胰岛素抵抗相关特征与认知功能下降有关：一项针对成年1型糖尿病患者的横断面研究。
Insulin resistance-related features are associated with cognitive decline: a cross-sectional study in adult patients with type 1 diabetes.
作者信息
Ji Xiaolin, Zou Wenjing, Fan Li, Zhou Zhiguang, Zhu Xiongzhao, Li Xia
机构信息
National Clinical Research Center for Metabolic Diseases, Key Laboratory of Diabetes Immunology (Central South University), Ministry of Education, Department of Metabolism and Endocrinology, The Second Xiangya Hospital of Central South University, 410011, Changsha, Hunan, China.
National Clinical Research Center for Mental Disorders, Medical Psychological Center, Medical Psychological Institute of Central South University, The Second Xiangya Hospital of Central South University, 410011, Changsha, Hunan, China.
出版信息
Diabetol Metab Syndr. 2024 Jan 11;16(1):13. doi: 10.1186/s13098-023-01249-w.
BACKGROUND
To investigate the associations between insulin resistance (IR)-related features and cognitive function in type 1 diabetes (T1D).
METHODS
A total of 117 adult patients with T1D were recruited in this cross-sectional study. IR-related features include overweight/obesity/central obesity, hypertension, atherogenic dyslipidemia, and decreased estimated insulin sensitivity (eIS). The Wechsler Memory Scale-Chinese Revision, Wisconsin Card Sorting Test, and Sustained Attention to Response Task was used to assess memory, executive function and sustained attention, respectively. A z-score was generated from each test, and a composite measure of global cognitive performance was calculated by averaging the z-scores of all tests. Cognitive differences were measured between T1D patients with and without IR-related features. The associations between IR-related features and and cognitive performance were analyzed using: logistic regression, partial correlation, and multivariate linear regression analysis.
RESULTS
A total of 53 (45.3%) T1D patients were defined as having IR-related features. Individuals with IR-related features displayed worse overall cognitive scores compared to those without and had a 4-fold increase in the risk for having global cognitive z-score < 0. Among the IR-related features, higher triglyceride (TG) and lower eIS showed linear correlation with lower global cognitive performance. And the subsequent regression analysis identified eIS as the factor independently associated with global cognitive performance.
CONCLUSIONS
We have provided evidence linking IR-related features to deteriorated cognitive function in adult patients with T1D. And eIS showed an independent positive correlation with global cognitive performance. Although no causal relationship can be drawn, IR emerges as an important factor reflecting cognitive function.
TRIAL REGISTRATION
ClinicalTrials.gov NCT03610984.
背景
探讨1型糖尿病（T1D）患者胰岛素抵抗（IR）相关特征与认知功能之间的关联。
方法
本横断面研究共纳入117例成年T1D患者。IR相关特征包括超重/肥胖/中心性肥胖、高血压、致动脉粥样硬化性血脂异常以及估计胰岛素敏感性（eIS）降低。分别采用韦氏记忆量表中文版、威斯康星卡片分类测验和持续注意力反应任务来评估记忆、执行功能和持续注意力。每项测试生成一个z分数，并通过对所有测试的z分数求平均值来计算整体认知表现的综合指标。比较有无IR相关特征的T1D患者之间的认知差异。使用逻辑回归、偏相关和多元线性回归分析来分析IR相关特征与认知表现之间的关联。
结果
共有53例（45.3%）T1D患者被定义为具有IR相关特征。与无IR相关特征的个体相比，具有IR相关特征的个体整体认知得分更差，且全球认知z分数<0的风险增加了4倍。在IR相关特征中，较高的甘油三酯（TG）和较低的eIS与较低的整体认知表现呈线性相关。随后的回归分析确定eIS是与整体认知表现独立相关的因素。
结论
我们提供了证据表明IR相关特征与成年T1D患者认知功能恶化有关。并且eIS与整体认知表现呈独立正相关。尽管无法得出因果关系，但IR成为反映认知功能的一个重要因素。
试验注册
ClinicalTrials.gov NCT03610984。
Zotero 插件