《基于人群的研究：中国农村老年糖尿病患者血糖控制与痴呆和身体功能的关系》
Associations of the Glycaemic Control of Diabetes with Dementia and Physical Function in Rural-Dwelling Older Chinese Adults: A Population-Based Study.
机构信息
Department of Neurology, Shandong Provincial Hospital, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, People's Republic of China.
Department of Neurology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, People's Republic of China.
出版信息
Clin Interv Aging. 2021 Aug 13;16:1503-1513. doi: 10.2147/CIA.S319633. eCollection 2021.
PURPOSE
To examine the associations of impaired fasting glucose (IFG) and glycaemic control of diabetes with dementia, global cognitive function and physical function among rural-dwelling Chinese older adults.
PATIENTS AND METHODS
This population-based cross-sectional study included 4583 participants (age ≥65 years, 57.3% women) living in Yanlou Town, Yanggu County, western Shandong Province, China. In 2018, data were collected through interviews, clinical examinations, neuropsychological tests, and laboratory tests. Diabetes status was defined by self-reported physician-diagnosed diabetes, current use of antidiabetic agents, and fasting blood glucose tests. Global cognitive function was assessed using the Mini-Mental State Examination. Dementia was diagnosed following DSM-IV criteria, and Alzheimer's disease (AD) was diagnosed following the National Institute on Aging-Alzheimer's Association criteria. Physical function was assessed by the Short Physical Performance Battery. Data were analysed using multiple logistic and general linear regression models.
RESULTS
IFG was found in 267 participants, and diabetes was diagnosed in 658 participants (257 with well-controlled diabetes, 401 with poorly controlled diabetes). Dementia was diagnosed in 166 participants (116 with AD), and physical functional impairment was found in 1973 participants. The multi-adjusted odds ratio (OR) of dementia associated with poorly controlled diabetes (vs without IFG or diabetes) was 2.41 (95% CI 1.52-3.84), and the OR of AD associated with poorly controlled diabetes was 2.32 (1.34-4.04). In addition, the adjusted OR of physical functional impairment was 1.40 (1.06-1.85) for well-controlled diabetes and 1.69 (1.35-2.12) for poorly controlled diabetes. However, IFG was not associated with cognitive or physical function.
CONCLUSION
The glycaemic control status of diabetes patients was associated with cognitive impairment and physical functional impairment.
目的
研究空腹血糖受损（IFG）和糖尿病血糖控制与中国农村老年人痴呆、总体认知功能和身体功能的关系。
方法
本基于人群的横断面研究纳入了来自中国山东省阳谷县阎楼镇的 4583 名参与者（年龄≥65 岁，57.3%为女性）。2018 年，通过访谈、临床检查、神经心理学测试和实验室检查收集数据。糖尿病的诊断依据是自我报告的医生诊断的糖尿病、当前使用的降糖药物以及空腹血糖检测。总体认知功能采用简易精神状态检查进行评估。痴呆症按照 DSM-IV 标准进行诊断，阿尔茨海默病（AD）按照美国国立衰老研究所-阿尔茨海默病协会标准进行诊断。身体功能通过短体适能测试评估。采用多因素逻辑回归和一般线性回归模型进行数据分析。
结果
267 名参与者存在 IFG，658 名参与者（257 名血糖控制良好，401 名血糖控制不佳）被诊断为糖尿病。166 名参与者（116 名患有 AD）被诊断为痴呆症，1973 名参与者存在身体功能障碍。与无 IFG 或糖尿病相比，血糖控制不佳（与无 IFG 或糖尿病相比）与痴呆症的多因素校正比值比（OR）为 2.41（95%CI 1.52-3.84），与 AD 的 OR 为 2.32（1.34-4.04）。此外，与血糖控制良好相比，血糖控制不佳的 OR 为 1.40（1.06-1.85），与血糖控制不佳相比，OR 为 1.69（1.35-2.12）。然而，IFG 与认知或身体功能无关。
结论
糖尿病患者的血糖控制状况与认知障碍和身体功能障碍有关。
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