Palomo-Osuna Jenifer, De Sola Helena, Dueñas María, Moral-Munoz Jose A, Failde Inmaculada
The Observatory of Pain, University of Cadiz, Cadiz, Spain.
Biomedical Research and Innovation Institute of Cadiz (INiBICA), Research Unit, Puerta Del Mar University Hospital, University of Cadiz, Cadiz, Spain.
Expert Rev Neurother. 2022 Mar;22(3):269-281. doi: 10.1080/14737175.2022.2048649. Epub 2022 Mar 15.
The aim of this study is to improve our knowledge of cognitive function in individuals with type 1 (T1DM) or type 2 (T2DM) diabetes mellitus and with peripheral diabetic neuropathy (DPN).
A systematic review and meta-analysis was performed of publications included in PubMed, Scopus, PsycInfo and Web of Science databases until November 2021. The study was registered in PROSPERO (CRD42021229163).
A total of 832 articles were identified, 19 of which were selected. The presence of DPN was associated with global cognitive impairment in the T1DM persons in two studies (p=0.046;p=0.03) and T2DM persons in four (p<0.00;p<0.02;p=0.011;p≤0.05) . Differences in specific dimensions - memory, attention, and psychomotor speed - were found in both kinds of diabetes. The meta-analysis showed that the individuals with T2DM and DPN presented a lower mean cognitive performance than those without DPN (-1.0448;95%CI:-1.93%;-0.16%). Depression was associated with impaired cognitive function in these diabetic persons (p < 0.01).
The review reveals the great variability in instruments and methodologies, while providing results that support the presence of both global and domain-specific cognitive impairment in diabetic persons with DPN.
本研究旨在增进我们对1型糖尿病（T1DM）或2型糖尿病（T2DM）以及伴有糖尿病周围神经病变（DPN）患者认知功能的了解。
对截至2021年11月在PubMed、Scopus、PsycInfo和科学网数据库中收录的文献进行系统综述和荟萃分析。该研究已在国际前瞻性系统评价注册库（PROSPERO，注册号：CRD42021229163）登记。
共检索到832篇文章，其中19篇被选中。两项研究表明，DPN的存在与T1DM患者的整体认知障碍相关（p = 0.046；p = 0.03），四项研究表明与T2DM患者的整体认知障碍相关（p < 0.00；p < 0.02；p = 0.011；p≤0.05）。在两种糖尿病类型中均发现了特定维度（记忆、注意力和精神运动速度）的差异。荟萃分析显示，患有T2DM和DPN的个体的平均认知表现低于无DPN的个体（-1.0448；95%置信区间：-1.93%；-0.16%）。抑郁与这些糖尿病患者的认知功能受损相关（p < 0.01）。
该综述揭示了研究工具和方法的巨大差异，同时提供的结果支持了伴有DPN的糖尿病患者存在整体和特定领域认知障碍。
