血清维生素B12与老年2型糖尿病轻度认知功能障碍的关系

doi:10.3969/j.issn.1004-583X.2024.01.005

摘要/Abstract

摘要：

目的探讨血清维生素B₁₂(VB₁₂)水平与老年2型糖尿病(T2DM)合并轻度认知功能障碍(MCI)的相关性。方法收集2023年1月-2023年7月在抚顺市中心医院内分泌科收治入院的老年T2DM患者共120例,根据血清VB₁₂正常水平进行三等分,将患者分为A组(200≤VB₁₂<500 ng/L)36例,B组(500≤VB₁₂<800 ng/L)71例,C组(800≤VB₁₂<1100 ng/L)13例,采用简易蒙特利尔认知评估(MoCA)量表对各组进行认知功能评定比较。比较3组MCI患病率。用logistic回归分析维生素B₁₂的不同水平与MCI 的相对风险。结果 MCI发病率随VB₁₂水平的增高而降低。校正了性别、年龄、TC、HDL-C、LDL-C变量后,logistic回归结果显示,以C组为参照组,A组发生MCI的OR值(95% $C I$ )为6.121(1.161~32.265)。结论 200≤VB₁₂<500 ng/L是老年 T2DM 患者合并MCI的独立危险因素。

关键词: 糖尿病, 2型, 维生素B₁₂, 轻度认知功能障碍

Abstract:

Objective To investigate the correlation between serum vitamin B₁₂ (VB₁₂) level and mild cognitive impairment (MCI) in elderly patients with type 2 diabetes mellitus (T2DM). Methods A total of 120 elderly T2DM patients admitted to the Endocrinology Department of Fushun Central Hospital from January 2023 to July 2023 were collected. According to the tertiles of the measured serum VB₁₂, patients were divided into A group (200 ng/L≤VB₁₂<500 ng/L, $n$ =36), B group (500 ng/L≤VB₁₂<800 ng/L, $n$ =71), and C group (800 ng/L≤VB₁₂<1100 ng/L, $n$ =13). The cognitive function of patients was evaluated using the Simple Montreal Cognitive Assessment (MoCA) scale. The prevalence of MCI was compared among the three groups. Logistic regression was performed to analyze the relative risks for MCI in elderly T2DM patients with different levels of vitamin B₁₂. Results The incidence of MCI decreased with the increasing serum VB₁₂ level. After adjusting for gender, age, total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), and low-density lipoprotein cholesterol (LDL-C), logistic regression results showed that with Group C as the reference group, the odds ratio ( $O R$ ) and corresponding 95% confidence interval ( $C I$ ) for MCI in Group A was 6.121 and 1.161-32.265, respectively. Conclusion Serum VB₁₂ ranging from 200 ng/L to 500 ng/L is an independent risk factor for MCI in elderly T2DM patients.

Key words: diabetes mellitus, type 2, vitamin B₁₂, mild cognitive impairment

中图分类号:

R587.1

张佳楠, 孙琳琳, 詹潇燕, 李冰. 血清维生素B₁₂与老年2型糖尿病轻度认知功能障碍的关系[J]. 临床荟萃, 2024, 39(1): 34-37.

Zhang Jianan, Sun Linlin, Zhan Xiaoyan, Li Bing. Correlation between serum Vitamin B₁₂ and mild cognitive impairment in elderly patients with type 2 diabetes mellitus[J]. Clinical Focus, 2024, 39(1): 34-37.

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链接本文: https://huicui.hebmu.edu.cn/CN/10.3969/j.issn.1004-583X.2024.01.005

https://huicui.hebmu.edu.cn/CN/Y2024/V39/I1/34

图/表 3

表1 三组临床资料比较

Tab.1 Comparison of clinical data among three groups

项目	A组( $n$ =36)	B组( $n$ =71)	C组( $n$ =13)	$F$ / $H$ /χ²值	$P$ 值
年龄(岁)	71.5(68, 75.75)	70(67, 73)	68(67, 71)	6.773	0.034
男/女(例)	22/14	30/41	6/7	3.429	0.180
BMI(kg/m²)	24.64±2.81	24.23±3.18	25.46±3.92	0.894	0.412
收缩压(mmHg)	150.47±21.61	150.69±18.71	148.46±23.49	0.140	0.869
舒张压(mmHg)	87.06±13.60	84.17±10.10	85.77±10.18	0.418	0.660
吸烟史[例(%)]	19.4	22.5	23.1	3.970	0.137
饮酒史[例(%)]	22.2	21.1	7.7	1.881	0.390
糖尿病病程(年)	10(1.25, 19.25)	10(5, 20)	10(4, 17)	1.167	0.558
受教育年限(年)	8.39±2.91	8.55±2.735	9.69±2.43	1.131	0.326
FPG(mmol/L)	10.40±3.17	10.70±3.29	9.81±2.25	0.468	0.628
TC(mmol/L)	5.91±1.36	5.25±1.37	5.11±1.60	3.373	0.038
TG(mmol/L)	2.36(1.56, 3.19)	1.80(1.34, 2.75)	1.51(1.27, 3.32)	0.250	0.882
HDL-C(mmol/L)	1.00±0.21	1.03±0.24	1.22±0.39	4.154	0.018
LDL-C(mmol/L)	3.87±0.80	3.18±0.91	2.86±1.18	9.274	0.001
FINS(mIU/L)	11.64(8.32, 16.19)	11.28(8.21, 19.76)	11.61(8.88, 22.21)	0.180	0.914
FC-P(ng/ml)	2.05(1.49, 2.80)	2.18(1.65, 3.00)	2.41(1.19, 3.59)	1.052	0.591
HbA₁c(%)	9.40±1.82	9.46±2.08	10.21±1.36	0.920	0.401
MoCA(分)	23.11±2.84	24.92±1.74	26.85±1.99	17.000	0.001

表1 三组临床资料比较

Tab.1 Comparison of clinical data among three groups

项目	A组( $n$ =36)	B组( $n$ =71)	C组( $n$ =13)	$F$ / $H$ /χ²值	$P$ 值
年龄(岁)	71.5(68, 75.75)	70(67, 73)	68(67, 71)	6.773	0.034
男/女(例)	22/14	30/41	6/7	3.429	0.180
BMI(kg/m²)	24.64±2.81	24.23±3.18	25.46±3.92	0.894	0.412
收缩压(mmHg)	150.47±21.61	150.69±18.71	148.46±23.49	0.140	0.869
舒张压(mmHg)	87.06±13.60	84.17±10.10	85.77±10.18	0.418	0.660
吸烟史[例(%)]	19.4	22.5	23.1	3.970	0.137
饮酒史[例(%)]	22.2	21.1	7.7	1.881	0.390
糖尿病病程(年)	10(1.25, 19.25)	10(5, 20)	10(4, 17)	1.167	0.558
受教育年限(年)	8.39±2.91	8.55±2.735	9.69±2.43	1.131	0.326
FPG(mmol/L)	10.40±3.17	10.70±3.29	9.81±2.25	0.468	0.628
TC(mmol/L)	5.91±1.36	5.25±1.37	5.11±1.60	3.373	0.038
TG(mmol/L)	2.36(1.56, 3.19)	1.80(1.34, 2.75)	1.51(1.27, 3.32)	0.250	0.882
HDL-C(mmol/L)	1.00±0.21	1.03±0.24	1.22±0.39	4.154	0.018
LDL-C(mmol/L)	3.87±0.80	3.18±0.91	2.86±1.18	9.274	0.001
FINS(mIU/L)	11.64(8.32, 16.19)	11.28(8.21, 19.76)	11.61(8.88, 22.21)	0.180	0.914
FC-P(ng/ml)	2.05(1.49, 2.80)	2.18(1.65, 3.00)	2.41(1.19, 3.59)	1.052	0.591
HbA₁c(%)	9.40±1.82	9.46±2.08	10.21±1.36	0.920	0.401
MoCA(分)	23.11±2.84	24.92±1.74	26.85±1.99	17.000	0.001

图1 3组MCI患病率比较注:与C组比较,* P<0.05;与B组比较,# P<0.05。A组为200 ng/L≤VB12<500 ng/L;B组为500 ng/L≤VB12<800 ng/L;C组为800 ng/L≤VB12<1100 ng/L

Fig.1 Comparison of prevalence of MCI among three groups

表2 不同水平VB12对MCI的影响

Tab.2 Effects of different levels of VB12 on MCI

模型	组别	$O R$ (95% $C I$ )	$P$ 值
1	A	8.667(1.969~38.151)	0.004
	B	4.301(1.090~16.974)	0.037
	C	1	-
2	A	7.657(1.687~34.766)	0.008
	B	4.100(1.031~16.295)	0.045
	C	1	-
3	A	6.121(1.161~32.265)	0.033
	B	3.643(0.855~15.523)	0.081
	C	1	-

表2 不同水平VB12对MCI的影响

Tab.2 Effects of different levels of VB12 on MCI

模型	组别	$O R$ (95% $C I$ )	$P$ 值
1	A	8.667(1.969~38.151)	0.004
	B	4.301(1.090~16.974)	0.037
	C	1	-
2	A	7.657(1.687~34.766)	0.008
	B	4.100(1.031~16.295)	0.045
	C	1	-
3	A	6.121(1.161~32.265)	0.033
	B	3.643(0.855~15.523)	0.081
	C	1	-

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血清维生素B₁₂与老年2型糖尿病轻度认知功能障碍的关系

Correlation between serum Vitamin B₁₂ and mild cognitive impairment in elderly patients with type 2 diabetes mellitus

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