Xia San-Shan, Xia Wen-Lin, Huang Jiao-Jiao, Zou Hua-Jie, Tao Jing, Yang Yan
Department of Endocrinology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China.
Ann Transl Med. 2020 Feb;8(4):104. doi: 10.21037/atm.2019.12.113.
The aim of the research was to investigate the factors contributing to cognitive dysfunction in type 2 diabetic patients, to distinguish the complex relationship between diabetic retinopathy (DR) and different cognitive status.
Two hundred and ninety-seven type 2 diabetes mellitus (T2DM) patients were enrolled in our study. We adopted the Clinical Dementia Rating (CDR), Mini-mental State Examination (MMSE) and Montreal Cognitive Assessment (MOCA) to evaluate the cognitive function. Firstly, cognition status was classified into dementia and non-dementia according to MMSE and CDR. Patients with non-dementia were further classified into mild cognitive impairment (MCI) and normal cognition status based on MOCA. The factors contributing to cognitive dysfunction were analyzed.
Among the 297 T2DM subjects, 47 were enrolled in the dementia group and 174 in the MCI group according to a battery of cognitive function tests, presenting a prevalence of 15.8% and 58.6% respectively. After adjustment for age, sex, and education level, waist circumference and DR were risk factors for dementia (OR: 1.057, P=0.011; OR: 2.197, P=0.040). Low-density lipoprotein cholesterol (LDL-C) was a risk factor for MCI (OR: 1.635, P=0.047), while age at T2DM onset and moderate drinking were protective factors for MCI (OR: 0.936, P=0.044; OR: 0.289, P=0.004).
MCI is common in T2DM patients. Waist circumference and DR are risk factors of dementia, LDL-C is a risk factor for MCI, and moderate drinking and age at T2DM onset are protective factors for MCI. DR is unrelated to MCI in T2DM.
本研究旨在探讨2型糖尿病患者认知功能障碍的影响因素，以区分糖尿病视网膜病变（DR）与不同认知状态之间的复杂关系。
本研究纳入了297例2型糖尿病（T2DM）患者。我们采用临床痴呆评定量表（CDR）、简易精神状态检查表（MMSE）和蒙特利尔认知评估量表（MOCA）来评估认知功能。首先，根据MMSE和CDR将认知状态分为痴呆和非痴呆。非痴呆患者再根据MOCA进一步分为轻度认知障碍（MCI）和正常认知状态。分析导致认知功能障碍的因素。
在297例T2DM受试者中，根据一系列认知功能测试，47例被纳入痴呆组，174例被纳入MCI组，患病率分别为15.8%和58.6%。在调整年龄、性别和教育水平后，腰围和DR是痴呆的危险因素（OR：1.057，P = 0.011；OR：2.197，P = 0.040）。低密度脂蛋白胆固醇（LDL-C）是MCI的危险因素（OR：1.635，P = 0.047），而T2DM发病年龄和适度饮酒是MCI的保护因素（OR：0.936，P = 0.044；OR：0.289，P = 0.004）。
MCI在T2DM患者中很常见。腰围和DR是痴呆的危险因素，LDL-C是MCI的危险因素，适度饮酒和T2DM发病年龄是MCI的保护因素。在T2DM中，DR与MCI无关。
