Relationship between mild cognitive impairment and body mass index in older adult patients with type 2 diabetes mellitus / 中国基层医药

ABSTRACT

Objective:To investigate the relationship between mild cognitive impairment (MCI) and body mass index (BMI) in older adult patients with type 2 diabetes mellitus (T2DM).Methods:A total of 327 patients with T2DM who received treatment in Wuyunshan Sanatorium from January 2016 to May 2019 were included in the T2DM group. Patients in theT2DM group were subdivided into an MCI group ( n = 73) and a non-MCI group ( n = 254) according to whether they had MCI. An additional 100 older adult volunteers who concurrently received physical examination were included in the control group. Sex, age, years of education, monthly family income, body mass index, living habits (drinking, smoking) and laboratory indexes were compared among the groups. The influential factors of MCI in patients with T2DM were analyzed by logistic regression model. The predictive value of BMI for MCI in older adult patients with T2DM was evaluated by receiver operating characteristic (ROC) curve. Results:Age, monthly family income, the proportion of patients with a history of diabetes mellitus, BMI, fasting blood glucose, glycosylated hemoglobin (HbA1C), low-density lipoprotein cholesterol (LDL-C) in the T2DM group were (73.10 ± 9.56) years old, 8 926 yuan RMB, 189/327, (24.18 ± 2.64) kg/m 2, (6.96 ± 0.88) mmol/L, (7.10 ± 0.84)%, (7.32 ± 0.84) mmol/L, respectively, which were higher than those in the control group [(68.28 ± 8.21) years old, 6 715 yuan RMB, 13/100, (22.30 ± 1.74) kg/m 2, (4.51 ± 0.72) mmol/L, (5.62 ± 0.68)%, (7.04 ± 0.67) mmol/L, t = 4.554, χ2 = 18.601, 61.654, t = 6.668, t = 25.360, 16.077, 3.049, all P < 0.05]. In the MCI group, the proportion of patients having a monthly family income < 5 000 yuan RMB, the proportion of patients having a history of diabetes mellitus, BMI, HbA1c value were 29/73, 60/73, (24.92 ± 2.43) kg/m 2, (7.54 ± 0.88)%, respectively , while they were 70/254, 129/254, (23.77 ± 2.59) kg/m 2, (6.92 ± 0.81)%, respectively in the non-MCI group. There were significant differences in these indexes between MCI and non-MCI groups ( χ2 = 6.144, 22.927, t = 3.389, 5.652, all P < 0.05). Multivariate logistic regression analysis showed that BMI and HbA1c were the influential factors of MCI complicated by T2DM in older adult patients ( OR = 0.274, 0.192, both P < 0.05). Monthly family income and family history of diabetes mellitus were not closely related to the development of MCI in older adult patients with T2DM ( OR = - 0.154, 0.093, both P > 0.05). The ROC curve revealed that when BMI value was 24.49 kg/m 2, Youden index was the largest (0.510), the corresponding sensitivity was 83.86%, and the specificity was 67.12%. The area under the ROC curve was 0.766 [95% CI (0.699 - 0.832)]. Conclusion:BMI is an influential factor of MCI development in older adult patients with T2DM, and may be one of the important indicators for early prediction of MCI.