β= 0.177, p = 0.003）是T2DM患者MoCA的独立危险因素。结论高血浆抵抗素水平预示着中国T2DM患者与胰岛素抵抗相关的早期认知能力下降易感性。该脂肪因子在导致糖尿病MCI的其他代谢紊乱中的作用及其在早期疾病筛查中的临床价值有待进一步研究。
BACKGROUND Metabolic disorders, including insulin resistance, obesity, and hyperlipidemia occur frequently prior to hyperglycemia in patients with type 2 diabetes mellitus (T2DM) and cause mild cognitive impairment (MCI). OBJECTIVE We investigated the involvement of resistin in these metabolic abnormalities contributes to MCI in patients with T2DM. METHODS A total of 138 hospitalized patients with T2DM were enrolled and categorized into MCI and non-MCI groups according to the Montreal Cognitive Assessment (MoCA) score. Metabolic indicators and cognitive state were assessed, and plasma resistin levels were determined by ELISA. RESULTS The resistin levels and homeostasis model assessment of insulin resistance (HOMA-IR) scores of MCI and gender-stratified subgroups were significantly higher than those of controls without MCI (all p < 0.01). Correlation analysis showed that the resistin level was negatively associated with majority of cognitive domains, e.g., MoCA (r = -0.693, p < 0.001) and Mini-Mental State Examination (r = -0.571, p < 0.001), and was related to HOMA-IR (r = 0.667, p < 0.001) but not to obesity and lipid indices. Multivariable regression analysis indicated that resistin (β= -0.675, p < 0.001) and educational level (β= 0.177, p = 0.003) were independent risk factors of MoCA in patients with T2DM. CONCLUSIONS High plasma resistin levels portend the insulin resistance-related susceptibility to early cognitive decline in Chinese patients with T2DM. The involvement of this adipokine in other metabolic disorders leading to diabetic MCI and its clinical value for early disease screening must be further studied.