Kaiser Permanente of Georgia, Division of Endocrinology, Atlanta, GA, United States of America; Division of Endocrinology, Emory University School of Medicine, Atlanta, GA, United States of America.
The Biostatistics Center, Department of Biostatistics and Bioinformatics, Milken Institute School of Public Health, George Washington University, Rockville, MD, United States of America.
J Diabetes Complications. 2021 Mar;35(3):107805. doi: 10.1016/j.jdiacomp.2020.107805. Epub 2020 Nov 26.
The association of renal dysfunction with tests of cognition in type 2 diabetes has been examined in individuals with moderate and advanced renal disease. Here we examine the association of renal dysfunction with tests of cognition in a cohort of middle-aged adults with short duration diabetes (mean 4.0 ± 2.8 years).
Baseline data were examined from the Glycemia Reduction Approaches in Diabetes (GRADE) study (n = 4998). Renal dysfunction was defined by the presence of albumin in the urine or by estimated glomerular filtration rate (eGFR). Cognition was assessed with the Spanish English Verbal Learning Test, Letter and Animal fluency tests, and the Digit Symbol Substitution Test.
Participants with albuminuria or eGFR <60 ml/min/1.73 m had significantly lower test scores of information processing speed and perception, executive function and ability to categorize information, and of verbal learning and memory compared to participants without renal disease. Adjustment for hypertension, dyslipidemia, and waist circumference attenuated many of these findings but markers of impaired learning and executive function continued to remain lower in association with higher urine albumin levels.
In type 2 diabetes of short duration, there are already subtle deficiencies in markers of cognition in association with renal disease in middle aged adults.
在中重度肾功能不全的患者中，已经研究了肾功能不全与 2 型糖尿病认知测试之间的关系。在此，我们在一组糖尿病病程较短（平均 4.0±2.8 年）的中年患者中，研究了肾功能不全与认知测试之间的关系。
对 Glycemia Reduction Approaches in Diabetes（GRADE）研究（n=4998）的基线数据进行了检查。肾功能不全的定义为尿白蛋白阳性或估算肾小球滤过率（eGFR）降低。认知功能通过西班牙语-英语词汇学习测试、字母和动物流畅性测试以及数字符号替代测试进行评估。
与无肾脏疾病的参与者相比，有白蛋白尿或 eGFR<60ml/min/1.73m2的参与者在信息处理速度和感知、执行功能和分类信息的能力以及词汇学习和记忆方面的测试分数明显较低。调整高血压、血脂异常和腰围后，许多这些发现都减弱了，但与更高的尿白蛋白水平相关的学习和执行功能受损标志物仍然较低。
在病程较短的 2 型糖尿病中，中年患者的肾功能不全与认知测试的标志物已经存在微妙的缺陷。
