Ma Lina, Li Yun
a Xuan Wu Hospital, Department of Geriatrics , Capital Medical University , Beijing , China.
Neurol Res. 2017 Mar;39(3):259-263. doi: 10.1080/01616412.2017.1281199. Epub 2017 Jan 20.
To explore the relationship between cognitive impairment and insulin resistance (IR) in elderly patients with type-2 diabetes mellitus.
Two hundred and twelve elderly patients with type-2 diabetes were enrolled in this study and assigned into either the cognitive impairment group (n = 100) or the normal cognitive group (n = 112). Gender, age, education, body mass index (BMI), total cholesterol, triglyceride, low-density lipoprotein cholesterol, creatinine (Cr), fasting plasma glucose, fasting insulin (FINS) and homeostasis model of assessment for IR index (HOMA-IR) were compared between the two groups. Multifactorial logistic regression analysis was performed.
In cognitive impairment group, education level (33.00 vs 53.57%, p < 0.01) was lower, the level of BMI [(28.7 ± 4.5) kg/m vs (23.9 ± 3.7) kg/m, p < 0.01], FINS [(21.8 ± 5.3) mU/L vs (12.9 ± 3.9) mU/L, p < 0.01], HOMA-IR [(6.9 ± 1.7) vs (3.9 ± 0.9), p < 0.01] were higher than the control group. In the logistic regression, education level (B = -0.996, p = 0.03), FINS (B = 1.120, p < 0.01) and HOMA-IR (B = 1.301, p < 0.01) were independent factors.
Our study demonstrates that the education level, FINS and HOMA-IR were independent factors of cognitive impairment in elderly patients with type-2 diabetes. IR is an important risk factor and higher education level in a protective factor for the cognitive impairment in elderly patients with type-2 diabetes.
探讨老年2型糖尿病患者认知功能障碍与胰岛素抵抗（IR）之间的关系。
本研究纳入212例老年2型糖尿病患者，分为认知功能障碍组（n = 100）和认知功能正常组（n = 112）。比较两组患者的性别、年龄、教育程度、体重指数（BMI）、总胆固醇、甘油三酯、低密度脂蛋白胆固醇、肌酐（Cr）、空腹血糖、空腹胰岛素（FINS）和IR指数的稳态模型评估（HOMA-IR）。进行多因素logistic回归分析。
认知功能障碍组的教育程度较低（33.00%对53.57%，p < 0.01），BMI水平[（28.7 ± 4.5）kg/m对（23.9 ± 3.7）kg/m，p < 0.01]、FINS水平[（21.8 ± 5.3）mU/L对（12.9 ± 3.9）mU/L，p < 0.01]、HOMA-IR水平[（6.9 ± 1.7）对（3.9 ± 0.9），p < 0.01]均高于对照组。在logistic回归中，教育程度（B = -0.996，p = 0.03）、FINS（B = 1.120，p < 0.01）和HOMA-IR（B = 1.301，p < 0.01）是独立因素。
我们的研究表明，教育程度、FINS和HOMA-IR是老年2型糖尿病患者认知功能障碍的独立因素。IR是一个重要的危险因素，而较高的教育程度是老年2型糖尿病患者认知功能障碍的保护因素。
