Relationship Between Cognitive Function And The Levels Of Aβ1-42、 SRAGE In Serum Of Type 2 Diabetic Patients

Objectives To study the the relationship of serum Amyloid beta eptide 1-42(Aβ1-42)and soluble receptor for advanced glycation end products(s RAGE) with cognition in male type 2 diabetes(T2DM) patients.Methods 120 patients of T2 DM are recruited from Endocrinology of Tangshan Worker’s Hospital from March 2014 to March 2015. Self-made questionnaire to collect subjects of demographic data and clinical indicators, then based on MMSE(Minimum Mental State Examination, MMSE) test all patients are divided into groups: cognitive dysfunction groups including 50 patients, non-cognitive impairment group including 70 cases. And using RBANS(Repeatable Battery for the Assessment of Neuropsychological Status,RBANS) assesses their cognitive function, ELISA(Enzyme linked immunosorbent assay,ELISA) detect the level of Aβ1-42 and s RAGE in serum from the subjects’ fasting venous blood.Then indicators are respectively analyzed and compared of the two groups above including the age, education, duration of diabetes, demographic information and fasting blood glucose(FBG), glycosylated hemoglobin A1c(Hb A1c), total cholesterol(TC),triglycerides(TG), low density lipoprotein(LDL), so as the levels of Aβ1-42, s RAGE in serum and RBANS score.It is to findig if there is difference in Aβ1-42, s RAGE levels in serum and cognitive function RBANS scale scores; Comparing RBANC scale five subtests immediate memory, visual span, language function, attention, delayed memory score and standard score serum Aβ1-42, s RAGE levels and other clinical indicators find the relationship.Results 1 Comparison of emographic characteristics and clinical biochemical indicators between impaired cognition group and normal cognition group: 26 males and 24 females in impaired cognition group, their mean age 48.56 ± 12.166. 38 males and 32 females in normal cognition group, the mean age 47.26 ± 12.291. No significant difference of age, sex,years of education and course constitute in the two groups(P>0.05). Compared with normal cognition group, the impaired cognition group FBG, TC and Hb A1 c higher, the difference was statistically significant(P<0.05), two groups of LDL, TG was no significant difference(P>0.05). 2 Comparison of the level of Aβ1-42, s RAGE in serum between impaired cognition group and normal cognition group: the level of Aβ1-42 in serum is significantly elevated,at the same time the level of s RAGE in serum is lower, the difference is statistically significant(P<0.05). There is relationship in Serum Aβ1-42 levels and cognitive impairment(OR value of 2.307, P=0.027), the same as serum levels of s RAGE and cognitive impairment(OR value of 0.434, P=0.026). 3 The influencing factors to the level of Aβ1-42,s RAGE in all Subjects’ serum: stepwise regression analysis showed it is influential of age, disease duration, FBG, TC, TG to the level of Aβ1-42 in serum(all P <0.05). Just age and Hb A1 c had significant effects on s RAGE’ concentration in serum(all P<0.001). 4 The of Aβ1-42 in serum has a negative correlation with immediate memory scores, visual span scores, language function scores, attention and standard scores( P<0.001), the concentration of s RAGE in serum positively correlates with immediate memory scores, visual span scores, language function scores, attention scores and standard scores(P<0.05), excluding the impact of age, education, duration, FBG, Hb A1 C, TC,LDLand TG, the level of Aβ1-42 in serum is still influential to immediate memory,language function, attention, delay memory and standard scored(all P<0.05), while s RAGE only impact on speech function score(P= 0.030). Compared with low Aβ1-42levels levels group, patients of high Aβ1-42 group had lower scores on immediate memory,visuospatial, language, attention, delayed memory indexes and total scores, the differences were statistically significant(all P<0.05). Compared with high s RAGE levels group,patients of low s RAGE levels group had lower scores on immediate memory, language,attention, delayed memory indexes and total scores, the differences were statistically significant(all P<0.05).Conclusions 1 The patients with cognitive dysfunction of T2 DM have a higher levels of Aβ1-42 in serum, in contrast decreased level of sRAGE.2 There is a negative correlation of serum Aβ1-42 and cognitive function in T2 DM patients,serum s RAGE was postively correlated with cognitive function in T2 DM patients.3 serum Aβ1-42 was negtively correlated with cognitive performance in T2 DM patient,serum s RAGE was postively correlated with cognitive performance in T2 DM patient.