Blasetti Annalisa, Chiuri Rosa Maria, Tocco Anna Maria, Di Giulio Concetta, Mattei Peter A, Ballone Enzo, Chiarelli Francesco, Verrotti Alberto
Department of Pediatrics, University of Chieti, Chieti, Italy.
J Child Neurol. 2011 Nov;26(11):1383-91. doi: 10.1177/0883073811406730. Epub 2011 May 13.
The purpose of this study was to investigate the existence and extent of cognitive impairment in type 1 diabetic children with episodes of recurrent severe hypoglycemia, using meta-analysis to synthesize data across studies. The meta-analysis sample included: 441 children with diabetes and recurrent severe hypoglycemia, 560 children with diabetes and without recurrent severe hypoglycemia. Overall, children with type 1 diabetes and recurrent severe hypoglycemia had slightly lower performance than diabetic children without severe hypoglycemia, only in some cognitive domains: intelligence, memory, learning, and verbal fluency/language. Greater impairment was found in memory and learning. No impairment was found for motor speed. Our results seem to confirm the hypothesis that recurrent severe hypoglycemia has a selective negative effect on the children's cognitive functions. However, these results must be considered with caution taking into account factors such as small sample sizes, the different definitions of severe hypoglycemia, and the variety of neuropsychological tests used.
本研究旨在通过荟萃分析综合各项研究数据，调查1型糖尿病伴反复严重低血糖发作患儿认知障碍的存在情况及程度。荟萃分析样本包括：441例患有糖尿病且反复发生严重低血糖的儿童，560例患有糖尿病但未反复发生严重低血糖的儿童。总体而言，1型糖尿病伴反复严重低血糖的儿童仅在某些认知领域的表现略低于无严重低血糖的糖尿病儿童，这些领域包括智力、记忆、学习以及语言流畅性/语言能力。在记忆和学习方面发现了更严重的损害。未发现运动速度受损。我们的结果似乎证实了反复严重低血糖对儿童认知功能有选择性负面影响这一假设。然而，考虑到样本量小、严重低血糖的不同定义以及所使用的各种神经心理学测试等因素，必须谨慎看待这些结果。
