Saczynski Jane S, Jónsdóttir María K, Garcia Melissa E, Jonsson Palmi V, Peila Rita, Eiriksdottir Gudny, Olafsdottir Elin, Harris Tamara B, Gudnason Vilmundur, Launer Lenore J
Division of Geriatric Medicine, University of Massachusetts Medical School, Biotech Four, Suite 315, 377 Plantation Street, Worcester, MA 01605, USA.
Am J Epidemiol. 2008 Nov 15;168(10):1132-9. doi: 10.1093/aje/kwn228. Epub 2008 Oct 3.
Persons with type 2 diabetes are at increased risk of cognitive dysfunction. Less is known about which cognitive abilities are affected and how undiagnosed diabetes and impaired fasting glucose relate to cognitive performance. The authors explored this question using data from 1,917 nondemented men and women (average age = 76 years) in the population-based Age, Gene/Environment Susceptibility-Reykjavik Study (2002-2006). Glycemic status groups included diagnosed diabetes (self-reported diabetes or diabetic medication use; n = 163 (8.5%)), undiagnosed diabetes (fasting blood glucose >or=7.0 mmol/L without diagnosed diabetes; n = 55 (2.9%)), and impaired fasting glucose (fasting blood glucose 5.6-6.9 mmol/L; n = 744 (38.8%)). Composites of memory, processing speed (PS), and executive function were constructed from a neuropsychological battery. Linear regression was used to investigate cross-sectional differences in cognitive performance between glycemic groups, adjusted for demographic and health factors. Persons with diagnosed diabetes had slower PS than normoglycemics (beta = -0.12; P < 0.05); diabetes duration of >or=15 years was associated with significantly poorer PS and executive function. Undiagnosed diabetics had slower PS (beta = -0.22; P < 0.01) and poorer memory performance (beta = -0.22; P < 0.05). Persons with type 2 diabetes have poorer cognitive performance than normoglycemics, particularly in PS. Those with undiagnosed diabetes have the lowest cognitive performance.
2型糖尿病患者发生认知功能障碍的风险增加。关于哪些认知能力受到影响以及未诊断的糖尿病和空腹血糖受损与认知表现之间的关系，人们了解得较少。作者利用基于人群的年龄、基因/环境易感性-雷克雅未克研究（2002 - 2006年）中1917名无痴呆症的男性和女性（平均年龄 = 76岁）的数据探讨了这个问题。血糖状态组包括已诊断糖尿病（自我报告糖尿病或使用糖尿病药物；n = 163（8.5%））、未诊断糖尿病（空腹血糖≥7.0 mmol/L且无已诊断糖尿病；n = 55（2.9%））和空腹血糖受损（空腹血糖5.6 - 6.9 mmol/L；n = 744（38.8%））。记忆、处理速度（PS）和执行功能的综合指标由一套神经心理测试构建而成。采用线性回归研究血糖组之间认知表现的横断面差异，并对人口统计学和健康因素进行了调整。已诊断糖尿病患者的PS比血糖正常者慢（β = -0.12；P < 0.05）；糖尿病病程≥15年与PS和执行功能显著较差有关。未诊断的糖尿病患者PS较慢（β = -0.22；P < 0.01）且记忆表现较差（β = -0.22；P < 0.05）。2型糖尿病患者的认知表现比血糖正常者差，尤其是在PS方面。未诊断糖尿病的患者认知表现最差。
