CAJ | 학술논문

目的：探讨老年2型糖尿病患者的胰岛素抵抗对其认知功能的影响。方法将212例年龄≥60岁的2型糖尿病患者根据是否存在认知功能损害分为2组：老年2型糖尿病合并认知功能损害患者组（病例组，n＝100），老年2型糖尿病认知功能正常患者组（对照组，n＝112），比较两组间性别、年龄、文化程度、体质量指数、血清总胆固醇、甘油三酯、低密度脂蛋白、肌酐、空腹血糖、空腹胰岛素和胰岛素抵抗指数的差异，并进行Logistic多因素分析。结果老年2型糖尿病合并认知功能损害组较对照组文化程度较低（大学及以上，33．00％比53．57％），体质量指数[（28．7±4．5）kg／m2比（23．9±3．7）kg／m2]、空腹胰岛素[（21．8±5．3）m U／L比（12．9±3．9）m U／L ]和胰岛素抵抗指数[（6．9±1．7）比（3．9±0．9）]较高，差异有统计学意义，Logistic回归分析显示文化程度、空腹胰岛素、胰岛素抵抗指数是认知功能损害的独立影响因素。结论文化程度、空腹胰岛素和胰岛素抵抗指数是老年2型糖尿病认知功能损害的独立影响因素，提示胰岛素抵抗是老年2型糖尿病患者发生认知功能损害的重要危险因素。
목적：탐토노년2형당뇨병환자적이도소저항대기인지공능적영향。방법장212례년령≥60세적2형당뇨병환자근거시부존재인지공능손해분위2조：노년2형당뇨병합병인지공능손해환자조（병례조，n＝100），노년2형당뇨병인지공능정상환자조（대조조，n＝112），비교량조간성별、년령、문화정도、체질량지수、혈청총담고순、감유삼지、저밀도지단백、기항、공복혈당、공복이도소화이도소저항지수적차이，병진행Logistic다인소분석。결과노년2형당뇨병합병인지공능손해조교대조조문화정도교저（대학급이상，33．00％비53．57％），체질량지수[（28．7±4．5）kg／m2비（23．9±3．7）kg／m2]、공복이도소[（21．8±5．3）m U／L비（12．9±3．9）m U／L ]화이도소저항지수[（6．9±1．7）비（3．9±0．9）]교고，차이유통계학의의，Logistic회귀분석현시문화정도、공복이도소、이도소저항지수시인지공능손해적독립영향인소。결논문화정도、공복이도소화이도소저항지수시노년2형당뇨병인지공능손해적독립영향인소，제시이도소저항시노년2형당뇨병환자발생인지공능손해적중요위험인소。
Objective To explore the relationship between cognitive function and insulin resistance in elderly patients with type 2 diabetes mellitus .Methods A total of 212 patients aged 60 and above with type 2 diabetes mellitus were divided into two groups :cognitive impairment group(case group ,n= 100) and non-cognitive impairment group(control group ,n= 112) .The gender ,age ,education level ,BMI , TC ,TG ,LDL -C ,Cr ,FPG ,FINS and HOMA -IR were compared between the two groups ,and lo‐gistic regression was analyzed .Results In case group ,education level was lower (33 .00% vs 53 .57% , P < 0 .01) ,the level of BMI[(28 .7 ± 4 .5)kg/m2 vs (23 .9 ± 3 .7)kg/m2 ,P < 0 .01] ,FINS[(21 .8 ± 5.3)mU/L vs (12 .9 ± 3 .9)mU/L ,P < 0 .01] ,HOMA -IR[(6 .9 ± 1 .7) vs (3 .9 ± 0 .9) ,P < 0 .01] were higher than the control group .In the logistic regression ,education level ,FINS and HOMA -IR were independent factors which affect the cognitive impairment .Conclusions The education level ,FINS and HOMA -IR were independent factors of cognitive impairment in elderly patients with type 2 diabetes mellitus .Insulin resistance is an important risk factor for the cognitive impairment in elderly type 2 dia‐betes patients .