Association Between ApoE、SLCO1B1 Gene Polymorphisms And Mild Cognitive Impairment In Elderly Patients With Type 2 Diabetes

Objective:To analyze the relationship between polymorphisms of apolipoprotein E(Apo E)and solute carrier organic anion transporter family member 1B1(SLCO1B1)genes,and mild cognitive impairment(MCI)combined with elderly type 2 diabetes mellitus(T2DM).Furthermore,investigate the risk factors that influence the occurrence of MCI in elderly individuals with T2DM.Methods:Based on the inclusion and exclusion criteria,a total of 110 cases were collected for this study,of which 79 were elderly T2DM patients.The included study cases were divided into three groups according to the Mini-mental State Examination(MMSE)and Montreal Cognitive Assessment(Mo CA)scores:the elderly T2DM with mild cognitive impairment(MCI(+))group consisted of 45 cases,the elderly T2DM without mild cognitive impairment(MCI(-))group consisted of 34 cases,and the normal control(NC)group consisted of 31 cases.The age,gender,education level,diabetes duration,body mass index(BMI)(BMI=weight kg/height m~2),as well as triglycerides(TG),total cholesterol(TC),high-density lipoprotein cholesterol(HDL-C),and low-density lipoprotein cholesterol(LDL-C)were collected for each group.To compare the differences in Apo E and SLCO1B1 allele frequencies and genotypes among the groups,this study used statistical analysis to determine if there were significant differences in their distribution and further explored the risk factors for elderly T2DM patients with MCI.Results:1.The differences in gender,age,BMI,education level,TC,TG,HDL-C,and LDL-C among the three groups of study subjects were not statistically significant(P>0.05).However,the duration of diabetes showed significant differences(P<0.05)among the three groups.2.The distribution differences of Apo E genotypes and allele frequencies among the three groups of study subjects were statistically significant(P<0.05).By comparing the genotypes,it was found that the frequencies of E2/E4 and E3/E4 genotypes were significantly higher in the MCI(+)group,and the frequency of genotypes containing the E4 allele was significantly increased in the MCI(+)group,with statistical significance(P<0.05).By comparing the allele frequencies,it was found that there were no statistically significant differences in the frequency distribution of E2 and E3 alleles among the three groups(P>0.05),but the frequency of the E4 allele was significantly higher in the MCI(+)group compared to the NC group(P<0.05).3.The distribution of 388A>G and 521T>C loci genotypes and allele frequencies of the SLCO1B1 gene among the three groups showed no statistically significant differences(P>0.05).4.In elderly T2DM patients,the cognitive scores in the domains of visuospatial and executive function,naming,attention and calculation,language,abstraction,memory,and orientation were significantly lower in the MCI(+)group compared to the MCI(-)group,with statistical significance(P<0.05).5.Logistic regression analysis indicated that the genotypes of SLCO1B1 gene 388A>G and 521T>C sites were not significantly associated with the presence of MCI in elderly T2DM patients,with no statistical significance(P>0.05).However,the duration of diabetes and Apo E genotypes may have an impact on the occurrence of MCI in elderly T2DM patients,with statistical significance(P<0.05).6.The receiver operating characteristic(ROC)curves demonstrated that the area under the curve(AUC)for predicting the risk of MCI in elderly T2DM patients was 0.623(95%CI:0.499-0.746)for Apo E-E4 allele carriers and 0.986(95%CI:0.966-1.000)for those with a longer duration of diabetes,both of which were statistically significant(P<0.05).Therefore,the presence of Apo E-E4 allele and the duration of diabetes may play a certain role in predicting the occurrence of MCI in elderly T2DM patients.Conclusion:In this study,the polymorphism of the Apo E gene was found to be associated with MCI in elderly T2DM patients,while there was no correlation observed between the polymorphism of the SLCO1B1 gene and elderly T2DM or its combined MCI.Moreover,the risk of MCI occurrence in elderly T2DM patients with a longer duration of diabetes and carrying the Apo E-E4 allele was found to be greater.This study also revealed that compared with elderly T2DM patients without MCI,those with combined MCI exhibited cognitive impairment in multiple domains,with significant declines in visuospatial and executive function,naming,attention and calculation,delayed memory,and orientation.