中华内分泌代谢杂志
中華內分泌代謝雜誌
중화내분비대사잡지
CHINESE JOURNAL OF ENDOCRINOLOGY AND METABOLISM
2010年
1期
22-26
,共5页
陈刚%傅飞还%梁继兴%黄惠彬%李连涛%林丽香
陳剛%傅飛還%樑繼興%黃惠彬%李連濤%林麗香
진강%부비환%량계흥%황혜빈%리련도%림려향
糖尿病%2型%轻度认知功能障碍%蒙特利尔认知评估量表
糖尿病%2型%輕度認知功能障礙%矇特利爾認知評估量錶
당뇨병%2형%경도인지공능장애%몽특리이인지평고량표
Diabetes mellitus%type 2%Mild cognitive impairment%Montreal Cognitive Assessment
目的 探讨2型糖尿病患者轻度认知功能障碍(mild cognitive impairment,MCI)的筛查及相关危险因素的分析.方法 选用蒙特利尔认知评估(Montreal Cognitive Assessment,MoCA)北京版量表作为认知功能的测评工具,选择2型糖尿病轻度认知功能障碍患者58例为研究对象,2型糖尿病无认知功能障碍30例为对照.检测入选病例的HbA_(1C)、血脂、肝肾功能和尿微量白蛋白水平.结果 与对照组比较,MCI组HbA_(1C)[(10.48±2.38对9.28±2.19)%,P<0.05]、总胆固醇[(4.87±1.18对4.18±1.04)mmol/L,P<0.01]、低密度脂蛋白胆固醇[LDL-C,(2.97±0.87对2.37±0.61)mmol/L,P<0.01]水平明显升高,高密度脂蛋白胆固醇水平降低[(1.084±0.34对1.25+0.33)mmol/L,P<0.05],甘油i酯、丙氨酸转氨酶(AIJT)、天冬氨酸转氨酶(AST)、肌酐、尿微量白蛋白差异无统计学意义.两组糖尿病病程、糖尿病视网膜病变、体重指数、腹围差异具有统计学意义(均P<0.05).MCI绀MoCA评分与HbA_(1C)(r=-0.396,P=0.002)和LDL-C(r=-0,275,P=0.036)呈负相关.多因素回归分析显示,HbA_(1C)是影响MoCA评分最为显著的因素.结论 2型糖尿病病程、肥胖、合并糖尿病并发症、血糖控制不良和血脂紊乱等因素与认知功能障碍相关.提示控制血糖、血脂,减轻体重,减少并发症有助于改善认知功能.
目的 探討2型糖尿病患者輕度認知功能障礙(mild cognitive impairment,MCI)的篩查及相關危險因素的分析.方法 選用矇特利爾認知評估(Montreal Cognitive Assessment,MoCA)北京版量錶作為認知功能的測評工具,選擇2型糖尿病輕度認知功能障礙患者58例為研究對象,2型糖尿病無認知功能障礙30例為對照.檢測入選病例的HbA_(1C)、血脂、肝腎功能和尿微量白蛋白水平.結果 與對照組比較,MCI組HbA_(1C)[(10.48±2.38對9.28±2.19)%,P<0.05]、總膽固醇[(4.87±1.18對4.18±1.04)mmol/L,P<0.01]、低密度脂蛋白膽固醇[LDL-C,(2.97±0.87對2.37±0.61)mmol/L,P<0.01]水平明顯升高,高密度脂蛋白膽固醇水平降低[(1.084±0.34對1.25+0.33)mmol/L,P<0.05],甘油i酯、丙氨痠轉氨酶(AIJT)、天鼕氨痠轉氨酶(AST)、肌酐、尿微量白蛋白差異無統計學意義.兩組糖尿病病程、糖尿病視網膜病變、體重指數、腹圍差異具有統計學意義(均P<0.05).MCI紺MoCA評分與HbA_(1C)(r=-0.396,P=0.002)和LDL-C(r=-0,275,P=0.036)呈負相關.多因素迴歸分析顯示,HbA_(1C)是影響MoCA評分最為顯著的因素.結論 2型糖尿病病程、肥胖、閤併糖尿病併髮癥、血糖控製不良和血脂紊亂等因素與認知功能障礙相關.提示控製血糖、血脂,減輕體重,減少併髮癥有助于改善認知功能.
목적 탐토2형당뇨병환자경도인지공능장애(mild cognitive impairment,MCI)적사사급상관위험인소적분석.방법 선용몽특리이인지평고(Montreal Cognitive Assessment,MoCA)북경판량표작위인지공능적측평공구,선택2형당뇨병경도인지공능장애환자58례위연구대상,2형당뇨병무인지공능장애30례위대조.검측입선병례적HbA_(1C)、혈지、간신공능화뇨미량백단백수평.결과 여대조조비교,MCI조HbA_(1C)[(10.48±2.38대9.28±2.19)%,P<0.05]、총담고순[(4.87±1.18대4.18±1.04)mmol/L,P<0.01]、저밀도지단백담고순[LDL-C,(2.97±0.87대2.37±0.61)mmol/L,P<0.01]수평명현승고,고밀도지단백담고순수평강저[(1.084±0.34대1.25+0.33)mmol/L,P<0.05],감유i지、병안산전안매(AIJT)、천동안산전안매(AST)、기항、뇨미량백단백차이무통계학의의.량조당뇨병병정、당뇨병시망막병변、체중지수、복위차이구유통계학의의(균P<0.05).MCI감MoCA평분여HbA_(1C)(r=-0.396,P=0.002)화LDL-C(r=-0,275,P=0.036)정부상관.다인소회귀분석현시,HbA_(1C)시영향MoCA평분최위현저적인소.결론 2형당뇨병병정、비반、합병당뇨병병발증、혈당공제불량화혈지문란등인소여인지공능장애상관.제시공제혈당、혈지,감경체중,감소병발증유조우개선인지공능.
Objective To study the assessment implement and its related factors in type 2 diabetic patients with mild cognitive impairment(MCI).Methods Montreal Cognitive Assessment(MoCA)(Beijing Version)was chosen as cognition assessment implement.58 type 2 diabetic patients with MCI were enrolled as the research group and 30 type 2 diabetic patients with normal cognitive function as control.HbA_(1C),blood lipid,urine microalbumin,liver and renal functions were measured in all subjects.Results Compared with control group,the blood levels of HbA_(1C)[(10.48±2.38 vs 9.28±2.19)%,P<0.05],total cholesterol[(4.87±1.18 vs 4.18±1.04)mmol/L,P<0.01],and low-density lipeprotein-cholesterol[LDL-C,(2.97±0.87 vs 2.37±0.61)mmol/L,P<0.01]increased,and high-density lipoprotein-cholesterol decreased[(1.084±0.34 vs 1.25±0.33)mmoL/L,P<0.05]in MCI group.There were significant differences in the duration of diabetes mellitus,diabetic retinopathy,body mass index,and abdominal circumference between MCI group and control group(all P<0.05).There were no significant differences in blood triglycerides,alanine aminotransferase(ALT),aspartate aminotransferase(AST),creatinine,and urine microalbumin between the two groups.MoCA scores were negatively correlated with HbA_(1C)(r=-0.396,P=0.002)and LDL-C(r=-0.275,P=0.036)in MCI group.Multiple regression analysis showed that HbA_(1C) was a significantly independent determinant for the MoCA scores.Conclusion The risk factors such as longer duration of diabetes mellitus.more diabetea mellitus complications,obesity,dyslipidemia,and inefficient control of blood glucoge all contribute to the development and aggravation of cognitive impairment.Therefore,good control of blood glucose and lipids,and reduction of complication and body weight may help to improve the cognitive function.
