Effects of serum levels of trace metals on cognitive function in older patients with type 2 diabetes mellitus

Autor: Chi-Hsun Lien, 連啟勛
Rok vydání: 2012
Druh dokumentu: 學位論文 ; thesis
Popis: 100
Objective Cognitive impairment and type 2 diabetes mellitus (DM) are common found in the elder people and a public health issue now. But the mechanism between cognitive impairment and type 2 DM was still unknown. Deficiency or decreased level of essential metals and increased level of non-essential metals in blood of type 2 DM patients seem had correct with effects of these metals to cognitive impairment and neurodegeneration. Methods We recruited cases in out-patient department of Endocrinology & Metabolism at Ping-Tung Christian Hospital who are patients of type 2 DM with regular followed-up and more than sixty-five years of age in 2010. We collected blood samples, basic socioeconomic data by questionnaire and medical records, and evaluated the cognitive function by MMSE and AD8. We separated two groups: normal and abnormal cognitive function by adjusted MMSE scores to analyze the relationship and effects. Results In total, 244 cases (132 males and 112 females) were recruited. The average years of age were 72.38±5.40 (72.89±5.50 in male and 71.77±5.24 in female, P value = 0.105). The average scores of MMSE were 26.11±3.53 in male and 23.60±4.57 in female, and P value < 0.001. There was no difference between ages, serum metal levels, serum creatinine level, and HbA1c, except genders (P value < 0.05). The aluminum level in serum was 81.903±98.214 of abnormal group and 74.499±41.660 of normal group (P value = 0.077). In logistical regression model, aluminum level in serum was a significant risk for cognitive impairment (Odd ratio: 1.009 (95% CI: 1.003-1.015)). Males also had more risk of cognitive impairment than females (Odd ratio: 0.288 (95% CI: 0.100-0.832), P value = 0.021) after adjusted variables. Discussion In this study, aluminum level in serum was a significant risk for cognitive impairment (Odd ratio: 1.009 (95% CI: 1.003-1.015)). It was consisted with the conclusion of the most studies in the past.Besides, aluminum level in serum also increased in abnormal groups, although it had no statistics significance. Increased aluminum level in serum of cognitive impairment group of older type 2 DM patients could be the result of released or uptake after metabolic progress from brain and nerve system of these patients. Other metals showed no significant effects, but the interaction and relationship between every metal showed difference. The changed of metal-metal interaction could be the cause of cognitive impairment. Males also had more risk of cognitive impairment than females (Odd ratio: 0.288 (95% CI: 0.100-0.832), P value = 0.021) after adjusted variables. In this study, males had increased risk of cognitive impairment because we didn’t differentiate between the neurodegenerative and vascular etiology.
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