Department of Geriatric Medicine, Dokuz Eylul University, Faculty of Medicine, Izmir, Turkey.
Alsancak Nevvar Salih Isgoren State Hospital, Izmir, Turkey.
Arch Gerontol Geriatr. 2020 May-Jun;88:104013. doi: 10.1016/j.archger.2020.104013. Epub 2020 Jan 20.
Type 2 Diabetes Mellitus(DM) is a well-known risk factor for cognitive impairment. Recent evidences suggest that Dipeptidyl peptidase-4(DPP-4) inhibitors might have neuroprotective effects. Therefore, this study aimed to investigate vildagliptin, a DPP-4 inhibitor, effects on cognitive function in older patients with DM.
A retrospective longitudinal clinical trial was carried out on total 130 subjects with type 2 DM. Patients underwent comprehensive geriatric assessment twice within six months interval. The patients were divided into three groups according to antidiabetic treatment: untreated control group (patients achieve individual goal HbA1c without antidiabetic medication), vildagliptin(+) group(patients using vildagliptin alone or combination) and the vildagliptin(-) group.
The mean age was 75.72 ± 7.46 years. The control group was older, of a lighter weight and also had a higher female gender ratio(p ≤ 0.01). When sex, age, educational level and metabolic profile were adjusted, there was only change in copying subdomain of Mini Mental State Examination between vildagliptin(+) and other groups at the end of 6 months. Vildagliptin also resulted in reduction of HbA1c and weight(p < 0.05).
The addition of vildagliptin to treatment improved the copying subdomain of cognitive function and metabolic control of the older patients with type 2 DM within 6 months.
2 型糖尿病（DM）是认知障碍的已知危险因素。最近的证据表明，二肽基肽酶-4（DPP-4）抑制剂可能具有神经保护作用。因此，本研究旨在探讨 DPP-4 抑制剂维格列汀对老年 2 型糖尿病患者认知功能的影响。
对 130 例 2 型糖尿病患者进行了回顾性纵向临床试验。患者在 6 个月的间隔内接受了两次全面老年评估。根据降糖治疗将患者分为三组：未治疗对照组（患者在不使用降糖药物的情况下达到个人 HbA1c 目标）、维格列汀（+）组（患者单独使用或联合使用维格列汀）和维格列汀（-）组。
平均年龄为 75.72±7.46 岁。对照组年龄较大，体重较轻，女性比例较高（p≤0.01）。当调整性别、年龄、教育水平和代谢特征后，仅在 6 个月末时，维格列汀（+）组与其他组之间的简易精神状态检查的复制子域发生了变化。维格列汀还导致 HbA1c 和体重下降（p<0.05）。
在 6 个月内，将维格列汀添加到治疗中改善了老年 2 型糖尿病患者的认知功能复制子域和代谢控制。
