摘要
目的探讨60岁以上2型糖尿病(T2DM)患者骨量异常与轻度认知障碍(MCI)的相关性。方法对2016年1月至2022年3月在南京大学医学院附属鼓楼医院内分泌科住院的60岁以上的T2DM患者进行回顾性分析,收集患者的全髋、股骨颈和第1~4腰椎椎体骨密度,并计算骨密度T值,评估患者总体认知功能及各认知域功能,包括即刻记忆、视觉广度、言语功能、注意力、延时记忆、工作记忆、处理速度、执行功能。根据MCI诊断标准将患者分为正常认知组及MCI组,根据骨密度检测结果将患者分为骨量正常组、骨量减少组和骨质疏松组。组间比较采用t检验、Mann‐Whitney U检验、χ^(2)检验、单因素方差分析、Kruskal-Wallis H检验。采用多因素logistic回归分析法分析60岁以上T2DM患者骨量减少、骨质疏松与MCI高风险的相关性。结果共纳入60岁以上T2DM患者267例,其中正常认知组165例,MCI组102例;骨量正常、骨量减少及骨质疏松3组分别为119、108和40例。MCI组骨量减少、骨质疏松的患病率均高于正常认知组[分别为48.0%(49/102)、35.8%(59/165)和22.5%(23/102)、10.3%(17/165),P<0.001]。MCI组股骨颈、全髋、第1~4腰椎骨密度及T值均低于正常认知组(均P<0.05)。骨质疏松组的即刻记忆、延时记忆、工作记忆、处理速度认知域较骨量正常组更差(均P<0.05)。多因素logistic回归分析结果显示,调整协变量后,骨量减少(OR=2.936,95%CI 1.511~5.706)、骨质疏松(OR=4.347,95%CI 1.600~11.808)与MCI高风险相关。结论60岁以上T2DM患者骨量异常与MCI风险升高有关。
Objective To evaluate the association between bone mass abnormality and mild cognitive impairment(MCI)in patients with type 2 diabetes mellitus(T2DM)aged over 60 years.Methods From January 2016 to March 2022,patients with T2DM aged over 60 years hospitalized in the Department of Endocrinology,Drum Tower Hospital affiliated to Nanjing University Medical School were retrospectively analyzed.Bone mineral density of the patients′total hip,femoral neck and lumbar spine(L1-4)were collected and the T values were calculated.The assessments of global cognition and cognitive domains function,including immediate memory,visuospatial ability,language,attention,delayed memory,working memory,processing speed and executive function were conducted for patients enrolled.At the same time,the patients′general clinical data and laboratory results were collected.According to the diagnostic criteria of MCI,the patients were divided into normal cognitive function group and MCI group.According to the results of bone density test,patients were divided into normal bone mass group,osteopenia group and osteoporosis group.The t test,Mann-Whitney U test,chi-square test,one-way analysis of variance and Kruskal Wallis H test were used to compare data between the groups.Multivariate logistic regression was used to analyze the risk factors of MCI in patients with T2DM over 60 years old.Results A total of 267 patients with T2DM aged over 60 years were enrolled,including 165 patients with normal cognitive function and 102 patients with MCI;the cases in the normal bone mass,osteopenia and osteoporosis groups were 119,108 and 40 respectively.The incidence of osteopenia and osteoporosis in the MCI group was significantly higher than that in cognitive normal group[48.0%(49/102)and 35.8%(59/165);22.5%(23/102)and 10.3%(17/165)respectively,P<0.001].There were significant differences in bone mineral density and T value of femoral neck,total hip and lumbar spine(L1-4)between the two groups(all P<0.05).The scores of immediate memory,delayed memory,working
作者
侯银娇
张洲
缪应雯
徐湘
丁群
于从从
杨东辉
毕艳
Hou Yinjiao;Zhang Zhou;Miao Yingwen;Xu Xiang;Ding Qun;Yu Congcong;Yang Donghui;Bi Yan(Department of Endocrinology,Drum Tower Clinical Medical College of Nanjing Medical University,Nanjing 210008,China;Department of Endocrinology,Drum Tower Hospital Affiliated to Nanjing University Medical School,Branch of National Clinical Research Centre for Metabolic Diseases,Nanjing 210008,China)
出处
《中华糖尿病杂志》
CAS
CSCD
北大核心
2023年第4期295-302,共8页
CHINESE JOURNAL OF DIABETES MELLITUS
基金
国家自然科学基金青年项目(82000775)。
关键词
糖尿病
2型
骨质疏松
骨密度
轻度认知障碍
Diabetes mellitus,type 2
Osteoporosis
Bone density
Mild cognitive impairment
