2型糖尿病脑白质病变与糖尿病性认知功能障碍的相关性分析

Correlation between white matter lesions and cognitive dysfunction in type 2 diabetic patients

对2016年6-12月郑州大学第二附属医院419例2型糖尿病（T2DM）住院患者进行头颅MRI检查。有脑白质高信号（WMH）改变诊断为脑白质病变，据此分为两组，无WMH组39例和WMH组380例。使用蒙特利尔认知量表（MoCA）进行认知测评。两组间糖尿病病程、患高血压病百分比、Tc水平及MoCA评分差异有统计学意义（P〈0．05）。年龄、糖尿病病程、是否患高血压以及糖化血红蛋白水平与脑白质病变明显相关（OR=I．157、1．116、5．184、1．128，P〈0．05）。是否患脑白质病变、年龄及BMI与T2DM患者认知功能下降明显相关（OR=2．137、1．175、1．247，P〈0．05）。提示脑白质病变与糖尿病性认知功能障碍密切相关，积极预防脑白质病变可能有预防和改善糖尿病性认知功能障碍的作用。

Cranial magnetic resonance imaging （MRI） examinations were performed in 419 patients with type 2 diabetes mellitus （T2DM） from June to December 2016. The brain white matter lesions were defined by white matter hyperintensity （WMH） in MRI, which was detected in 380 cases （WMH group） and not detected in 39 cases （non-WMH group）. The Montreal Cognitive Assessment （MoCA） was used to evaluate the cognitive function. The study showed that there were significant differences in the duration of diabetes, the proportion of hypertension, total cholesterol （TC） and MoCA scores between the two groups （all P〈0.05）. The age, duration of diabetes, hypertension and glyclated hemoglobin （HbAlc） were significantly correlated with white matter lesions （OR= 1.157, 1.116,5.184, 1.128 ; P〈0.05）; and the white matter lesions, age, and body mass index （BMI） were significantly correlated with cognitive dysfunction in diabetic patients （OR=2.137, 1.175, 1.247; P〈0.05）. The study result indicates that control of white matter lesions may prevent and improve cognitive dysfunction in T2DM patients.