糖尿病相关指标与认知功能障碍的关系

Correlation Between Cognitive Impairment and Diabetes Related Factors in Patients with Type 2 Diabetes Mellitus

目的:研究2型糖尿病(T2DM)的认知功能域损害特征及其与糖尿病相关指标的关系。方法:对44名T2DM及37名非糖尿病对照组(ND)进行全面的神经心理测量,并检测糖尿病相关指标[糖化血红蛋白(HbA1c)、空腹血糖、空腹胰岛素、稳态胰岛素评价指数(HOMA-IR)],并分析两者关系。结果:与ND相比,T2DM在全脑认知,语言功能,注意力和即刻记忆上无显著差异,但在执行功能(P=0.035)和延迟记忆(P=0.003)上明显受损。HbA1c和HOMA-IR与执行功能和延迟记忆呈显著性负相关(P<0.05)。多元回归分析显示,高龄(P=0.015)、高HbA1c(P=0.009)和受教育程度低(P=0.000)是认知功能障碍的独立危险因素。结论:T2DM患者选择性损害执行功能和延迟记忆,而HbA1c作为认知功能障碍的可控的独立危险因素需要引起高度重视。

Objective. To investigate the cognitive impairment in type 2 diabetes mellitus （T2DM） and the relationship between the cognitive impairment and diabetes related factors. Methods. 81 sub- jects were divided into T2DM group （n=44） and, non-T2DM control group （ND group, n=37）. All participants underwent a thorough neuropsychological assessment and series tests of diabetes related factors such as glycosylated hemoglobin （HbAlc）, fasting glucose, fasting insulin, and homeostasis model of insulin resistance （HOMA-IR）. The relationships between cognitive impair- ment and diabetes related factors were studied. Results. Compared with ND group, there was no significant difference in the global cognitive function, immediate memory, language and attention in T2DM group, while executive function （P=0. 035） and delayed memory （P=0. 003） were im- paired significantly. There was a significant negative correlation of all subjects between diabetes related factors （HbAlc and HOMA-IR） and executive function as well as delayed memory （P=0.05）. Multiple logistic regression analysis showed that older age （P=0. 015）, higher HbAlc level（P=0. 009） and less education （P= 0. 000）were risk factors for cognitive impairment. Conclusion. The executive function and delayed memory were selectively damaged in T2DM. And we should pay more attention to the HbAlc which is a controllable risk factor for cognitive im- pairment.