探究甲状腺功能与2型糖尿病患者认知功能障碍的关系

Investigate the Relationship between Thyroid Function and Cognitive Dysfunction in Patients with Type 2 Diabetes Mellitus

摘要: 目的：探讨甲状腺功能与2型糖尿病患者认知功能障碍的关系。方法：选取2023年4月至2023年08月山东大学第二医院健康查体中心收治的120例2型糖尿病患者作为研究组。根据2型糖尿病患者是否合并认知功能障碍分为非认知障碍组(n = 50)和认知障碍组(n = 70)。比较两组间一般资料、甲状腺功能及生化指标水平的差异；采用线性相关分析探讨甲状腺相关激素、生化指标水平及一般资料与认知功能的相关性；采用多因素Logistic回归分析探讨2型糖尿病患者认知功能障碍的影响因素。结果：在一般资料中，认知障碍组的收缩压及年龄更高、舒张压及受教育程度更低(P < 0.05)；在生化资料中，认知障碍组血清FT3、FT4水平更低，TC、FBG、HDL-C及TSH水平更高(P < 0.05)。相关分析显示，血清FT3与蒙特利尔认知评估量表(Montreal cognitive assessment, MoCA)评分呈显著正相关(r = 0.396, P < 0.001)，血清TSH与MoCA评分呈显著负相关(r = −0.440, P < 0.001)。多因素回归分析显示，受教育水平(OR = 0.752, 95%CI: 0.639~0.884)、FT3 (OR = 0.24, 95%CI: 0.081~0.712)、TSH (OR = 2.098, 95%CI: 1.165~3.778)是2型糖尿病患者认知功能障碍的影响因素。结论：FT3可能是T2DM患者发生认知障碍的保护性因素，而TSH可能是T2DM患者发生认知障碍的危险因素。

Abstract: Objective: To investigate the relationship between thyroid function and cognitive dysfunction in patients with type 2 diabetes mellitus. Methods: 120 cases of type 2 diabetic patients admitted to the author’s Health Screening Center from April 2023 to August 2023 were selected as the study group. The patients with type 2 diabetes mellitus were divided into a non-cognitive impairment group (n = 50) and a cognitive impairment group (n = 70) according to whether or not they had cognitive impairment. We compared the differences in general information, thyroid function and biochemical index levels between the two groups; A linear correlation analysis was used to explore the correlation between the levels of thyroid-related hormones, biochemical indicators, general information and cognitive functions. The influencing factors of cognitive dysfunction in type 2 diabetes mellitus patients were investigated by using univariate and multivariate logistic regression analysis; Results: In the general information, the systolic blood pressure and age were higher while the diastolic blood pressure and educational level were lower in the cognitive impairment group (P < 0.05). In the biochemical data, the levels of serum free triiodothyronine (FT3) and free thyroxine (FT4) were lower, while the levels of total cholesterol (TC), fasting blood glucose (FBG), high-density lipoprotein cholesterol (HDL-C) and thyroid-stimulating hormone (TSH) were higher in the cognitive impairment group (P < 0.05). Correlation analysis showed that serum FT3 was positively correlated with the Montreal Cognitive Assessment Scale (MoCA) score (r = 0.396, P < 0.001), and serum TSH was negatively correlated with the MoCA score (r = −0.440, P < 0.001). Multifactorial regression analysis showed that education level (OR = 0.752, 95%CI: 0.639~0.884), FT3 (OR = 0.24, 95%CI: 0.081~0.712), and TSH (OR = 2.098, 95%CI: 1.165~3.778) were the influencing factors of cognitive dysfunction in type 2 diabetic patients. Conclusions: FT3 may be a protective factor for the development of cognitive impairment in patients with T2DM, whereas TSH may be a risk factor for the development of cognitive impairment in patients with T2DM.