1型糖尿病患者认知功能受损与低血糖初发年龄相关

Cognitive Dysfunction Associated with the Onset Age of Hypoglycemia in Children with Type 1 Diabetes

目的:探讨严重低血糖初次发作年龄对1型糖尿病患儿认知功能的影响。方法:采用韦氏智力量表,韦氏记忆量表对95名1型糖尿病患儿和75名健康儿童分别进行智商、记忆功能、注意力、感知推理能力、空间感知能力和信息处理速度进行评估。结果 :严重低血糖组在全智商分数(p<0.001),数字广度测验(p=0.024)和相似性测验分数(p<0.001)显著低于正常对照组,记忆功能测试的差异不显著。而无严重低血糖发作组与正常对照组相比,各项测试差异均未达到差异显著水平。严重低血糖早发作组(发作年龄<7岁)在视觉记忆测试结果,包括瞬时记忆(F1, 40=8.03,p=0.007)和延时记忆均(F1, 40=4.54, p=0.039)显著低于严重低血糖迟发作组(发作年龄≥7岁)。结论:本研究发现经历过严重低血糖发作的1型糖尿病患儿在智商水平,注意力水平和感知推理能力方面明显低于正常儿童。在1型糖尿病患者中,显示严重低血糖早发作(<7岁)的患儿比严重低血糖迟发作(≥7岁)的患儿视觉记忆功能明显降低。

Objective:To explore the impact of the age of the first severe hypoglycemia episode on the cognitive function of children with type 1 diabetes.Methods:In this study,we used the Wechsler Intelligence Scale and the Wechsler Memory Scale to evaluate intelligence quotient(IQ),memory function,attention,perceptual reasoning ability,spatial perception ability,and processing speed in children with type 1 diabetes(n=95) and healthy controls(HCs,n=75),respectively.Results:The IQ score(p<0.001),digit span test(p=0.024),and similarity test(p<0.001) were significantly lower in the severe hypoglycemia group than the healthy control group,whereas the memory function test was not.There was no significant difference between the non-severe hypoglycemia group and the healthy control group in each test.Compared with the late severe hypoglycemia group,the early severe hypoglycemia group(onset age<7 years) performed worse on the visual memory tests,including immediate visual memory(F1,40=8.03,p=0.007) and delayed visual memory(F1,40=4.54,p=0.039).Conclusions:Children with type 1 diabetes who experienced severe hypoglycemia had significantly lower levels of IQ,attention,and perceptual reasoning ability than healthy children.Among the patients with type 1 diabetes,the visual memory function was significantly lower in the children with early onset of severe hypoglycemia(<7 years) than the children with late onset(7≥years).