高血糖与2型糖尿病认知功能关系研究

Study the relationship of hyperglycemia and the cognitive function of patients with type 2 diabetes mellitus

目的:探讨高血糖对2型糖尿病患者认知功能的影响。方法:对135例2型糖尿病患者进行认知功能问卷,评定认知功能,同时测定问卷当日三餐前后及睡前血糖。比较不同血糖组间认知功能差异,并将空腹血糖(FPG)、餐后血糖(PPG)、最高血糖及平均血糖(MBG)与认知功能作相关性分析。结果:FPG≥6.1mmol/L和<6.1mmol/L组间、PPG≥10.0mmol/L组和<10.0mmol/L组间、最高血糖≥10.0mmol/L组和<10.0mmol/L组间认知功能差异均有显著性(P<0.05)。以日7次血糖平均值的中位数8.7mmol/L作为切点,≥8.7mmol/L组和<8.7mmol/L组间在MMSE定向、MMSE构图、听觉词语延时记忆等方面差异有显著性(P<0.05);FPG、PPG、最高血糖及MBG水平与认知功能均呈负相关关系。结论:高血糖可加重认知功能损害;空腹血糖≥6.1mmol/L或非空腹血糖≥10.0mmol/L就可出现认知功能减退;控制高血糖、减少血糖波动对保护认知功能有着重要意义。

Objective：To study the relationship of hyperglycemia and the cognitive function of patients with type 2 diabetes mellitus （T2DM）.Methods：Questionnaires were used to study cognitive function of 135 T2DM patients. Pre- and postprandial and pre-bed seven- point glucoses （fingerstick） were collected. The differences of cognitive function among the different glucose level groups were ana- lyzed. Results： ① Fasting plasma glucose （FPG）≥6.1 mmol / L group and 〈6.1 mmol / L group had prominent difference in the total scores,orientation and composition of a picture of mini-mental state examination （MMSE）,the second body regions immediate memory, the first immediate auditory verbal and pictorial recognition（P 〈 0.05）.②There were significant differences between the postprandial glucose （PPG）≥10.0 mmol / L group and 〈10.0 mmol / L group on the wrong numbers of the cancelling test,naming picture and motor testing.③In the highest glucose group（the 7-point-daily capillary glucose≥10.0 mmol /L）,the rapid verbal retrieve2 （animal）,the second body regions immediate memory,the delayed body regions memory,the clued body regions memory and digital span had lower scores than those in 〈10.0 mmol/L group. ④When the median of mean blood glucose （MBG） （8.7 mmol/L）acted as cut point,compare to 〈8.7 mmol / L group,≥8.7 mmol/L group has bad performance in the orientation and composition of a picture of MMSE,the delayed auditory verbal,the clued auditory verbal and naming picture.⑤There was no significant difference between the two FPG,PPG group, the highest glucose group and MBG group on sex,age,duration of diabetes,educational level,combined hypertension or not and blood lipid. HbA1c had no effect on cognitive function in PPG group,the highest glucose group and MBG group,but had effects on cognition in the two FPG groups. ⑥FPG,PPG,the highest glucose of the 7-point-daily capillary glucose and MBG were negatively correlated with cognitive function. Con clusion：Hyperglycemia may aggravate the cognitive dysfunction of T2DM. patiewts with FPG ≥6.1 mmol / L or PPG≥10.0 mmol / L coule have cognitive lesion. Controlling hyperglycemia and reducing the glucose fluctuation effectively will be beneficial to preserve cognitive function of T2DM patients.