Value of iron deposition in different brain regions combined with triglyceride-glucose index and neutrophil-lymphocyte ratio in predicting cognitive impairment in elderly patients with type 2 diabetes

Rong Liping; Lu Huimin; Chen Liliang; Wu Huimei

doi:10.13406/j.cnki.cyxb.004060

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Value of iron deposition in different brain regions combined with triglyceride-glucose index and neutrophil-lymphocyte ratio in predicting cognitive impairment in elderly patients with type 2 diabetes

Endocrine regulation and metabolic diseases | 更新时间：2026-04-15

- Value of iron deposition in different brain regions combined with triglyceride-glucose index and neutrophil-lymphocyte ratio in predicting cognitive impairment in elderly patients with type 2 diabetes
- Journal of Chongqing Medical University Vol. 51, Issue 4, Pages: 486-492(2026)
- 作者机构：
  
  1.安徽医科大学第一临床学院，合肥 230031
  2.安庆市立医院医学影像科，安庆 246000
  3.安庆市立医院老年医学科，安庆 246000
- 作者简介：
- 基金信息：
- DOI：10.13406/j.cnki.cyxb.004060
  CLC： R749.1
- Received：04 November 2025，
  
  Revised：2026-01-14，
  
  Accepted：15 January 2026，
  
  Published：28 April 2026
- 稿件说明：
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荣丽萍，卢慧敏，陈力量，等.脑分区铁沉积联合TyG、NLR对老年2型糖尿病合并认知障碍的预测价值[J].重庆医科大学学报，2026，51（4）：486-492.

Rong Liping,Lu Huimin,Chen Liliang,et al.Value of iron deposition in different brain regions combined with triglyceride-glucose index and neutrophil-lymphocyte ratio in predicting cognitive impairment in elderly patients with type 2 diabetes[J].Journal of Chongqing Medical University,2026,51(4):486-492.
荣丽萍，卢慧敏，陈力量，等.脑分区铁沉积联合TyG、NLR对老年2型糖尿病合并认知障碍的预测价值[J].重庆医科大学学报，2026，51（4）：486-492. DOI： 10.13406/j.cnki.cyxb.004060.

Rong Liping,Lu Huimin,Chen Liliang,et al.Value of iron deposition in different brain regions combined with triglyceride-glucose index and neutrophil-lymphocyte ratio in predicting cognitive impairment in elderly patients with type 2 diabetes[J].Journal of Chongqing Medical University,2026,51(4):486-492. DOI： 10.13406/j.cnki.cyxb.004060.

摘要

目的

探讨甘油三酯-葡萄糖指数（triglyceride-glucose index，TyG）及中性粒细胞淋巴细胞比值（neutrophil-to-lymphocyte ratio，NLR）与老年2型糖尿病合并认知障碍的相关性及预测效能，并分析灰质核团各区磁化率值在两者之间介导的中介效应。

方法

选取209例老年2型糖尿病患者，根据蒙特利尔认知评估量表（Montreal Cognitive Assessment，MoCA）评分，分为认知障碍组和非认知障碍组，比较2组临床、实验室资料及定量磁化率成像（quantitative susceptibility mapping，QSM）参数值差异，建立多因素logistic回归模型分析认知障碍的独立危险因素，偏相关分析比较认知障碍组TyG、NLR与各认知领域的相关性，并进行中介效应检验，最后通过受试者工作特征（receiver operating characteristic curve，ROC）曲线评价预测效能。

结果

认知障碍组TyG、NLR较非认知障碍组高（

0.05）。多因素logistic回归分析显示TyG和NLR是认知障碍的独立危险因素，NLR与视空间及执行功能呈负相关（

=-0.425，

0.001）；TyG与延迟回忆、注意、视空间及执行功能呈负相关（

r=-

0.372，

0.008；

r=-

0.514，

0.001；

r=-

0.367，

0.009）。中介效应显示海马及苍白球区铁沉积在NLR、TyG与认知障碍中起到部分中介作用，而尾状核区铁沉积仅对TyG与认知障碍之间存在部分中介作用。NLR、TyG及两者联合预测认知障碍曲线下面积分别为0.753、0.822、0.901。

结论

TyG、NLR升高与2型糖尿病患者合并认知障碍密切相关，联合预测效能更佳，中枢神经系统铁沉积在它们之间起到部分中介效应。

Abstract

Objective

To investigate the association of triglyceride-glucose index（TyG） and neutrophil-lymphocyte ratio（NLR） with cognitive impairment in elderly patients with type 2 diabetes，as well as their predictive efficacy and the mediating effect of magnetic susceptibility values of gray matter nuclei between them.

Methods

A total of 209 elderly patients with type 2 diabetes were enrolled，and according to Montreal Cognitive Assessment score，they were divided into cognitive impairment group and non-cognitive impairment group. The two groups were compared in terms of clinical data，laboratory data，and quantitative susceptibility mapping parameters. A multivariate logistic regression model was established to investigate the independent risk factors for cognitive impairment；the partial correlation analysis was used to investigate the correlation of TyG and NLR with each cognitive domain in the cognitive impairment group，and a mediating effect analysis was performed；the receiver operating characteristic（ROC） curve was used to assess predictive efficacy.

Results

The cognitive impairment group

had significantly higher TyG and NLR than the non-cognitive impairment group（

0.05）. The multivariate logistic regression analysis showed that TyG and NLR were independent risk factors for cognitive impairment. NLR was negatively correlated with visuospatial and executive function（

=-0.425，

0.001），while TyG was negatively correlated with delayed recall（

=-0.372，

=0.008），attention（

=-0.514，

0.001），and visuospatial/executive function（

=-0.367，

=0.009）. The mediating effect analysis showed that iron deposition in the hippocampus and the globus pallidus exerted a partial mediating effect on the relationship between NLR/TyG and cognitive impairment，while iron deposition in the caudate nucleus only exerted a partial mediating effect on the relationship between TyG and cognitive impairment. In predicting cognitive impairment，NLR or TyG used alone had an area under the ROC curve （AUC） of 0.753 and 0.822，respectively，while the combination of NLR and TyG had an AUC of 0.901.

Conclusion

Increases in TyG and NLR are closely associated with cognitive impairment in patients with type 2 diabetes，and the combination of NLR and TyG had a better predictive performance. Iron deposition in the central nervous system exerts a partial mediating effect on the relationship between TyG/NLR and cognitive impairment.

关键词

Keywords

references

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