老年2型糖尿病患者的认知特征及其与血浆皮质醇水平变化的关系

Characteristics of cognition and plasma levels of cortisol in geratic patients with type 2 diabetes

目的探讨老年2型糖尿病(DM)患者的认知特征、血浆皮质醇水平变化及两者的关系。方法应用多维度神经心理学测试评估89例老年2型DM患者及年龄、教育程度相匹配的40例对照者的神经认知功能;采用放射免疫分析法检测血浆皮质醇水平。结果(1)2型DM组神经心理学测试包括连线测试B(TMT B)、听觉词语记忆测试的延迟回忆项(AVLT-DR)、符号数字转换测试(SDMT),词语流畅性测试(VFT)及画钟测试(CDT)的成绩均明显差于对照组(均P<0.01);(2)2型DM组血浆皮质醇水平明显高于对照组(P<0.05);对照组和总人群组中血浆皮质醇浓度与CDT成绩均成负相关(分别为R=-0.356,P=0.024;R=-0.219,P=0.012),但2型DM组血浆皮质醇浓度与各项认知成绩均无相关性(P>0.05)。结论2型DM可能导致患者出现多项认知功能损伤,并伴有血浆皮质醇水平升高,但2型DM患者认知功能可能与其血浆皮质醇水平无关。

Objective The aims of this study were to investigate the characteristics of cognitive function in patients with Type 2 diabetes （DM） and their relationships with the plasma levels of corti- sol. Methods 89 patients with Type 2 DM and 40 nondiabetic controls with ages and education levels matched were included in this study, all the subjects have received a set of multi-dimension neuropsycho- logic tests for the cognitive assessment. A radioimmunoassay was used to measure plasma cortisol concentra- tions. Results （ 1 ） The performances of type 2 DM group in the Trial marking test B （TMT B）, the delayed recall of auditory verbal learning test （AVLT-DR）, the symbol digit modulation test （ SDMT）, verbal fluency test （VFT） and clock drawing test （CDT） are obviously worse than those of controls group （P 〈 0. 01 ） . （2） The plasma levels of cortisol in DM group is significantly higher than those in controls group （P 〈 0. 05 ） . In both control and whole group, the plasma levels of cotisol show negtive correlation with the scores of CDT （R= -0.356, P=0.024; R= -0.219, P=0.012）, but in type 2 DM group the correlation analysis between plasma levels of cortisol and scores of each neuropsy-chological test gets no positive result （P 〉 0. 05） . Conclusions Patients with Type 2 DM prone to have muhi-domain cognitive impairments, with a higher plasma levels of cortisol accompanied. But the plasma levels of cortisol seem to have no correlation with cognitive function in type 2 DM .