2型糖尿病患者轻度认知功能改变特点及其相关因素的研究
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哈尔滨市科技创新人才研究专项课题(2013RFXYJ052)


Characteristics of mild cognitive dysfunction in type 2 diabetes patients and its related factors
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    摘要:

    目的 探讨2型糖尿病(T2DM)患者轻度认知功能障碍(MCI)的特点及其相关影响因素。方法 选用蒙特利尔认知评估量表(MoCA)作为认知功能检测工具,筛选出T2DM合并MCI患者90例(MCI组)和T2DM无MCI的患者93例(对照组)。对两组患者进行体格检查,并收集患者的一般资料,检测血压、体质量指数(BMI)、糖化血红蛋白(HbA1c)、同型半胱氨酸(HCY)以及总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C),并对两组患者的认知评分和相关因素进行对比分析。结果 在MoCA中,MCI组患者的记忆力、注意力、抽象能力、视空间与执行功能及总分显著低于对照组(P<0.05);MCI组患者MoCA评分与受教育程度、糖尿病病程、HbA1c、HCY、TC及LDL-C存在相关性;多因素逐步回归分析显示,受教育程度、糖尿病病程、HbA1c、HCY是MoCA量表评分的独立危险因素(P<0.05)。结论 T2DM容易并发MCI,且存在多领域的认知损害。有效地控制血糖、降低HCY、提高受教育程度可能有助于预防或延缓T2DM患者认知功能障碍的发生。

    Abstract:

    Objective To investigate the features of mild cognitive impairment (MCI) in type 2 diabetes mellitus (T2DM) patients and its related influencing factors. Methods Simple Montreal Cognitive Assessment (MoCA) scale was used as a cognitive function testing tool to evaluate 183 T2DM patients, from them 90 cases were determined as MCI group, while the other 93 cases without MCI were assigned as control group. Their general information and clinical data, such as blood pressure, body mass index (BMI), glycosylated hemoglobin (HbA1c), homocysteine (HCY), total cholesterol (TC), triglycerides (TG), low density lipoprotein-cholesterol (LDL-C), high density lipoprotein-cholesterol (HDL-C), and cognitive scores were collected after physical check-up. Their MoCA scores and related factors were analyzed. Results MCI group had significantly lower total score and scores in memory, attention, abstract ability, visual space and executive functions than the control group (P<0.05). There was correlation between education level, duration of diabetes, plasma levels of HbA1c, HCY, TC, LDL-C and MoCA scores in patients of MCI group. Multivariate stepwise regression analysis showed that the education level, duration of diabetes, and serum levels of HbA1c and HCY were independent risk factors for MoCA rating scale (P<0.05). Conclusion T2DM patients are prone to MCI, which may be involved in many aspects of cognitive impairment. Effective control of blood sugar, reduction of HCY level, and higher education level may be beneficial in the prevention or delay of cognitive dysfunction in T2DM patients.

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李 梅,马 兰*,范 鹰,宋志强,李 静.2型糖尿病患者轻度认知功能改变特点及其相关因素的研究[J].中华老年多器官疾病杂志,2016,15(01):6~10

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  • 收稿日期:2015-08-29
  • 最后修改日期:2015-10-23
  • 录用日期:2015-10-23
  • 在线发布日期: 2016-01-25
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