非痴呆2型糖尿病患者总体认知功能、执行功能与血糖控制水平相关性
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四川省卫生健康委员会科研课题(19PJ169);成都市科技项目(2019-YF09-00120-SN)


Study on the correlation between global cognitive function, executive function and blood glucose control level in non-dementia type 2 diabetes patients
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    摘要:

    目的 研究非痴呆2型糖尿病患者的总体认知功能及执行功能,并从认知功能角度探讨2型糖尿病患者最佳血糖控制水平。方法 纳入2018年7月~2019年7月于成都市第三人民医院神经内科就诊的309例2型糖尿病患者(T2DM组)及同期132例无糖尿病对照人群(对照组)为研究对象。收集一般临床资料,并进行简易精神状态评价量表(MMSE)、长沙版蒙特利尔认知量表(MOCA)、形状连线测验(STT)、华山版Stroop色词测验(SCWT)测试,比较两组之间MMSE、MOCA、STT、SCWT的差异。T2DM组根据糖化血红蛋白(HbA1c)水平分为3个亚组,即HbA1c<7%组, 7%≤HbA1c<8%组, HbA1c≥8%组,比较3个亚组与对照组MMSE、MOCA、STT、SCWT的差异。结果 T2DM组与对照组一般资料比较差异无统计学意义(P>0.05),T2DM组MOCA分值低于对照组, STT-A耗时、STT-B耗时、STT耗时差值、SCWT-A耗时、SCWT-B耗时、SCWT-C耗时大于对照组,SCWT-C正确数低于对照组(P<0.05)。T2DM组糖化血红蛋白水平与总体认知功能及执行功能相关,HbA1c<7%时总体认知功能和执行功能与对照组比差异均无统计学意义(P>0.05)。HbA1c≥7%的两组MOCA及部分执行功能指标低于对照组,HbA1c≥8%时有更多的执行功能指标低于对照组和HbA1c<7%组(P<0.05)。结论 2型糖尿病患者在非痴呆阶段即有总体认知功能及执行功能下降,且与血糖控制水平相关,从认知功能角度,建议2型糖尿病患者糖化血红蛋白控制在6%~7%,延缓认知功能恶化进展。

    Abstract:

    Objective To study the global cognitive function and executive function of non-dementia type 2 diabetes patients, and explore the optimal blood glucose control level of type 2 diabetes patients from the perspective of cognitive function.Methods From July 2018 to July 2019, 309 patients with type 2 diabetes mellitus (T2DM group) and 132 patients without diabetes control group (control group) were enrolled in the Department of Neurology of The Third People's Hospital of Chengdu. General clinical data were collected. The differences of MMSE, MOCA, STT and SCWT between the two groups were compared. T2DM group was divided into 3 subgroups according to HbA1c level, namely HbA1c < 7% group, 7%≤HbA1c < 8% group and HbA1c≥8% group. MMSE, MOCA, STT and SCWT of the 3 subgroups were compared with the control group.Results There was no statistical difference in general clinical data between T2DM group and control group. The MOCA score of T2DM group was lower than that of the control group. The STT-A time, STT-B time, STT time difference, SCWT-A time, SCWT-B time and SCWT-C time were longer than that of control group, and SCWT-C correct was lower than that of control group. The level of HbA1c in T2DM group was correlated with the global cognitive function and executive function. No difference on global cognitive function or executive function was observed when HbA1c<7% compared with control group. When HbA1c≥7%, the MOCA score and some executive function indices were lower than that of control group. When HbA1c≥8%, more executive function indexes were lower than those in the control group and HbA1c<7% group.ConclusionPatients with type 2 diabetes have the decline of global cognitive function and executive function even in non-dementia stage, which is related to the level of blood glucose control. From the perspective of cognitive function, it is still recommended that HbA1c should be controlled between 6%~7% to delay cognitive impairment.

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  • 在线发布日期: 2022-04-15
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