老年2型糖尿病患者轻度认知功能障碍的危险因素分析

Risk factors of mild cognitive impairment in elderly type 2 diabetes mellitus

目的探讨老年2型糖尿病(T2DM)患者轻度认知功能障碍(MCI)的危险因素。方法以蒙特利尔认知评估量表(MoCA)和临床痴呆分级量表(CDR)作为认知功能的测评工具,筛选老年T2DM合并MCI患者200例(MCI组),和2型糖尿病无MCI患者60例(对照组)。收集2组患者的病史,检测血压、体质指数(BMI)、空腹血糖(FBG)、糖化血红蛋白(HbA1c)、血脂、血肌酐、同型半胱氨酸(HCY)、叶酸、维生素B12。结果 MCI组和对照组患者的年龄、受教育程度、糖尿病病程、HbA1c、高血压病史、高血压病程、收缩压、HCY、叶酸、维生素B12水平比较,差异有统计学意义;而两组患者的性别构成、BMI、舒张压、FPG、血脂、血肌酐水平比较,差异均无统计学意义。相关分析发现受教育程度、叶酸水平与MoCA量表评分呈正相关;年龄、HbA1c、高血压病史,高血压病程、收缩压、HCY水平与MoCA量表评分呈负相关。多元逐步回归分析发现,年龄、HbA1c、高血压病史、HCY水平是MoCA量表评分的独立危险因素。结论高龄、血糖控制不佳、合并高血压、高HCY血症可能是老年T2DM患者发生MCI的危险因素。

Objective To analyze the risk factors of mild cognitive impairment （MCI） in elderly type 2 diabetic patients . Methods Montreal cognitive assessment scale （MoCA） and clinical dementia rating scale （CDR） were used as cognition assess‐ment tool .200 elderly type 2 diabetic patients with MCI （MCI group） and 60 elderly type 2 diabetic patients with normal cogni‐tive function （control group） were enrolled as subjects .Information of disease history ,blood pressure ,BMI ,FBG ,HbA1c , blood lipid ,serum creatinine ,plasma homocysteine （HCY） ,folic acid and vitamin B12 of all subjects were collected .Results There were statistically significant differences in the age ,level of education ,course of diabetes ,HbA1c ,history of hypertension , course of hypertension ,systolic blood pressure ,level of HCY ,folic acid and vitamin B12 between the MCI group and control group .No statistically significant differences were found in the gender composition ,BMI ,diastolic blood pressure ,fasting blood glucose ,blood lipid levels ,serum creatinine levels between the MCI group and control group .MoCA scores were positively cor‐related with level of education and folic acid ,and were negatively correlated with the age ,HbA1c ,history of hypertension , course of hypertension ,systolic blood pressure ,level of HCY .Multiple regression analysis showed that age ,HbA1c ,the history of hypertension and the level of HCY were independent risk factors for the MoCA scores .Conclusions Older age ,poor blood glucose control ,hypertension ,hyperhomocysteinemia might be risk factors for MCI in elderly type 2 diabetic patients .