2型糖尿病患者发生轻度认知障碍相关因素分析

Analysis of related factors of mild cognitive impairment in patients with type 2 diabetes mellitus

目的探讨2型糖尿病(T2DM)患者发生轻度认知障碍(MCI)的相关因素,为预防T2DM患者认知功能减退甚至向痴呆转变提供科学依据。方法采用蒙特利尔认知量表(MoCA)对212例T2DM患者认知功能进行测定,根据MoCA评分将患者分为MCI组(MoCA评分≤26分,74例)和非MCI组(MoCA评分>26分,138例),对影响T2DM患者发生MCI的危险因素进行单因素和多因素Logistic回归分析,对T2DM患者MCI发病影响因素与MoCA评分的关系进行Pearson相关分析。结果T2MD患者的MCI患病率为34.9%。单因素分析发现,MCI和非MCI患者的年龄、受教育程度、血红蛋白水平、空腹血葡萄糖水平、服用二甲双胍年限、糖尿病病程、糖化血红蛋白(HbA1c)水平、血清C-肽(空腹、餐后0.5h、餐后1h、餐后2h)水平和高密度脂蛋白胆固醇水平比较,差异均有统计学意义(P<0.05);多因素Logistic回归分析发现,高龄、糖尿病病程长、HbA1c水平高、服用二甲双胍年限短、受教育程度低是T2DM患者发生MCI的独立危险因素。Pearson相关分析结果显示,T2DM患者的年龄、糖尿病病程、HbA1c水平与MoCA评分呈负相关(P<0.05);服用二甲双胍年限、受教育程度与MoCA评分呈正相关(P<0.05)。结论高龄、糖尿病病程长、HbA1c水平高是T2DM患者发生MCI的危险因素,服用二甲双胍年限长、受教育程度高是保护因素。早期对T2DM患者进行认知功能评价,针对患者发生MCI的影响因素及时进行有效干预,对预防、延缓阿尔茨海默病的发生具有重要意义。

Objective To explore the related factors of mild cognitive impairment (MCI) in patients with type 2 diabetes mellitus (T2DM),so as to provide a scientific basis for preventing cognitive decline or even occurring transition to dementia in patients with T2DM.Methods The cognitive function of 212 patients with T2DM was measured by the Montreal Cognitive Assessment (MoCA).Patients were divided into MCI group (MoCA score ≤26,74 cases) and non-MCI group (MoCA score>26,138 cases) in accordance with MoCA scores.Univariate analysis and multivariate logistic regression analysis were performed on risk factors for MCI in patients with T2DM.Pearson correlation analysis was performed on the relationship between the effective factors of MCI pathogenesis and MoCA scores in T2DM patients.Results The prevalence rate of MCI in T2MD patients was 34.9%.Univariate analysis revealed that age,educational qualification,hemoglobin level,fasting blood glucose level,duration of taking metformin,duration of diabetes,hemoglobin A1c (HbA1c) level,serum C-peptide (fasting,0.5 h postprandial,1h postprandial,2h postprandial) level,and high-density lipoprotein cholesterol level in the MCI and non-MCI group,was statistically significantly different ( P <0.05),whereas multivariate logistic regression analysis showed that advanced age,long duration of diabetes,high HbA1c level,short duration of taking metformin,and low educational qualification were independent risk factors for MCI in T2DM patients.Pearson correlation analysis revealed that age,duration of diabetes,and HbA1c level were negatively correlated with MoCA scores in T2DM patients ( P <0.05),while there was a positive correlation between the duration of taking metformin,educational qualification and MoCA scores ( P <0.05).Conclusion Advanced age,long duration of diabetes,and high HbA1c level are risk factors for MCI in patients with T2DM.The long duration of taking metformin and the high level of educational qualification are protective factors.It is of great significance to prevent and delay the occurrence of Alzheimer′s disease through early evaluating the cognitive function in patients with T2DM,and timely and effectively intervening influencing factors of MCI in T2DM patients.