2型糖尿病血糖控制水平及其相关因素与维族老年人认知功能障碍的关系

Association between blood glucose level control and cognitive impairment in elderly type 2DM Uygur patients

目的探讨2型糖尿病血糖控制水平与维吾尔族老年人轻度认知功能障碍(mild cognitive impairment,MCI)的关系,并分析其相关影响因素。方法将2009~2015年收住我院的2型糖尿病维吾尔族患者412例,根据糖化血红蛋白(HbA1c)水平分4组,HbA1c≤6.5%A组105例,HbA1c6.6%~7.4%B组106例,HbA1c7.5%~8.4%C组109例,HbA1c≥8.5%D组92例,另选同民族年龄、性别、文化程度等相匹配的非2型糖尿病健康老年人89例为对照组,收集相关病史、检测生化指标、糖尿病并发症筛查、评价认知功能,分析相关影响因素,探讨HbA1c水平与MCI的关系。结果与对照组比较,A、B、C和D组MCI和痴呆发生率明显升高(9.5%、8.5%、15.6%和21.7%vs 2.2%,3.8%、2.8%、4.6%和8.7%vs 0,P<0.05)。多因素logisitic回归分析显示,HbA1c≥8.5%、颈动脉不稳定斑块、脑白质病变、糖尿病微血管并发症是2型糖尿病患者发生MCI的危险因素。结论糖尿病患者HbA1c水平以及糖尿病血管并发症与维族老年人MCI的发生率密切相关。

Objective To study the association between blood glucose level control and mild cognitive impairment （MCI） in elderly type 2 DM Uygur patients and analyze its relative influencing factors. Methods Four hundred and twelve elderly type 2 DM Uygur patients admitted to our hospital from 2009 to 2015 were divided into HbAlc ≤ 6.5 % group （group A, n = 105）, HbA1 c= 6.6%-7.4% group （group B,n=106） ,HbAlc=7. 5%-8.4% group （goup C,n=109） ,HbA1c≥ 8.5 % group （group D,n= 92） with 89 age-, sex- and education-matched healthy elderly subjects served as a control group. Their medical history, biochemical parameters,DM and its complica- tions, and cognitive function were compared. The factors influencing the association between HbAlc and MCI were analyzed. Results The incidence of MCI and dementia was significantly higher in groups A-D than in control group （9.5%,8.5%,15.6% and 21.7% vs 2.2%,3.8%, 2.8%,4.6% and 8.7% vs 0,P〈0.05）. HbAlc≥8.5%,carotid unstable plaque,white matter lesion,microvaseular complications of DM were the risk factors for MCI in type 2 DM Uygur patients. Conclusion HbAlc and microvascular complications of DM are closely associated with the incidence of MCI in type 2 DM Uygur patients.