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2型糖尿病对中国早期阿尔茨海默病患者神经心理症状的影响。

The Effect of Type 2 Diabetes Mellitus on Neuropsychological Symptoms in Chinese Early Alzheimer's Disease Population.

作者信息

Shi Qianqian, Zhou Faying, Mei Jing, Yang Haimei, Li Huiyun

机构信息

Department of Neurology, Daping Hospital, Army Medical University, Chongqing 400042, People's Republic of China.

出版信息

Neuropsychiatr Dis Treat. 2020 Mar 26;16:829-836. doi: 10.2147/NDT.S240529. eCollection 2020.

Abstract

OBJECTIVE

To explore the effect of Type 2 diabetes mellitus (T2DM) on the development of neuropsychiatric symptoms (NPS) in early Alzheimer's disease (AD).

METHODS

From September 2017 to March 2019, a cross-sectional study was conducted on the clinical data of 158 early AD patients over 65 years old in the Department of Neurology of Daping Hospital. All early stage of AD patients were divided into early stage of AD with NPS group and early stage of AD without NPS group according to the presence or absence of NPS. Clinical data of age, sex, body mass index (BMI), smoking and alcohol consumption, history of hypertension, hyperlipidemia, white matter leisure (WML) and T2DM, MMSE, CDR and NPI-Q scores were collected. Multivariate logistic regression analyses were performed to examine the relationship between T2DM and NPS in early AD.

RESULTS

Compared with the early stage of AD group without NPS, the early stage of AD group with NPS was older, the proportion of women was higher, the proportion of T2DM, hypertension, hyperlipidemia and WML was higher, and the MMSE score was lower (P< 0.05). T2DM was an independent risk factor for NPS in early stage of AD patients (OR 3.48, 95% CI 2.91-3.84). The incidence of T2DM in AD patients with depression, anxiety, nighttime behavioral disturbances, and appetite disturbances was significantly higher than in AD patients without these symptoms. T2DM was an independent risk factor of depression (OR 2.04, 95% CI 1.71-2.38), anxiety (OR 1.69, 95% CI 1.38-1.97), nighttime behavioral disturbances (OR 1.95, 95% CI 1.75-2.13) and appetite disturbances (OR 1.62, 95% CI 1.33-1.94) in early AD patients.

CONCLUSION

T2DM was an important independent risk factor for NPS in early AD, which promotes the occurrence of depression, anxiety, nighttime behavioral disturbances and appetite disturbances in early AD.

摘要

目的

探讨2型糖尿病(T2DM)对早期阿尔茨海默病(AD)神经精神症状(NPS)发生发展的影响。

方法

2017年9月至2019年3月,对陆军军医大学第二附属医院(大坪医院)神经内科158例65岁以上早期AD患者的临床资料进行横断面研究。根据是否存在NPS,将所有AD早期患者分为伴有NPS的AD早期组和不伴有NPS的AD早期组。收集年龄、性别、体重指数(BMI)、吸烟饮酒情况、高血压、高脂血症、脑白质疏松(WML)和T2DM病史、简易精神状态检查表(MMSE)、临床痴呆评定量表(CDR)及神经精神问卷(NPI-Q)评分等临床资料。采用多因素logistic回归分析探讨T2DM与AD早期NPS的关系。

结果

与不伴有NPS的AD早期组相比,伴有NPS的AD早期组年龄更大,女性比例更高,T2DM、高血压、高脂血症和WML的比例更高,MMSE评分更低(P<0.05)。T2DM是AD早期患者发生NPS的独立危险因素(比值比[OR]3.48,95%置信区间[CI]2.91-3.84)。伴有抑郁、焦虑、夜间行为障碍和食欲障碍的AD患者中T2DM的发生率显著高于无这些症状的AD患者。T2DM是AD早期患者发生抑郁(OR 2.04,95%CI 1.71-2.38)、焦虑(OR 1.69,95%CI 1.38-1.97)、夜间行为障碍(OR 1.95,95%CI 1.75-2.13)和食欲障碍(OR 1.62,95%CI 1.33-1.94)的独立危险因素。

结论

T2DM是AD早期发生NPS的重要独立危险因素,可促进AD早期抑郁、焦虑、夜间行为障碍和食欲障碍的发生。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/77d6/7105356/581664dac0e0/NDT-16-829-g0001.jpg

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