CAJ | 학술논문

2型糖尿病是诱发认知障碍的独立危险因素之一，其发病机制除与长期高血糖引起的糖毒性、胆固醇代谢异常密切相关外，还与中枢胰岛素信号转导异常、下丘脑-垂体-肾上腺轴（hypothalamic-pituitary-adrenal axis，HPA）功能亢进有关，而多种生化指标及细胞信号通路的异常不仅增加β淀粉样蛋白引起的神经毒性作用，诱发神经细胞凋亡，而且可加剧脑微血管病变，破坏血脑屏障的正常生理结构及功能，促进2型糖尿病认知障碍的发生发展。本文就2型糖尿病认知障碍进程中的上述关键因子展开讨论，探讨相关防治策略，为开发2型糖尿病认知障碍的治疗药物奠定基础。
2형당뇨병시유발인지장애적독립위험인소지일，기발병궤제제여장기고혈당인기적당독성、담고순대사이상밀절상관외，환여중추이도소신호전도이상、하구뇌-수체-신상선축（hypothalamic-pituitary-adrenal axis，HPA）공능항진유관，이다충생화지표급세포신호통로적이상불부증가β정분양단백인기적신경독성작용，유발신경세포조망，이차가가극뇌미혈관병변，파배혈뇌병장적정상생리결구급공능，촉진2형당뇨병인지장애적발생발전。본문취2형당뇨병인지장애진정중적상술관건인자전개토론，탐토상관방치책략，위개발2형당뇨병인지장애적치료약물전정기출。
Type 2 diabetes mellitus is one of the independent risk factors that can induce cognitive impairment. Except for chronic hyperglycemia-induced glucotoxicity and disorder of cholesterol metabolism, impaired insulin signaling, hyperfunction of HPA axis(hypothalamic-pituitary-adrenal axis)and other factors are also attributed to the pathogenesis of diabetic cognitive dysfunction. Furthermore, many biochemical indicators and abnormal cell signaling pathways not only increase the neurotoxicity of amyloid-βpeptide and induce nerve cells apoptosis, but also aggravate cerebral microvessels disease and damage both the structure and function of blood-brain barrier and then promote the occurrence and development of cognitive impairment in type 2 diabetes mellitus. This paper reviewed the key mechanisms in the process of cognitive impairment in type 2 diabetes mellitus and presented the strategies for its prevention and treatment, and subsequently laid the foundation for development of drugs which can effectively treat diabetic cognitive dysfunction.