2型糖尿病中老年住院患者轻度认知障碍与载脂蛋白E基因多态性的关系

目的探讨2型糖尿病（T2DM）中老年住院患者轻度认知功能障碍（MCI）与载脂蛋白E（ApoE）基因多态性的关系。方法采用蒙特利尔认知评估（MoCA）量表和日常生活能力评定（ADL）量表对研究对象的认知功能进行评定，共纳入T2DM患者218例，其中合并MCI患者114例（T2DM合并MCI组），认知功能正常患者104例，以糖耐量正常、认知功能正常的119例健康者为正常对照组。采用等位基因特异性多重（multi—ARMS）聚合酶链反应（PCR）技术检测研究对象的ApoE基因型。分析各组等位基因及基因型频率分布特点并比较MoCA评分结果。结果T2DM合并MCI患者的E4／X基因型（包括基因型e3／4和e4／4）频率（37．0％）、￡4等位基因频率（24．6％）均高于患T2DM且认知功能正常患者（分别为19．8％、12．0％）及正常对照组（分别为16．4％、10．1％），差异均有统计学意义（P〈0．05）。携带84等位基因的T2DM患者MoCA测试中视空间与执行能力、注意力与计算力、抽象和定向评分均低于未携带￡4等位基因的T2DM患者，差异均有统计学意义（P〈0.05）。结论ApoE基因多态性与T2DM合并MCI有关，S4等位基因可能是T2DM合并MCI的危险因素。

The relationship between apolipoprotein E gene polymorphisms and the mild cognitive impairment in the hospitalized elderly patients with type 2 diabetes mellitus

Objectlve To explore the relationship between polymorphisms of apolipoprotein E ApoE gene and mild cognitive impairment （MCI） in the hospitalized elderly type 2 diabetes mellitus （T2DM） patients. Methods The cognitive function in 218 hospitalized elderly T2DM patients （114 T2DM cases with MCI and 104 T2DM cases without MCI） and 119 healthy controls was assessed with Motreal Cognitive Assessment （MoCA） scale and Activities of Daily Living （ADL） scale. The polymorphisms of the ApoE gene were detected by Multiplex Amplification Refractory Mutation System （multi-ARMS） polymerase chainreaction （PCR）. The frequencies of alleles and genotypes were analyzed and compared with MoCA scores. Results The frequencies of ApoE E4/X genotype （37.0%） and 4 allele （24.6%） in T2DM with MCI group were significantly higher than those in T2DM without MCI group （ 19.8%, 12.0%, respectively） or healthy control group （ 16.4%, 10.1%, respectively ） （P〈0.05）. The scores of visuo-spatial and executive ability, attention and computing power, abstract and directive force in T2DM patients with 4 allele were significantly lower than those in T2DM patients without 4 allele （P〈0.05）. Conclusion The polymorphisms of ApoE gene are associated with T2DM with MCI. ApoE 4 allele may be a risk factor of MCI in T2DM patients.