Logroscino Giancarlo, Kang Jae Hee, Grodstein Francine
Department of Epidemiology, Harvard School of Public Health, Boston, MA 02115, USA.
BMJ. 2004 Mar 6;328(7439):548. doi: 10.1136/bmj.37977.495729.EE. Epub 2004 Feb 23.
To examine the association of type 2 diabetes with baseline cognitive function and cognitive decline over two years of follow up, focusing on women living in the community and on the effects of treatments for diabetes.
Nurses' health study in the United States. Two cognitive interviews were carried out by telephone during 1995-2003.
18 999 women aged 70-81 years who had been registered nurses completed the baseline interview; to date, 16 596 participants have completed follow up interviews after two years.
Cognitive assessments included telephone interview of cognitive status, immediate and delayed recalls of the East Boston memory test, test of verbal fluency, delayed recall of 10 word list, and digit span backwards. Global scores were calculated by averaging the results of all tests with z scores.
After multivariate adjustment, women with type 2 diabetes performed worse on all cognitive tests than women without diabetes at baseline. For example, women with diabetes were at 25-35% increased odds of poor baseline score (defined as bottom 10% of the distribution) compared with women without diabetes on the telephone interview of cognitive status and the global composite score (odds ratios 1.34, 95% confidence interval 1.14 to 1.57, and 1.26, 1.06 to 1.51, respectively). Odds of poor cognition were particularly high for women who had had diabetes for a long time (1.52, 1.15 to 1.99, and 1.49, 1.11 to 2.00, respectively, for > or = 15 years' duration). In contrast, women with diabetes who were on oral hypoglycaemic agents performed similarly to women without diabetes (1.06 and 0.99), while women not using any medication had the greatest odds of poor performance (1.71, 1.28 to 2.281, and 1.45, 1.04 to 2.02) compared with women without diabetes. There was also a modest increase in odds of poor cognition among women using insulin treatment. All findings were similar when cognitive decline was examined over time.
Women with type 2 diabetes had increased odds of poor cognitive function and substantial cognitive decline. Use of oral hypoglycaemic therapy, however, may ameliorate risk.
研究2型糖尿病与基线认知功能的关联以及两年随访期间的认知衰退情况，重点关注社区女性以及糖尿病治疗的效果。
美国护士健康研究。1995 - 2003年期间通过电话进行了两次认知访谈。
18999名年龄在70 - 81岁的注册护士完成了基线访谈；截至目前，16596名参与者在两年后完成了随访访谈。
认知评估包括认知状态的电话访谈、东波士顿记忆测试的即时和延迟回忆、语言流畅性测试、10个单词列表的延迟回忆以及倒背数字广度。通过将所有测试结果与z分数进行平均来计算总体得分。
经过多变量调整后，2型糖尿病女性在基线时所有认知测试中的表现均比无糖尿病女性差。例如，在认知状态的电话访谈和总体综合得分方面，与无糖尿病女性相比，糖尿病女性基线得分较差（定义为分布的最低10%）的几率增加了25% - 35%（优势比分别为1.34，95%置信区间1.14至1.57；以及1.26，1.06至1.51）。病程较长（≥15年）的女性认知能力差的几率特别高（分别为1.52，1.15至1.99；以及1.49，1.11至2.00）。相比之下，使用口服降糖药的糖尿病女性表现与无糖尿病女性相似（优势比分别为1.06和0.99），而未使用任何药物的女性表现较差的几率最高（与无糖尿病女性相比，优势比分别为1.71，1.28至2.281；以及1.45，1.04至2.02）。使用胰岛素治疗的女性认知能力差的几率也有适度增加。随着时间推移检查认知衰退情况时，所有结果相似。
2型糖尿病女性认知功能差和显著认知衰退的几率增加。然而，使用口服降糖治疗可能会降低风险。
