Serum 25(OH)D and β2 microglobulin levels in elderly patients with diabetes mellitus complicated with cognitive dysfunction and their clinical significance
SHAN Xiangxiang1 ZHAN Jiangping1 ZHOU Jianping1 REN Xiangdong2 FAN Rengen3
1.Department of Geriatrics, Yancheng First Hospital Affiliated to Nanjing University School of Medicine Yancheng First People’s Hospital, Jiangsu Province, Yancheng 224000, China;
2.Department of Endocrinology, Yancheng First Hospital Affiliated to Nanjing University School of Medicine Yancheng First People’s Hospital, Jiangsu Province, Yancheng 224000, China;
3.Department of General Surgery, Yancheng First Hospital Affiliated to Nanjing University School of Medicine Yancheng First People’s Hospital, Jiangsu Province, Yancheng 224000, China
Abstract：Objective To investigate the serum levels of 25- hydroxyvitamin D (25 [OH] D ) and β2 microglobulin (β2-MG) in elderly patients with diabetes mellitus complicated with cognitive dysfunction and their clinical significance. Methods The clinical data of 80 elderly patients with diabetes treated in Yancheng First Hospital Affiliated to Nanjing University School of Medicine from January 2019 to January 2022 were retrospectively analyzed. According to whether the patients had cognitive impairment, they were divided into cognitive impairment group (38 cases) and normal cognitive function group (42 cases). The general data of the two groups were compared, and the levels of blood lipids, blood sugar, 25(OH)D, and β2-MG were detected. Multivariate logistic regression analysis was used to determine the risk factors of cognitive dysfunction in elderly diabetic patients. Receiver operator characteristic curve (ROC) was used to analyze the predictive value of 25(OH)D and β2-MG in elderly diabetic patients with cognitive dysfunction. Results The proportion of patients with hypertension, microangiopathy, leukoencephalopathy, glycated hemoglobin（HbA1c）, insulin resistance index（HOMA-IR） and β2-MG in cognitive impairment group were higher than those in normal cognitive function group, and 25(OH)D was lower than that in normal cognitive function group (P＜0.05). Logistic regression analysis showed that hypertension (OR=2.714, 95%CI:1.258-5.855), microangiopathy (OR=2.542, 95%CI:1.176-5.495), white matter lesions (OR=2.669, 95%CI:1.176-5.495), HbA1c (OR=3.648, 95%CI:1.483-8.974), HOMA-IR (OR=3.841, 95%CI:1.520-9.706), 25(OH)D (OR=3.144, 95%CI:1.316-7.511) and β2-MG (OR=3.356, 95%CI:1.417-7.948) were influencing factors for cognitive dysfunction in elderly patients with diabetes mellitus (P＜0.05). ROC analysis showed that the areas under the curve of 25(OH)D and β2-MG in predicting cognitive dysfunction in elderly diabetic patients were 0.753 and 0.744, respectively (P＜0.05). Conclusion Monitoring the level of 25(OH)D and β2-MG have important clinical significance in early recognition of cognitive impairment in elderly diabetes mellitus.
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