2型糖尿病合并认知功能障碍的危险因素  

Risk factors of type 2 diabetes mellitus complicated with cognitive impairment

作　　者：朱玲玲 朱骏[1] 王敏 董靖德[1] ZHU Ling-ling;ZHU Jun;WANG Min;DONG Jing-de(Department of Geriatrics, Nanjing Brain Hospital Affiliated to Nanjing Medical University, Nanjing 210029, China)

机构地区：[1]南京医科大学附属脑科医院老年科,江苏省南京市210029

出　　处：《实用老年医学》2021年第6期606-608,共3页Practical Geriatrics

摘　　要：目的探讨T2DM与认知功能障碍的相关性。方法选取2015年1月至2019年8月南京医科大学附属脑科医院收治的T2DM合并认知功能障碍的住院病人50例,另外选取同期无认知功能障碍的T2DM病人50例,年龄均≥65岁。收集2组的一般资料及疾病信息,检测血脂、HbA1c、空腹胰岛素(FINS)、肌酐(Cr)、Hcy、血清叶酸、游离脂肪酸(FFAs)、炎症因子水平等,采用多因素Logistic回归法分析T2DM病人发生认知功能障碍的相关危险因素。结果与T2DM组比较,T2DM合并认知功能障碍组病人的年龄、病程、BMI、LDL-C、HbA1c、Hcy、脂蛋白相关磷脂酶A2(Lp-PLA2)、TNF-α、IL-6水平升高,叶酸水平下降,差异具有统计学意义(P<0.05);Logistic回归分析结果显示,年龄、病程、Hcy、HbA1c、LDL-C及TNF-α是T2DM病人发生认知功能障碍的独立危险因素。结论病人的年龄、病程、Hcy、HbA1c、LDL-C及TNF-α在T2DM并发认知功能障碍的过程中可能起到一定的作用,对这些因素加以控制,对防治和延缓T2DM病人并发认知功能障碍有重要的作用。Objective To explore the relationship between type 2 diabetes mellitus(T2DM)and cognitive impairment.Methods From January 2015 to August 2019,a total of 50 hospitalized T2DM patients with cognitive impairment in Nanjing Brain Hospital Affiliated to Nanjing Medical University were selected.In addition,50 case of T2DM patients without cognitive impairment in the same period were selected.All the patients were aged over 65 years old.The general data and disease information of the two groups were collected,and the levels of blood lipid,glycosylated hemoglobin(HbA1c),fasting insulin(FINS),creatinine(Cr),homocysteine(Hcy),free fatty acids(FFAs)and inflammatory factors were measured.Multivariate Logistic regression was used to analyze the risk factors of cognitive impairment in the T2DM patients.Results Compared with T2DM group,age,disease course,body mass index(BMI),low-density lipoprotein cholesterol(LDL-C),HbA1c,Hcy,lipoprotein phospholipase(Lp-PLA2),tumor necrosis factor-α(TNF-α)and interleukin-6(IL-6)levels in the T2DM patients with cognitive impairment were increased,while the folate level was decreased(P<0.05).Logistic regression analysis showed that age,disease course,Hcy,HbA1c,LDL-C and TNF-αwere independent risk factors for cognitive impairment in the T2DM patients.Conclusions Age,course of disease,Hcy,HbA1c,LDL-C and TNF-αmay play certain roles in the process of cognitive dysfunction in the elderly patients with T2DM.It is important to control these factors to prevent and delay the cognitive dysfunction in the patients with type 2 diabetes.

关 键 词：2型糖尿病 认知功能障碍 危险因素 

分 类 号：R587.1[医药卫生—内分泌]