血清β2-MG、1,5-AG、GLP-1与糖尿病患者胰岛功能的关系及其对合并认知功能障碍的预测价值OA

Objective To investigate the relationship between serum β2-microglobulin(β2-micro-globulin,β2-MG),1,5-anhydro-D-sorbitol(1,5-Anhydroglucitol,1,5-AG),glucagon-like peptide-1(glucagon-like peptide-1,GLP-1)and pancreatic islet function in patients with diabetes mellitus(diabetes mellitus,DM),and to explore the predictive value of these indicators for comorbid cognitive impairment(cognition impairment,CI)in DM patients.Methods A total of 206 patients with type 2 diabetes mellitus(type 2 diabetes,T2DM)admitted to Jin Niu Hospital of Sichuan Provincial People's Hospital from August 2020 to August 2024 were prospectively selected as the T2DM group.According to the presence of CI,they were further divided into a CI group(n=62)and a non-CI(N-CI)group(n=144).Another 206 healthy volunteers undergoing physical examinations during the same period were selected as the normal control(NC)group.Serum levels of β2-MG,1,5-AG,and GLP-1 were measured.Pearson correlation analysis was used to assess the correlation between serum levels of β2-MG,1,5-AG,GLP-1 and pancreatic islet function indicators.Multivariate logistic regression was applied to identify influencing factors for comorbid CI in T2DM patients.The predictive value of serum β2-MG,1,5-AG,and GLP-1 levels for comorbid CI in T2DM patients were evaluated using receiver operating characteristic(ROC)curves.Results Compared with the NC group,the T2DM group showed increased levels of FPG,2hPG,HbA1c,FINS,HOMA-IR,and β2-MG,and decreased levels of HOMA-β,1,5-AG,and GLP-1(P＜0.05).Serum β2-MG levels were positively correlated with FPG,2hPG,HbA1c,FINS,and HOMA-IR,and negatively correlated with HOMA-β(P＜0.05),while 1,5-AG and GLP-1 showed opposite correlations(P＜0.05).Compared with the N-CI group,the CI group had fewer years of education and lower serum levels of 1,5-AG and GLP-1,but longer T2DM duration and higher β2-MG levels(P＜0.05).After adjusting for years of education,Fazekas' total score and T2DM duration,β2-MG,1,5-AG,and GLP-1 remained independent influencing factors for comorbid CI in T2DM patients(P＜0.05).The area under the curve(AUC)for the combined prediction of comorbid CI in T2DM patients using serum β2-MG,1,5-AG,and GLP-1 levels(0.968)was significantly higher than that of any single indicator(0.817,0.845,0.840)(P＜0.05).Internal validation indicated good model fit(Hosmer-Lemeshow test:x2=4.554,P=0.804),with predicted probabilities consistent with actual outcomes.The DCA curve showed that the combined detection model provided higher net benefit within the threshold probability range of 0.04 to 0.96.Conclusion T2DM patients exhibit elevated serum β2-MG levels and decreased 1,5-AG and GLP-1 levels,which are closely associated with islet function and CI.The combined detection of these markers demonstrates high predictive efficacy for comorbid CI in T2DM patients.