GLP-1RA司美格鲁肽对2型糖尿病患者认知功能和血清Aβ1-42水平的影响

武玮; 郝树立; 梅艳洁; 石方方; 李新杰

doi:10.16766/j.cnki.issn.1674-4152.004451

GLP-1RA司美格鲁肽对2型糖尿病患者认知功能和血清Aβ1-42水平的影响

doi: 10.16766/j.cnki.issn.1674-4152.004451

1.
安徽医科大学附属亳州市人民医院内分泌代谢病科，安徽亳州 236800
2.
安徽医科大学附属亳州市人民医院口腔医学科，安徽亳州 236800

基金项目:

安徽省卫生健康科研项目 AHWJ2022b117

详细信息

通讯作者:
郝树立，E-mail：m13909685956@163.com

中图分类号: R587.1
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出版历程
- 收稿日期: 2025-08-12

The effect of GLP-1RA semaglutide on cognitive function and serum Aβ1-42 levels in patients with type 2 diabetes

1.
Department of Endocrinology, Bozhou People's Hospital Affiliated to Anhui Medical University, Bozhou, Anhui 236800, China

摘要

摘要: 目的探讨胰高血糖素样肽-1受体激动剂司美格鲁肽对2型糖尿病患者MoCA认知评分及血清β-淀粉样蛋白1-42(Aβ1-42)水平的影响，旨在为改善2型糖尿病患者的认知功能提供新的治疗途径。方法选取2022年12月—2023年12月在亳州市人民医院内分泌科收治住院的60例2型糖尿病患者作为研究对象，采用随机数字法分为2组，每组30例。常规组予以口服药物或(和)胰岛素降糖治疗，司美格鲁肽组予以司美格鲁肽联合口服药物或(和)胰岛素治疗，周期为6个月。比较治疗后2组MoCA认知功能评分及血清Aβ1-42水平。结果治疗后2组空腹血糖(FBG)、糖化血红蛋白比值(HbA1c%)、甘油三酯(TG)、总胆固醇(TC)、胰岛素抵抗指数(HOMA-IR)比较，差异均无统计学意义(P>0.05)。司美格鲁肽组MoCA认知评分[28.00(26.00, 29.00)分]高于常规组[24.50(23.00, 26.00)分，P＜0.001], 血清Aβ1-42水平[(100.67±23.34)pg/mL]低于常规组[(119.03±34.43)pg/mL, P＜0.001]。结论司美格鲁肽可降低2型糖尿病患者血清Aβ1-42水平，升高MoCA认知评分，改善认知功能。
- 2型糖尿病 /
- 司美格鲁肽 /
- 认知功能 /
- 血清人β-淀粉样蛋白 1-42
Abstract: Objective This study explores the effects of the glucagon-like peptide-1 receptor agonist semaglutide on the MoCA cognitive score and serum β-amyloid protein 1-42 (Aβ1-42) levels in patients with type 2 diabetes, aiming to provide a new therapeutic approach for improving the cognitive function of patients with type 2 diabetes. Methods Sixty patients with type 2 diabetes mellitus admitted to the Endocrinology Department of Bozhou People ' s Hospital from December 2022 to December 2023 were selected as the research subjects and randomly divided into two groups by random number method, with 30 cases in each group. The conventional group was treated with oral hypoglycemic drugs and/or insulin, while the semaglutide group was treated with semaglutide combined with oral hypoglycemic drugs and/or insulin. The treatment period was 6 months. The MoCA cognitive function scores and serum Aβ1-42 levels of the two groups after treatment were compared. Results There were no statistically significant differences in fasting blood glucose (FBG), glycosylated hemoglobin ratio (HbA1c%), triglycerides (TG), total cholesterol (TC), and insulin resistance index (HOMA-IR) between the two groups after treatment (P>0.05). The MoCA cognitive score of the semaglutide group [28.00 (26.00, 29.00) points] was higher than that of the control group [24.50 (23.00, 26.00) points, P < 0.001], and the serum Aβ1-42 level [(100.67±23.34) pg/mL] was lower than that of the control group [(119.03±34.43) pg/mL, P < 0.001]. Conclusion Semaglutide can reduce the serum Aβ1-42 level in patients with type 2 diabetes, increase the MoCA cognitive score, and improve cognitive function.
- Type 2 diabetes /
- Semaglutide /
- Cognitive function /
- Serum human β-amyloid protein 1-42
利益冲突 无

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表 1 2组2型糖尿病患者治疗前后生化指标、MoCA评分及Aβ1-42水平比较

Table 1. Comparison of biochemical indicators, MoCA scores, and Aβ1-42 levels before and after treatment between two groups of patients with type 2 diabetes

组别	例数	FBG[M(P₂₅, P₇₅), mmol/L]			TG[M(P₂₅, P₇₅), mmol/L]
组别	例数	治疗前	治疗后	治疗前后差值	治疗前	治疗后	治疗前后差值
司美格鲁肽组	30	10.64(8.44, 13.62)	9.30(6.90, 10.93)	-1.64(-5.82, 1.32)	2.27(1.40, 4.18)	1.73(1.29, 2.77)	-0.40(-1.65, 0.55)
对照组	30	9.91(7.90, 14.78)	7.52(5.99, 12.36)	-2.17(-0.67, 0.60)	1, 61(1.17, 2.84)	1.23(0.82, 2.57)	-0.28(-0.90, 0.32)
统计量		-0.651^a	-0.747^a	-0.251^a	-1.515^a	-1.486^a	-0.436^a
P值		0.515	0.455	0.802	0.130	0.137	0.663
组别	例数	HOMA-IR[M(P₂₅, P₇₅)]				MoCA评分[M(P₂₅, P₇₅), 分]
组别	例数	治疗前	治疗后	治疗前后差值	治疗前	治疗后	治疗前后差值
司美格鲁肽组	30	0.018(0.010, 0.029)	0.017(0.009, 0.023)	0.003(-0.007, 0.004)	24.00(23.75, 26.50)	28.00(26.00, 29.00)	3.00(2.00, 4.00)
对照组	30	0.009(0.005, 0.133)	0.012(0.006, 0.020)	0.002(-0.004, 0.010)	24.50(22.00, 26.25)	24.50(23.00, 26.00)	0.50(0.00, 1.00)
统计量		-3.531^a	-1.673^a	-1.495^a	-0.574^a	-4.420^a	-5.455^a
P值		< 0.001	0.094	0.135	0.566	＜0.001	< 0.001
组别	例数	HbA1C(x±s, %)		TC(x±s, mmol/L)		Aβ1-42(x±s, pg/mL)
组别	例数	治疗前	治疗后	治疗前	治疗后	治疗前	治疗后
司美格鲁肽组	30	9.59±1.99	7.75±1.57	4.23±1.27	4.53±1.25	121.34±37.85	119.03±34.42
对照组	30	9.73±2.19	8.17±1.99	4.77±1.02	4.89±1.27	122.66±36.98	100.67±23.34
统计量		0.270^b	0.739^c	1.814^b	0.245^c	0.137^b	76.303^c
P值		0.788	0.303	0.075	0.622	0.892	＜0.001
注：^a为Z值，^b为t值，^c为F值。

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表 2 2型糖尿病患者认知功能的相关因素分析

Table 2. Analysis of factors associated with cognitive function in patients with type 2 diabetes

变量	MOCA评分			Aβ1-42
变量	r值	P值	95% CI	r值	P值	95% CI
FBG(mmol/L)	0.082	0.535	-0.183~0.336	-0.061	0.646	-0.317~0.204
HbA1C(%)	0.090	0.496	-0.176~0.343	0.058	0.660	-0.206~0.314
TG(mmol/L)	-0.046	0.730	-0.305~0.220	0.239	0.086	-0.026~0.472
TC(mmol/L)	0.072	0.587	-0.193~0.327	0.082	0.535	-0.183~0.336
HOMI-1R	-0.034	0.798	-0.292~0.229	0.061	0.642	-0.203~0.317

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表 3 影响2型糖尿病患者认知功能的多因素线性回归分析

Table 3. Multivariate linear regression analysis of factors affecting cognitive function in patients with type 2 diabetes

自变量	B	SE	β	t值	P值	共线性统计
自变量	B	SE	β	t值	P值	容差	VIF
MoCA评分
FBG(mmol/L)	-0.050	0.224	-0.163	-1.317	0.193	0.415	2.408
TG(mmol/L)	0.043	0.071	0.065	0.605	0.458	0.560	1.785
TC(mmol/L)	0.053	0.136	0.043	0.390	0.698	0.534	1.871
HbA1C%	0.150	0.093	0.197	1.618	0.112	0.433	2.308
HOMA-IR	1.518	14.881	0.009	0.102	0.919	0.771	1.296
Aβ1-42(pg/ml)	-0.097	0.010	-0.814	-10.067	< 0.001	0.979	1.022
注：模型整体拟合结果：R²=0.668，F=17.404，P＜0.001。

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