血糖波动对老年2型糖尿病患者认知功能的影响  

Effects of glucose excursion on cognitive function in aged type 2 diabetes

作　　者：章晓燕[1] 钟远[1] 苗雅[1] 朱洁华[1] 燕虹[1] 金俊[1] 王蓓云[1] 胡廷军[1] 

机构地区：[1]上海交通大学附属第六人民医院老年科,200233

出　　处：《中华老年医学杂志》2012年第8期646-648,共3页Chinese Journal of Geriatrics

基　　金：上海交通大学医学院科技基金项目（09XJ21028）

摘　　要：目的 探讨血糖波动对老年2型糖尿病患者认知功能的影响。方法选取老年2型糖尿病患者248例，所有患者均接受3d动态血糖监测（CGMS），根据监测结果计算日内平均血糖波动幅度（MAGE）、日间血糖波动幅度（MODD）。CGMS测定期间所有患者接受简易智力状态量表（MMsE）评估认知功能。分别以MAGE中位数、MODD中位数为切点分组，分别比较不同波动幅度患者间MMSE分数值的差异。结果日内血糖波动大的患者MMSE分数低于波动小的患者，分别为（24．25±6．75）分比（25．97±0．47）分，差异有统计学意义（P=0．025）；日间血糖波动大的患者较波动小的患者MMSE分数低，分别为（24．21±6．47）分比（26．01±5．49）分，差异有统计学意义（P=0．019）。MMSE分数与MAGE（r=-0．308，P〈0．001）、MODD（r=0．226，P=0．001）呈负相关。结论血糖波动对老年2型糖尿病患者认知功能产生影响，血糖波动较大的患者认知功能较差。Objective To investigate the relationship between glucose excursion and cognitive function in aged type 2 diabetes. Methods A total of 248 aged type 2 diabetes were recruited in this study, all of them wore continuous glucose monitoring system （CGMS） for 3 d to evaluate the glucose excursion including mean amplitude of glycemic excursions （MAGE） which was used for assessing intra-day glycemia variability, and mean daily difference （MODD） which represented day-to-day glycemic variability. During the period of CGMS monitoring, all subjects accepted mini mental status examination （MMSE） for evaluating cognitive function. The relationships of MAGE and MODD with performance on cognitive tests were assessed. Results The over intra-day glucose excursion group had lower MMSE score than the narrow intra-day glucose excursion group[（24.25±6.75）vs. （25.97±0.47）, P= 0. 025]. The MMSE score was decreased in over day-to-day glucose excursion group compared with the narrow day-to-day glucose excursion group [（24. 21± 6. 47） vs. （26.01 ±- 5.4,9）, P=0. 0193. A statistically significant association was observed between MAGE and the score of MMSE（r=-0. 308, P〈0.001）, and between MODD and MMSE（r= -0. 226, P=0.001）. Conclusions Glucose excursion may affect cognitive function in aged type 2 diabetes. The over glucose excursion decreases the score of MMSE.

关 键 词：糖尿病 2型 认知障碍 葡萄糖代谢障碍 

分 类 号：R587.1[医药卫生—内分泌]