摘要
目的探讨摄食抑制因子(Nefatin-1)水平差异对不同高糖化血红蛋白(HbA1e)的2型糖尿病(T2DM)患者执行功能的影响。方法以88例T2DM患者为研究对象。采用执行功能行为评定量表成人版(BRIEF-A)评价执行功能,问卷调查获得患者人口统计学信息,常规体格检查及糖脂代谢指标检测,酶联免疫吸附法测定清晨空腹血血浆Nesfatin-1、C-反应蛋白(CRP)和白介素-6(IL6)浓度。分析不同HbA1c及Nesfatin-1浓度与BRIEF-A得分的相关性。结果与HbAlc≤7%组比较,HbAle>7%组吸烟及糖尿病周围神经病变例数显著增加(P<0.05),甘油三酯(TG)、空腹血糖(FPG)、餐后血糖(PPG)、CRP.JL6及Nesfatin-1浓度显著增高(P<0.05),BRIEF-A评定量表中,执行功能各系统模块得分均显著增加(P<0.05),相关性分析结果表明,HbA1c≤7%组患者血浆HbA1e水平与胆固醇(TC)(r=0.496,P=0.019)及低密度脂蛋白胆固醇(LDL-C)(r=0.492,P=0.020)浓度呈正相关。而HbA1c>7%组患者血浆HbA1c.水平与FPG(r=0.341,P=0.005)及PPG(r=0.296,P=0.020)浓度呈正相关,且血浆Nefatin-1浓度与CRP(r=0.570,P<0.01)及IL-6(r=0.659,P<0.001)浓度亦呈正相关。以第50位百分位数为界限,高血浆Nesfatin-1浓度T2DM患者在行为管理指数、转换及抑制功能中的得分显著高于低血浆Nesfatin-1浓度患者(P<0.05)。结论血浆Nesfatin-1浓度及其相关的血浆CRP和IL6浓度升高是参与T2DM患者执行功能下降的可能因素。
Objective To investigate the role of Nesfatin-1 in the impairent of executive ability in type 2 diabetes mellitus(T2DM)patients,and explore ils relationship with glycated hemoglobin A1c(HbA1c)level.Methods Eighty-eight T2DM patients in the endocrinology department of the fouth ailiated hospital of Anhui Medical Uni-versity were enrolled.Executive ability was assessed using Behavior Rating Inventory of Executive Function-Adult Version(BRIEF-A).Demographic information and biochemical parameters were taken from questionnaire and medical records.Fasting blood was collected in the morning,and the plasma concentrations of Nesfatin-1,C-reac-tive protein(CRP),and interleukin-6(IL-6)were measured via enzyme-linked immunosorbent assay.The corre-lation between the plasma levels of HbA1c or Nesfatin-1 and the BRIEF-A score was analyzed via Pearson correla-tion test.Results Compared with that in the HbA1c≤7% group,the frequencies of smoking and diabetic periph-eral neuropathy cases,and serum concentrations of tiglyceride(TG),fasting plasma glucose(FPG),post-prandial glucose(PPG),CRP,IL-6 and Nesfatin-l were all increased in the HbAlc>7% group(P<0.05).In the BRIEF-A rating scale,the scores of inhibition,shift,emotional control,self-monitor,initiation,working memory,plan/organization,organization of materials and task monitor factors,behavioral regulation and metacognition in-dex,and the BRIEF-A total score were also increased in the HbA1c>7% group(P<0.05).Results of Pearson correlation test showed that the plasma HbAlc level was positively correlated with the concentrations of total choles-terol(TC)(r=0.496,P=0.019)and low-density lipoprotein cholesterol(LDL-C)(r=0.492,P=0.020)in HbA1c≤7% group;Plasma HbAlc level was positively correlated with FPG(r=0.341,P=0.005)and PPG(r=0.296,P=0.020),and plasma Nesfatin-1 concentrations was positively correlated with concentration of CRP(r=0.570,P<0.01)and IL-6(r=0.659,P<0.001)in HbAlc>7% group.Furthermore,grouped by the 50th per-centile of plasma Nesfatin-1 concentration,the scores of behavioral regulation index,inbibition,and shift in the high plasma Nesfatin-1 concentration group were significantly higher than that of the low plasma Nesfatin-1 concen-tration group(P<0.05).Conclusion The increased plasma Nesfatin-1 concentration and its related elevation of plasma CRP and IL-6 concentrations may play an important role in the impairment of executive ability in T2DM pa-tients.
作者
余越
王艳燕
陈征
韩引秀
陈星星
方可
朱鹏
朱道民
葛金芳
Yu Yue;Wang Yanyan;Chen Zheng(School of Pharmacy,Anhui Medical Unversity,Hefei 230032;Dept of Pharmacy,The Fourth affiliated Hospital of Anhui Medical Unersity,Hefei 230032;Dept of Endocrinology,The Fourth affiliated Hospital of Anhui Medical Unersity,Hefei 230032)
出处
《安徽医科大学学报》
CAS
北大核心
2019年第12期1966-1971,共6页
Acta Universitatis Medicinalis Anhui
基金
国家自然科学基金项目(编号:81401122、81870403)
