The Relationship Of Cognitive Function And Aβ And White Matter Lesions In Diabetes And The Role Of Zibu PiYin Recipe

Objective: To study the clinical features, influencing factors of combinedcognitive dysfunction of type2diabetic patients, as well as its correlation with plasmaA1-42and white matter lesions. Observe the changes of diabetic encephalopathy rathippocampal and cortical A1-42level and the role of Zibu PiYin Recipe.Methods: Select98cases of patients diagnosed as type2diabetes patients inendocrine wards in Second Affiliated Hospital of Dalian Medical University from2011.9to2012.3, make them a diabetic group, and give each patient questionnairesand tests of cognitive function. Through cognitive tests, patients with diabetes weredivided into diabetic cognitive impairment group and diabetic non-cognitive impairmentgroup. Fasting venous blood of64cases of the two groups were drawn off, and plasmaA1-42levels were tested. Randomly select20patients from the two groups, do brainmagnetic resonance, and watch the white matter lesions. Select about40physicalexaminees from Second Affiliated Hospital of Dalian Medical Examination Center,whose age, gender, and education level were matched with the diabetes groups, as thehealthy control group, and draw off their fasting venous blood and test their plasmaA1-42levels.The rats are divided into five groups,namely blank control group,diabeticgroup,spleen Yin group,spleen Yin diabetic group and Zibu PiYin Recipe group.Theplasma A1-42level in diabetic patients and soluble and insoluble A1-42ofhippocampuss and cortex in rats are measured by ELISA. Comparisons of measurementdata are made with the t-test, comparisons of the count data are made with2test, andpairwise comparisons of the3groups of data are made using analysis of variance. Usethe non-conditional logistic regression model to do analysis of influencing factors oftype2diabetes cognitive dysfunction, and calculate the odds ratio (OR) and95% confidence interval (95%CI). Use the bivariate correlation analysis to analyze thecorrelation of the factors affecting cognitive function and cognitive test scores.Results: Compare diabetic patients and healthy subjects,waistcircumference,systolic blood bressure,smoking,alcohol consumption,fasting glucose,triglycerides and HDL have statistically significant differences(P<0.05).MMSE totalscore and the immediate memory,orientation,calculation,attention and visual spatialperception scores in MMSE of diabetic cognitive impairment group are lower thannon-diabetic cognitive impairment group(P<0.01);MoCA score and thememory,connection test,cube test,watches drawing test, visual spatial skills,calculation,attention,naming ability and orientateon in MoCA of diabetic cognitiveimpairment group are lower than non-diabetic cognitive impairment group(P<0.05).Through logistic regression analysis,factors that affect cognitive function in diabeticpatients are age,education level,diabetic peripheral neuropathy and systolic bloodpressure(P<0.05).Through bivariate correlateion analysis,age and MMSE score,and theimmediate memory,calculation and attention,visual spatial perception in MMSE isnegative correlated(P<0.05),with MoCA score and the immediate memory,delayedrecall,repeatability,ability to execute,calculation,attention and abstract ability in MoCAis negatively correlated(P<0.05),with ADL score is significant correlated(P<0.01),thereis no significant correlation with HAMD(P>0.05);Educational level and MMSE andMoCA scores showe a positive correlation(P<0.05),and ADL and HAMD scores arenegatively correlated(P<0.05);There are no significant correlations between diabeticperipheral neuropathy and MMSE,MoCA,ADL and HAMD scores(P>0.05);Systolicblood pressure with MoCA score and the immediate memory score in MoCA arenegatively correlated(P<0.05).Diabetic cognitive impairment group with mild to severeWML is significantly higher than non-diabetic cognitive impairment group.UsingKendall correlation analysis method to analyze the relationship between WML andMMSE,MoCA,ALD and HAMD scores:WML and MMSE score, visual spatial skillsand ability to execute scores in MoCA are negatively correlated(P<0.05).Comparedwith non-diabetic cognitive impairment patients and the health,plasma A1-42levels aresignificantly incrased in diabetic cognitive impairment patients(P<0.01).Soluble andinsoluble A1-42levels in the hippocampus and cortex of diabetic rats and spleen Yindeficiency diabetic rats are increased than narmal rats and spleen Yin deficiencyrats(P<0.05). Soluble and insoluble A1-42levels in the hippocampus and cortex ofZBPYR group are lower than diabetic group.Compared with spleen Yin deficiency group, soluble and insoluble A1-42levels in the hippocampus of ZBPYR group arereduced(P<0.05).Conclusion: Patients with diabetes cognitive dysfunction are worse than thosewith normal cognitive function in terms of memory,attention,visual spatialability,orientation and naming ability and so on.The impact factors for cognitive delineinclude age,education level,diabetes peripheral neuropathy and systolic blood pressure.Age,educational level and systolic blood pressure are risk factors of cognitive,anddiabetic peripheral neuropathy is protective factor of cognitive.WML in patients withdiabetes cognitive dysfunction is mostly mild and severe.WML can affect visual spatialskills and ability to execute in patients with diabetes.The plasma A1-42levels of type2diabetes cognitive dysfunction patients are higher than cognitive normal ones. A1-42contents in hippocampus and cortex of diabetic rats and spleen Yin deficiency diabeticrats are higher than nomal rats and spleen Yin deficiency rats. A1-42levels inhippocampus and cortex of ZBPYR rats are lower than diabetic rats and spleen Yindeficiency diabetic rats,it means that ZBPYR can effectively reduce A1-42levels inhippocampus and cortex of rats.