Jagielski A C, Jiang C Q, Xu L, Taheri S, Zhang W S, Cheng K K, Lam T H, Thomas G N
Public Health, Epidemiology and Biostatistics, University of Birmingham, Birmingham, UK Birmingham and Black Country NIHR CLAHRC, Birmingham, UK.
Guangzhou Number 12 People's Hospital, Guangzhou, China.
Age Ageing. 2015 Jan;44(1):65-71. doi: 10.1093/ageing/afu088. Epub 2014 Jul 8.
an association between T2DM and cognitive impairment has been reported among Western populations, but data are limited in other settings. We investigated the cross-sectional association between fasting blood glucose (FBG) and cognition in an older Chinese population.
the Guangzhou Biobank Cohort Study included 27,971 individuals (50-96 years, mean age 61.5 years, 72% female) with measures of cognitive function assessed using modified Delayed Word Recall Test (DWRT) and Mini-Mental State Examination (MMSE). Fasting glucose and lipids, and potential confounders were measured.
after adjustment for potential confounders, the risk for cognitive impairment as measured by DWRT, significantly increased [odds ratio (OR) = 1.18, 95% CI 1.00-1.40] but the association was of borderline significance when measured by MMSE (OR = 1.04, 95% CI 0.73-1.47) in those with diabetes relative to those without diabetes. Fasting blood glucose was significantly negatively associated with cognitive function as measured by DWRT but not MMSE, with an increase of 1 mmol/l of FBG associated with a decrease of 0.02 in DWRT (P < 0.05, 95% CI -0.03 to -0.002) and 0.03 in MMSE score (P = 0.114, 95% CI -0.06-0.01).
an FBG level indicative of T2DM was associated with increased risk for cognitive impairment. The findings also demonstrate that glycaemia is continuously associated with cognitive impairment, suggesting that dysfunction is associated with increasing glucose levels even in the normoglycaemic range.
西方人群中已报道2型糖尿病（T2DM）与认知障碍之间存在关联，但其他环境下的数据有限。我们调查了中国老年人群中空腹血糖（FBG）与认知之间的横断面关联。
广州生物样本库队列研究纳入了27971名个体（年龄50 - 96岁，平均年龄61.5岁，72%为女性），使用改良的延迟词语回忆测试（DWRT）和简易精神状态检查表（MMSE）评估认知功能。测量了空腹血糖、血脂及潜在混杂因素。
在对潜在混杂因素进行调整后，与无糖尿病者相比，糖尿病患者中以DWRT测量的认知障碍风险显著增加[比值比（OR）= 1.18，95%置信区间（CI）1.00 - 1.40]，但以MMSE测量时该关联具有临界显著性（OR = 1.04，95% CI 0.73 - 1.47）。空腹血糖与以DWRT测量的认知功能显著负相关，但与MMSE测量的认知功能无显著相关性，FBG每升高1 mmol/L，DWRT降低0.02（P < 0.05，95% CI -0.03至 -0.002），MMSE评分降低0.03（P = 0.114，95% CI -0.06 - 0.01）。
提示T2DM的FBG水平与认知障碍风险增加相关。研究结果还表明，血糖水平持续与认知障碍相关，这表明即使在血糖正常范围内，功能障碍也与血糖水平升高有关。
