嗅觉功能障碍是轻度认知障碍和 2 型糖尿病共病的危险因素。
Olfactory dysfunction is a risk factor for the comorbidity of mild cognitive impairment and Type 2 diabetes mellitus.
机构信息
Intensive Care Unit, Department of Neurology, Third Xiangya Hospital, Central South University, Changsha 410013.
Department of Nursing, Third Xiangya Hospital, Central South University, Changsha 410013.
出版信息
Zhong Nan Da Xue Xue Bao Yi Xue Ban. 2021 Aug 28;46(8):831-837. doi: 10.11817/j.issn.1672-7347.2021.200046.
OBJECTIVES
Diabetes can accelerate cognitive decline and hence affect the prognosis of patients with Type 2 diabetes mellitus (T2DM). Olfactory assessment can facilitate the early identification of cognitive impairment among T2DM patients. This study aims to evaluate the effects of olfactory function on mild cognitive impairment (MCI) in patients with T2DM.
METHODS
A total of 472 T2DM patients who were hospitalized in a first-class hospital in Changsha City from June 2018 to June 2019 were enrolled for this study. Olfactory function and cognitive function were assessed by the alcohol sniff test and the Montreal Cognitive Assessment (MoCA) scale, respectively. Participants were categorized into a comorbidity of MCI and T2DM group and a T2DM group. General information was collected and some biochemical indices were tested. Difference in the alcohol sniff test score between the 2 groups was assessed by 2-sample -test. Difference in the presence of olfactory dysfunction between the 2 groups was assessed by test, and multivariable logistic regression was used to determine the relevant factors contributing to the comorbidity of MCI and T2DM.
RESULTS
Of the 472 participants, 162 were identified with MCI, making the comorbidity rate at 34.3%. Values of isopropyl alcohol sniff test were significantly different between the 2 groups [(9.15±3.22) cm vs (21.03±4.36) cm, <0.05]. The number of patients with olfactory dysfunction also differed significantly between the 2 groups (120 vs 50). After adjustment for age, educational level, T2DM duration, fasting insulin, and glycosylated hemoglobin (HbA1c), multivariate logistic regression analysis showed older age (OR=1.14, 95% CI 1.09 to 1.20), longer course of diabetes (OR=1.21, 95% CI 1.12 to 1.31), and olfactory-impaired (OR=4.61, 95% CI 3.04 to 6.18) were independent risk factors for T2DM combined with MCI, and the high education level (OR=0.26, 95% CI 0.15 to 0.38) was an independent protective factor for T2DM combined with MCI.
CONCLUSIONS
Olfactory dysfunction is an independent risk factor for the comorbidity of MCI and T2DM. Special attention should be paid to those with olfactory dysfunction when carrying out cognitive interventions in T2DM patients.
目的
糖尿病可加速认知能力下降，从而影响 2 型糖尿病（T2DM）患者的预后。嗅觉评估可有助于早期发现 T2DM 患者的认知障碍。本研究旨在评估嗅觉功能对 T2DM 患者轻度认知障碍（MCI）的影响。
方法
选取 2018 年 6 月至 2019 年 6 月在长沙市某三甲医院住院的 472 例 T2DM 患者进行本研究。采用酒精嗅探试验和蒙特利尔认知评估量表（MoCA）分别评估嗅觉功能和认知功能。将患者分为 MCI 合并 T2DM 组和 T2DM 组。收集一般资料，检测部分生化指标。采用两样本 t 检验比较两组间酒精嗅探试验评分的差异，采用卡方检验比较两组间嗅觉障碍发生率的差异，采用多变量 logistic 回归分析确定导致 MCI 合并 T2DM 的相关因素。
结果
472 例参与者中，162 例患有 MCI，合并率为 34.3%。两组异丙醇嗅探试验值差异有统计学意义[(9.15±3.22)cm 比（21.03±4.36）cm，<0.05]。两组嗅觉障碍患者人数也存在显著差异（120 例比 50 例）。校正年龄、受教育程度、T2DM 病程、空腹胰岛素和糖化血红蛋白（HbA1c）后，多变量 logistic 回归分析显示，年龄较大（OR=1.14，95%CI 1.09 至 1.20）、糖尿病病程较长（OR=1.21，95%CI 1.12 至 1.31）和嗅觉障碍（OR=4.61，95%CI 3.04 至 6.18）是 T2DM 合并 MCI 的独立危险因素，高教育水平（OR=0.26，95%CI 0.15 至 0.38）是 T2DM 合并 MCI 的独立保护因素。
结论
嗅觉障碍是 MCI 合并 T2DM 的独立危险因素。在对 T2DM 患者进行认知干预时，应特别注意嗅觉障碍患者。
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