长期既往血糖控制对2型糖尿病患者执行功能的影响。
The effect of long-term past glycemic control on executive function among patients with type 2 diabetes mellitus.
作者信息
Minami Taichi, Ito Yuzuru, Yamada Masayo, Furuta Ryutaro, Minagawa Fuyuki, Kamata Kentaro, Kameda Akiko, Terauchi Yasuo
机构信息
1Division of Metabolism and Endocrinology, Department of Internal Medicine, Yokohama Sakae Kyosai Hospital, Federation of National Public Service Personnel Mutual Associations, 132 Katsura-cho, Sakae-ku, Yokohama, Japan.
Department of Diabetes and Endocrinology, Saiseikai Yokohamashi Nanbu Hospital, 3-2-9 Konandai, Konan-ku, Yokohama, Japan.
出版信息
Diabetol Int. 2019 Oct 3;11(2):114-120. doi: 10.1007/s13340-019-00411-y. eCollection 2020 Apr.
OBJECTIVE
Patients with type 2 diabetes mellitus (T2DM) show more executive dysfunction than nondiabetics. However, how long poor glycemic control affects executive function remains unclear. Thus, we aimed to investigate the relationships in a cross-sectional study.
METHODS
We studied 118 T2DM outpatients (age, ≥ 60 years; excluding history of stroke, dementia and severe hypoglycemia). HbA1c values were recorded every ≤ 12 weeks for ≥ 5 years. All patients underwent verbal-fluency tests (reflecting executive function) and Mini-Mental State Examination (MMSE). The correlation between past glycemic control values and both cognitive tests scores was investigated. As markers of past glycemic control, we used average hemoglobin A1c (HbA1c) values and glycemic control variability [coefficient of variation (CV) of HbA1c values (HbA1c-CV)].
RESULTS
Verbal-fluency tests scores correlated with HbA1c-CV, but not with average HbA1c values, after adjusting for age, years of education and sex. Verbal-fluency tests scores correlated with HbA1c-CV for the past 5 years, best compared with HbA1c-CV for past < 5 years. MMSE scores were also related to only HbA1c-CV for the past 3 years in an adjustment model.
CONCLUSIONS
Five-year HbA1c variability affected executive function in T2DM patients, but not average HbA1c values. Long-term longitudinal studies may be required.
目的
2型糖尿病（T2DM）患者比非糖尿病患者表现出更多的执行功能障碍。然而，血糖控制不佳对执行功能的影响持续多久仍不清楚。因此，我们旨在通过一项横断面研究来调查两者之间的关系。
方法
我们研究了118例T2DM门诊患者（年龄≥60岁；排除中风、痴呆和严重低血糖病史）。在≥5年的时间里，每≤12周记录一次糖化血红蛋白（HbA1c）值。所有患者均接受言语流畅性测试（反映执行功能）和简易精神状态检查表（MMSE）。研究过去血糖控制值与两项认知测试分数之间的相关性。作为过去血糖控制的指标，我们使用平均糖化血红蛋白（HbA1c）值和血糖控制变异性[HbA1c值的变异系数（CV）（HbA1c-CV）]。
结果
在调整年龄、受教育年限和性别后，言语流畅性测试分数与HbA1c-CV相关，但与平均HbA1c值无关。言语流畅性测试分数与过去5年的HbA1c-CV相关，与过去<5年的HbA1c-CV相比相关性最佳。在一个调整模型中，MMSE分数也仅与过去3年的HbA1c-CV相关。
结论
5年的HbA1c变异性影响T2DM患者执行功能，但不影响平均HbA1c值。可能需要进行长期纵向研究。
Zotero 插件