Department of Diabetes and Endocrine Internal Medicine, Chubu Rosai Hospital, Nagoya, Japan.
Diabetes Res Clin Pract. 2011 Oct;94(1):91-9. doi: 10.1016/j.diabres.2011.06.014. Epub 2011 Jul 13.
We conducted a 3-year longitudinal study concerning an association between cognitive function and cerebral small vessel disease (SVD) seen on magnetic resonance imaging (MRI) in elderly type 2 diabetic patients.
Four cognitive function tests--MMSE, word recall, Digit Symbol Substitution (DSS), and Stroop Color Word (Stroop)--were performed in 67 diabetic patients twice in 2006 and 2009. SVD was diagnosed as silent brain infarct (SBI) and white matter lesions (WMLs) according to MRI.
Number of SBI was significantly correlated with a decline in DSS and Stroop tests, while WMLs grade was only associated with it in DSS tests after adjustment for age, gender, education years, the presence of hypertension and dyslipidemia, and smoking. Severity of SVD at baseline was stronger associated with cognitive function after the 3-year follow-up than at baseline. WMLs progression was associated with more rapid decline of DSS tests compared to a group without progression.
SVD seen on MRI is a good marker for predicting future cognitive decline, and monitoring of treatment through the use of such markers is expected to maintain a good quality of life for elderly diabetic patients.
我们进行了一项为期 3 年的纵向研究，旨在探讨老年 2 型糖尿病患者磁共振成像（MRI）上观察到的认知功能与脑小血管疾病（SVD）之间的关系。
在 2006 年和 2009 年，我们对 67 名糖尿病患者进行了 4 项认知功能测试——简易精神状态检查（MMSE）、单词回忆、数字符号替代（DSS）和斯特鲁普颜色词（Stroop）——两次。根据 MRI 诊断 SVD 为无症状性脑梗死（SBI）和脑白质病变（WML）。
SBI 的数量与 DSS 和 Stroop 测试的下降显著相关，而在调整年龄、性别、教育年限、高血压和血脂异常以及吸烟等因素后，WML 分级仅与 DSS 测试相关。SVD 严重程度在基线时与认知功能的相关性在 3 年随访后比基线时更强。与没有进展的组相比，WML 进展与 DSS 测试的下降速度更快相关。
MRI 上观察到的 SVD 是预测未来认知能力下降的良好标志物，通过使用这些标志物监测治疗有望维持老年糖尿病患者的生活质量。
