Abstract:

Objective To investigate the relationship between cognitive dysfunction and human β Amyloid 1-42 (Aβ1-42) in patients with diabetic kidney disease (DKD). Methods In this study, patients(n=161) with type 2 diabetes mellitus (T2DM) who were treated in the Department of Endocrinology, Affiliated Hospital of Xuzhou Medical University from May 2020 to May 2021 were as subjects. These patients were enrolled into normoalbuminuria (DM) group (n=60), microalbuminuria (DKD1) group (n=58) and macroalbuminuria (DKD2) group (n=43) according to urine albumin creatine ratio(UACR)levels. The patients' cognitive function was assessed by the Montreal Cognitive Assessment (MoCA) scale. Aβ1-42, UACR, Cystatin C (CysC), estimated glomerular filtration rate (eGFR) were detected, and the relationship between the above indicators and MoCA score was analyzed.Results Compared with DM group, CysC and Aβ1-42 in DKD1 and DKD2 groups increased (P<0.05), and eGFR decreased (P<0.05). Compared with DKD1 group, CysC increased and eGFR drcreased in DKD2 group(P<0.05). The MoCA scores in the DKD groups were superior to those in DM group (P<0.05), which in the DKD2 group were prevalent (P<0.05). MoCA scores in the three groups were negatively correlated with Aβ1-42, UACR, and CysC (all P<0.01), and positively correlated with eGFR (P<0.01). Aβ1-42 in the three groups was positively correlated with UACR and CysC (all P<0.01), and negatively correlated with eGFR (P<0.01). The results of multivariate linear regression analysis showed that Aβ1-42 and UACR were the influencing factors for MoCA score in DKD patients. Conclusion Cognitive dysfunction exists in DKD patients, which is closely related to the level of Aβ1-42 and the severity of renal damage.

Key words: diabetic nphropathies, diabetes mellitus, type 2, cognitive dysfunction, amyloid beta-peptides