Elias P K, Elias M F, D'Agostino R B, Cupples L A, Wilson P W, Silbershatz H, Wolf P A
Department of Mathematics, Boston University, USA.
Diabetes Care. 1997 Sep;20(9):1388-95. doi: 10.2337/diacare.20.9.1388.
To determine if NIDDM and blood pressure are risk factors for poor cognitive performance and if history and duration of NIDDM and blood pressure interact such that the risk of poor performance is greater for subjects with both NIDDM and hypertension.
We used a large prospective cohort sample with 187 NIDDM subjects and 1,624 nondiabetic subjects who were followed for 28-30 years. Cognitive function was assessed using eight tests of learning, memory, visual organization, verbal fluency attention, concept formation, and abstract reasoning. A composite score was also calculated. Odds ratios were used to estimate the relative risk of performing below the lower 25th percentile of z scores on these tests.
NIDDM and blood pressure interacted such that diagnosis and duration of NIDDM were associated with greater risk of poor performance on tests of visual memory and on the composite score for hypertensive subjects. Duration of NIDDM was associated with increased risk for poor performance on tests of verbal memory and concept formation. Insulin-treated NIDDM subjects were at higher risk for poor cognitive performance than those NIDDM subjects treated with oral agents or diet. Blood pressure level was associated independently with a measure of verbal fluency.
History and duration of NIDDM and high blood pressure are significant risk factors for poor cognitive performance. Hypertensive people with NIDDM are at greatest risk for poor performance on tests measuring visual organization and memory.
确定非胰岛素依赖型糖尿病（NIDDM）和血压是否为认知功能不佳的风险因素，以及NIDDM和血压的病史及病程是否相互作用，从而使同时患有NIDDM和高血压的受试者认知功能不佳的风险更高。
我们使用了一个大型前瞻性队列样本，其中包括187名NIDDM受试者和1624名非糖尿病受试者，随访时间为28至30年。使用八项学习、记忆、视觉组织、语言流畅性注意力、概念形成和抽象推理测试来评估认知功能。还计算了一个综合分数。比值比用于估计在这些测试中z分数低于第25百分位数下限的相对风险。
NIDDM和血压相互作用，使得NIDDM的诊断和病程与高血压受试者的视觉记忆测试及综合分数表现不佳的风险更高相关。NIDDM的病程与语言记忆和概念形成测试表现不佳的风险增加相关。接受胰岛素治疗的NIDDM受试者比接受口服药物或饮食治疗的NIDDM受试者认知功能不佳的风险更高。血压水平独立地与语言流畅性的一项指标相关。
NIDDM和高血压的病史及病程是认知功能不佳的重要风险因素。患有NIDDM的高血压患者在测量视觉组织和记忆的测试中表现不佳的风险最大。
