| Objective: To study serum cystatin C,Carotid atherosclerosis' s clinical value in estimation elderly T2 DM patients with cognitive function impairment,analysis the relevance between tree,and the differences in different regions of cognitive function impairment.Methods: Select a total of 169 cases of elderly T2 DM patients in the Second Hospital of Lanzhou University,include males 106 cases,females 63 cases,all according to the diagnosis standards of WHO(1999),exclude the illness in mental.Taking MMSE(Mini-mental state examination)as the estimation tool of diagnosing T2 DM complication with cognitive function impairment,groups division according to the total scores of MMSE,MMSE scores<27 points as the cognitive function impairment group,while on the contrary,MMSE scores?27 points as the case-control group,which is the T2 DM cognitive function nomal group,at the same time,to rule out the possible influence of education,when the years of education?12,then add one point to the total scores.There are 69 cases in T2DM-NC,while as 100 cases in T2 DM cognitive function impairment group,Base on the frequency matching method,matching the,sex,age,education between two groups,comparing the MMSE total scores,each component scores,and analysis of general clinical informations.Meanwhile going the single factor and the muptiple factors unconditional logistic regression analysis,comparing the diagosis value of serum cystatin C,Carotid atherosclerosis in elderly T2 DM patients with cognitive function impairment,investigation others risk factors of T2 DM with cognitive function impairment.Taking IMT(Intima-media thickness)as the diagnosis standards of Carotid atherosclerosis,there are 103 cases of without carotid intimal thickening which IMT ? 1.0mm,and IMT > 1.0mm as the Carotid atherosclerosis group including 66 cases,comparing the relevance of different degree of Carotid atherosclerosis with MMSE total scores,each component area scores.Result:1 Two groups comparative analysis shows that sex,age,BMI,different cures on T2 DM have no statistical significance(P>0.05),indicate the well matching,while complication with HighPressure between two groups has huge statistical significance(P < 0.001),T2 DM cognitive function impairment complication with High Pressure shows a tendency of more people.2 The serum cystatin C level in elderly T2DM-NC group is 1.04±0.49mg/L,IMT thickness is0.96±0.18 mm,while in T2 DM patients with cognitive function impairment group,the serum cystatin C level is 1.32±0.48mg/L,IMT thickness is 1.1±0.24 mm,compare datas of two groups,shows that T2 DM patients with cognitive function impairment group has more elevate level of serum cystatin C and IMT thickness,difference between two has statistical significance(P <0.001).T2DM-NC group MMSE score is 28.19±0.98,while T2 DM with cognitive function impairment group is 22.49±4.01,difference between two groups has statistical significance(P<0.001).In addition,TG,HDL-C have statistical significance in two groups as well(P<0.05),while CHO,LDL-C,CR,UA have no statistical significance.Point to the condition of association with diabetes mellitus between two groups,Diabetes duration,HbA1 c,fasting plasma glucose,Insulin resistance have statistical significance(P<0.05),HbA1 c at the edge of statistical significance(P=0.049),but 2 hour postprandial blood glucose has no statistical significance(P>0.05).3 Bound by IMT=1.0mm,comparing the differences in different degree of Carotid atherosclerosis on MMSE score,each component.MMSE score is 25.11±3.78 in IMT?1.0mm group,while 22.06±3.77 in IMT>1.0mm group,difference of MMSE score between two groups has statistical significance(P<0.001),MMSE each component include orientation,memory,attention,recall and language have huge statistical significance(P<0.05).Serum cystatin C has negative correlation with MMSE total score,each component score,the Pearson correlation of MMSE,orientation,attention,language with Serum cystatin C are-0.455(P<0.05),-0.423(P<0.05),-0.383(P<0.05),-0.411(P<0.05)respectively,while the negative correlation of memory,recall are-0.142(P<0.05),-0.146(P<0.05)respectively,which at edge of statistical significance.However,Serum cystatin C is positive correlation with IMT thickness.4 Under the inspection level of 0.05,multiple factors Logistic unconditional regression analysis shows that six variables come in the equation,including Diabetes duration,HbA1 c,Serum cystatin C,IMT,complication with High Pressure,cure of Diabetes.Diabetes duration,Serum cystatin C,IMT,HbA1 c have huge statistical significance with T2 DM cognitive function impairment risks,which figures are(OR:0.291,95%CI:0.167-0.510,P<0.001),(OR:0.450,95%CI:0.242-0.836,P=0.012),(OR:0.495,95%CI:0.264-0.925,P=0.028),(OR:0.549,95%CI:0.361-0.834,P=0.005)respectively.Conclusions:T2DM cognitive function impairment risk factors including Serum cystatin C,IMT thickness,High pressure,Diabetes duration and HbA1 c.Serum cystatin C,IMT may worktogether participating in the cognitive impairment of patients with T2DM. |
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