2型糖尿病患者高三酰甘油血症腰围表型对认知功能的影响  

Effects of hypertriglyceridemic-waist phenotype on cognitive function in patients with type 2 diabetes

作　　者：高欣[1] 时秋宽[2] 于会艳[3] 秦斌[3] 高芳堃[4] 

机构地区：[1]北京医院国家老年医学中心临床试验研究中心,100730 [2]北京医院期刊编辑部,100730 [3]北京医院神经内科,100730 [4]北京老年医学研究所

出　　处：《中华老年医学杂志》2017年第8期840-843,共4页Chinese Journal of Geriatrics

基　　金：国家自然科学基金项目（30400361）;北京医院院级课题（BJ-2012-52）

摘　　要：目的观察老年2型糖尿病患者高三酰甘油血症腰围表型（HTWC）对认知功能的影响。方法前瞻性研究。将304例2型糖尿病患者以血三酰甘油≥1．7mmoL／L、腰围男性≥90cm或女性≥80cm为切点，分为三酰甘油和腰围正常组（正常组）65例、单纯高三酰甘油组（高三酰甘油组）53例、单纯腹型肥胖组（纯腹型肥胖组）114例、HTWC组72例，对各组患者应用简易智能状态检查量表（MMSE）和蒙特利尔认知评估量表（MOCA）进行认知评估。结果HTWC组的MMSE总分低于正常组，（27．1±1．9）分比（29．0±1．32）分（F=2．869，P=0．019），注意和计算（4.0±1．4）分比（4．6±0．9）分（F=1．605，P=0．047），回忆（2．2±0．9）分比（2．6±0．6）分（F=1．959，P=0．043）；HTWC组MOcA总分（23．4±3．9）分均低于正常组（25．9±3．6）分（F=1．975，P=0．031），视空间与执行功能（3．5±1．4）分、注意（5．1±1．4）分和定向（5．6±1．0）分，低于正常组（4．1±0．9）分、（5．7±0．9）分、（6．0±0．0）分（F值分别为1．537、1．660、2．362，P值分别为0．048、0．048、0．030）。结论糖尿病合并高三酰甘油血症腰围表型患者的认知功能下降更为明显，应积极进行干预和治疗。Objective To investigate the effect of hypertrlglyceridemic-waist（HTWC） phenotype on cognitive function in patients with type 2 diabetes. Methods According to the standard of plasma triglycerides concentration≥1.7 mmoL/L, waist circumference （WC） ≥ 90 cm in men or ≥ 80 cm in women,304 patients with type 2 diabetes were divided into four groups：normal triglycerides and waist circumference group（group A, n = 65）, normal waist circumference and hypertriglyceridemia group （group B, n= 53）, abdominal obesity and normal triglycerides group（group C, n = 114）, and HTWC group（group D, n =72）for prospective studies. Patients in four groups were surveyed with Mini-mental state examination （MMSE） and Montreal cognitive assessment （MOCA）. And changes of cognitive function among the four groups were compared. Results Total score for the MMSE was significantly lower in group D than in group A（27. 1±1.9 vs. 29.0±1.3,F=2. 869,P=0. 019）. The subscales of attention and calculation（4.0 ± 1.4 vs. 4.6 ± 0.9, F= 1. 605, P= 0. 047） and recall （ 2.2 ±0. 9 vs. 2.6±0.6,F=1. 959,P=0. 043） were significantly lower in group D than in group A. Total score for the MOCA was significantly lower in group D than in group A（23.4±3.9 vs. 25.9±3.6,F =1. 975,P=0. 031）. The subscales of visuospatial and executive（3.5±1.4 vs. 4.1±0.9,F=1. 537,P =0. 048） ,attention（5. 1±1.4 vs. 5.7±0.9,F=1. 660,P=0. 048）and orientation（5.6±1. 0 vs. 6. 0±0.0,F=2. 362,P=0. 030）were significantly lower in group D than in group A. Conclusions There is a statistically more significant decline in cognitive function in patients with HTWC phenotype and the effective intervention and treatment are needed.

关 键 词：糖尿病 2型 甘油三酯类 认知障碍 

分 类 号：R587.2[医药卫生—内分泌]