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2 型糖尿病患者的认知功能障碍特征与动脉僵硬度。

Cognitive dysfunction profile and arterial stiffness in type 2 diabetes.

机构信息

University Hospital Alexandrovska, Clinic of Neurology, Sofia, Bulgaria.

出版信息

J Neurol Sci. 2012 Nov 15;322(1-2):152-6. doi: 10.1016/j.jns.2012.07.046. Epub 2012 Aug 5.

Abstract

BACKGROUND

The causative mechanisms of type 2 diabetes (T2D) on cognitive dysfunction are still undergoing development.

AIM

To explore the cognitive dysfunction profile and its relation to the potential role of arterial stiffness in later middle age T2D patients.

METHODS

We studied 37 patients with T2D (age range 45-65 years) and 22 normal controls. All participants underwent comprehensive neuropsychological assessment. The carotid-femoral pulse wave velocity (CF-PWV) measurements were taken with the PulsePen device.

RESULTS

Our results showed significantly poorer performance on all tests assessing attention/executive functions and processing speed in patients with T2D. In addition to cognitive slowing T2D patients demonstrated significant deficits in almost all measures of verbal episodic memory after adjustment for age, education and blood pressure (BP) levels (p<0.05). Carotid-femoral pulse wave velocity (CF-PWV) appeared significantly higher in T2D subjects than in normal controls after adjustment for age and BP level (p<0.001). Significant relationship was observed between CF-PWV and cognitive status.

CONCLUSION

We revealed that arterial stiffness was increased and associated with cognitive impairment in T2D. The cognitive profile indicates hippocampal amnestic type mild cognitive impairment associated with a pronounced dysexecutive syndrome suggesting that diabetes may affect cognition through both vascular and neurodegenerative processes. However, neurodegenerative cognitive profile caused by hippocampal atrophy in a pure vascular process could not be excluded.

摘要

背景

2 型糖尿病(T2D)导致认知功能障碍的机制仍在发展中。

目的

探讨中年 2 型糖尿病患者认知功能障碍的特征及其与动脉僵硬度潜在作用的关系。

方法

我们研究了 37 例 T2D 患者(年龄 45-65 岁)和 22 例正常对照者。所有参与者均接受了全面的神经心理学评估。使用 PulsePen 设备测量颈股脉搏波速度(CF-PWV)。

结果

我们的结果显示,T2D 患者在所有评估注意力/执行功能和处理速度的测试中表现明显较差。除了认知速度减慢外,T2D 患者在几乎所有的言语情景记忆测试中都表现出明显的缺陷,这些缺陷在调整年龄、教育程度和血压(BP)水平后仍然存在(p<0.05)。调整年龄和 BP 水平后,T2D 患者的颈股脉搏波速度(CF-PWV)明显高于正常对照组(p<0.001)。CF-PWV 与认知状态之间存在显著的相关性。

结论

我们发现动脉僵硬度在 T2D 中增加,并与认知障碍相关。认知特征表明与明显的执行功能障碍综合征相关的海马健忘型轻度认知障碍,提示糖尿病可能通过血管和神经退行性过程影响认知。然而,不能排除单纯血管过程中海马萎缩引起的神经退行性认知特征。

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