Dey J, Misra A, Desai N G, Mahapatra A K, Padma M V
Department of Neurosurgery, All India Institute of Medical Sciences, New Delhi, India.
Diabetes Care. 1997 Jan;20(1):32-5. doi: 10.2337/diacare.20.1.32.
To examine central nervous system involvement as a possible complication of diabetes by performing a comprehensive neuropsychological evaluation of relatively young (age < 55 years) NIDDM patients and a group of control subjects.
A cross-sectional comparative study of 28 patients, with duration of diabetes 5-18 years (mean +/- SD +/- 3.2 years), screened for acceptable glycemic control and absence of hypoglycemia on the day of examination, compared with 28 demographically similar, nondiabetic control subjects. Neuropsychometric tests performed were Mini-Mental Status Examination (MMSE), Neurobehavioral Cognitive Status Examination (NCSE), and P300 latencies (endogenous evoked potentials).
Seven (25.0%) patients reported history suggestive of cognitive impairment during day-to-day activities, and 17 (60.7%) had distal symmetrical polyneuropathy. Average P300 latencies were significantly delayed among the diabetic patients compared with the control subjects (349.5 +/- 28.2 vs. 312.9 +/- 19.3 ms; t = 5.68, P < 0.001). Although there was no significant difference in MMSE scores, compared with control subjects significantly more patients had impairment in NCSE tests of attention (chi 2 = 7.38, P < 0.01), repetition (chi 2 = 4.073, P < 0.05), and memory (chi 2 = 5.83, P < 0.05), while there was no significant difference in tests of comprehension, naming, construction, and calculation. Duration of diabetes, HbA1c levels, and the presence of distal symmetrical polyneuropathy among patients each did not correlate with any of the parameters of cognitive function evaluated. Higher blood glucose levels during the electrophysiological testing were associated with less delay in P300 latencies among the patients.
Central nervous system impairment, manifesting as mild impairments in certain cognitive skills, should be recognized as a possible complication of long-standing NIDDM, even in relatively younger individuals.
通过对相对年轻（年龄<55岁）的非胰岛素依赖型糖尿病（NIDDM）患者及一组对照者进行全面的神经心理学评估，来检查中枢神经系统受累情况是否为糖尿病的一种可能并发症。
一项横断面比较研究，研究对象为28例糖尿病病程5 - 18年（平均±标准差±3.2年）、在检查当天血糖控制可接受且无低血糖的患者，与28例人口统计学特征相似的非糖尿病对照者进行比较。所进行的神经心理测试包括简易精神状态检查表（MMSE）、神经行为认知状态检查表（NCSE）以及P300潜伏期（内源性诱发电位）。
7例（25.0%）患者报告有日常活动中提示认知功能受损的病史，17例（60.7%）有远端对称性多发性神经病变。与对照者相比，糖尿病患者的平均P300潜伏期显著延长（349.5±28.2对312.9±19.3毫秒；t = 5.68，P<0.001）。虽然MMSE评分无显著差异，但与对照者相比，更多患者在NCSE的注意力测试（χ2 = 7.38，P<0.01）、复述测试（χ2 = 4.073，P<0.05）和记忆测试（χ2 = 5.83，P<0.05）中存在受损情况，而在理解、命名、结构和计算测试中无显著差异。患者的糖尿病病程、糖化血红蛋白水平以及远端对称性多发性神经病变的存在情况均与所评估的任何认知功能参数无关。电生理测试期间较高的血糖水平与患者中P300潜伏期较短延迟相关。
中枢神经系统损害表现为某些认知技能的轻度受损，应被视为长期NIDDM的一种可能并发症，即使在相对年轻的个体中也是如此。
