未服用二甲双胍2型糖尿病患者发生轻度认知功能障碍的影响因素分析
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摘要
目的探讨未服用二甲双胍的2型糖尿病(T2DM)患者发生轻度认知功能障碍(MCI)的影响因素。方法选取149例未服用二甲双胍的T2DM患者,收集患者的一般资料、体格检查及实验室检查结果,分析未服用二甲双胍的T2DM患者发生MCI的影响因素。结果 149例T2DM患者中,98例发生MCI,发生率为65.8%。文化程度低、胱抑素C和糖化血红蛋白(HbA1c)升高是未服用二甲双胍的T2DM患者发生MCI的独立危险因素(P<0.05)。结论文化程度低、胱抑素C和HbA1c增高是未服用二甲双胍T2DM患者发生MCI的独立危险因素。
Objective To investigate the influencing factors of developing mild cognitive impairment(MCI) in patients with type 2 diabetes mellitus(T2DM) without oral administration of metformin. Methods A total of 149 T2DM patients without oral administration of metformin were enrolled,and their general data and physical examination and laboratory results were collected. The influencing factors of developing MCI in T2DM patients without oral administration of metformin were analyzed. Results Ninety-eight of the 149 patients with T2DM suffered from MCI,accounting for 65.8%. Low educational level and increased cystatin C and hemoglobin A1c(HbA1c) were independent risk factors for developing MCI in T2DM patients without oral administration of metformin(all P<0.05). Conclusion Low educational level and increased cystatin C and HbA1c are independent risk factors for developing MCI in T2DM patients without oral administration of metformin.
Objective To investigate the influencing factors of developing mild cognitive impairment(MCI) in patients with type 2 diabetes mellitus(T2DM) without oral administration of metformin. Methods A total of 149 T2DM patients without oral administration of metformin were enrolled,and their general data and physical examination and laboratory results were collected. The influencing factors of developing MCI in T2DM patients without oral administration of metformin were analyzed. Results Ninety-eight of the 149 patients with T2DM suffered from MCI,accounting for 65.8%. Low educational level and increased cystatin C and hemoglobin A1c(HbA1c) were independent risk factors for developing MCI in T2DM patients without oral administration of metformin(all P<0.05). Conclusion Low educational level and increased cystatin C and HbA1c are independent risk factors for developing MCI in T2DM patients without oral administration of metformin.
引文
[1]中华医学会糖尿病学分会.中国2型糖尿病防治指南(2010年版)[J].中国医学前沿杂志(电子版),2011,3(6):54-109.
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[9]张红霞,高霞,管庆波,等.2型糖尿病患者认知功能障碍和血清总同型半胱氨酸水平的关系[J].中国慢性病预防与控制,2009,17(2):148-150.
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[12]Sun Y,Lee HJ,Yang SC,et al.A nationwide survey of mild cognitive impairment and dementia,including very mild dementia,in Taiwan[J].PLo S One,2014,9(6):e100303.
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[14]李敏,张丽,王敏哲.老年2型糖尿病与轻度认知功能障碍的关系研究[J].中国全科医学,2011,14(14):1 537-1 539.
[15]Ghidoni R,Benussi L,Glionna M,et al.Plasma cystatin Cand risk of developing Alzheimer's disease in subjects with mild cognitive impairment[J].J Alzheimers Dis,2010,22(3):985-991.
[16]Tian J,Shi J,Mann DM.Cerebral amyloid angiopathy and dementia[J].Panminerva Med,2004,46(4):253-264.
[17]Sundel9f J,Arnl9v J,Ingelsson E,et al.Serum cystatin C and the risk of Alzheimer disease in elderly men[J].Neurology,2008,71(14):1 072-1 079.
[18]罗镧,胡毓洪,拓西平.老年2型糖尿病患者血清胱抑素C水平与轻度认知损害的相关性[J].第二军医大学学报,2011,32(10):1 122-1 125.
[19]Umegaki H,Iimuro S,Shinozaki T,et al.Risk factors associated with cognitive decline in the elderly with type 2 diabetes:pooled logistic analysis of a 6-year observation in the Japanese Elderly Diabetes Intervention Trial[J].Geriatr Gerontol Int,2012,12(Suppl 1):110-116.
[20]虎子颖,袁慧娟,郑瑞芝,等.老年糖尿病患者轻度认知功能障碍与内脏脂肪素的相关性研究[J].中华老年医学杂志,2017,36(8):836-839.
[21]Gao Y,Xiao Y,Miao R,et al.The prevalence of mild cognitive impairment with type 2 diabetes mellitus among elderly people in China:a cross-sectional study[J].Arch Gerontol Geriatr,2016,62:138-142.
[22]沈芳芳,谢云,赵霞,等.TNF-α基因多态性与2型糖尿病患者轻度认知功能障碍的相关性[J].天津医药,2010,38(2):94-96.
[23]郜振红,刘媛,王新平,等.2型糖尿病患者血糖及相关危险因素与认知功能障碍的关系[J].吉林医学,2012,33(8):1 603-1 605.
[24]Muranyi M,Fujioka M,He Q,et al.Diabetes activates cell death pathway after transient focal cerebral ischemia[J].Diabetes,2003,52(2):481-486.
[2]Yang WY,Lu JM,Weng JP,et al.Prevalence of diabetes among men and women in China[J].N Engl J Med,2010,362(12):1 090-1 101.
[3]Luchsinger JA.Type 2 diabetes and cognitive impairment:linking mechanisms[J].J Alzheimers Dis,2012,30(Suppl 2):S185-S198.
[4]Kroner Z.The relationship between Alzheimer's disease and diabetes:type 3 diabetes?[J].Altern Med Rev,2009,14(4):373-379.
[5]Ng TP,Feng L,Yap KB,et al.Long-term metformin usage and cognitive function among older adults with diabetes[J].JAlzheimers Dis,2014,41(1):61-68.
[6]Imfeld P,Bodmer M,Jick SS,et al.Metformin,other antidiabetic drugs,and risk of Alzheimer's disease:a population-based case-control study[J].J Am Geriatr Soc,2012,60(5):916-921.
[7]Nasreddine ZS,Phillips NA,Bédirian V,et al.The Montreal Cognitive Assessment,Mo CA:a brief screening tool for mild cognitive impairment[J].J Am Geriatr Soc,2005,53(4):695-699.
[8]胡曼云,张喜,胡艳文,等.2型糖尿病患者轻度认知障碍相关影响因素的研究[J].中国糖尿病杂志,2015,23(5):448-451.
[9]张红霞,高霞,管庆波,等.2型糖尿病患者认知功能障碍和血清总同型半胱氨酸水平的关系[J].中国慢性病预防与控制,2009,17(2):148-150.
[10]Fei M,Yan Ping Z,Ru Juan M,et al.Risk factors for dementia with type 2 diabetes mellitus among elderly people in China[J].Age Ageing,2013,42(3):398-400.
[11]Ewers M,Buerger K,Teipel SJ,et al.Multicenter assessment of CSF-phosphorylated tau for the prediction of conversion of MCI[J].Neurology,2007,69(24):2 205-2 212.
[12]Sun Y,Lee HJ,Yang SC,et al.A nationwide survey of mild cognitive impairment and dementia,including very mild dementia,in Taiwan[J].PLo S One,2014,9(6):e100303.
[13]马彪,杨勇,孟宪海,等.2型糖尿病伴轻度认知功能减退与载脂蛋白Eε4等位基因等因素的关系[J].中国慢性病预防与控制,2014,22(1):81-83.
[14]李敏,张丽,王敏哲.老年2型糖尿病与轻度认知功能障碍的关系研究[J].中国全科医学,2011,14(14):1 537-1 539.
[15]Ghidoni R,Benussi L,Glionna M,et al.Plasma cystatin Cand risk of developing Alzheimer's disease in subjects with mild cognitive impairment[J].J Alzheimers Dis,2010,22(3):985-991.
[16]Tian J,Shi J,Mann DM.Cerebral amyloid angiopathy and dementia[J].Panminerva Med,2004,46(4):253-264.
[17]Sundel9f J,Arnl9v J,Ingelsson E,et al.Serum cystatin C and the risk of Alzheimer disease in elderly men[J].Neurology,2008,71(14):1 072-1 079.
[18]罗镧,胡毓洪,拓西平.老年2型糖尿病患者血清胱抑素C水平与轻度认知损害的相关性[J].第二军医大学学报,2011,32(10):1 122-1 125.
[19]Umegaki H,Iimuro S,Shinozaki T,et al.Risk factors associated with cognitive decline in the elderly with type 2 diabetes:pooled logistic analysis of a 6-year observation in the Japanese Elderly Diabetes Intervention Trial[J].Geriatr Gerontol Int,2012,12(Suppl 1):110-116.
[20]虎子颖,袁慧娟,郑瑞芝,等.老年糖尿病患者轻度认知功能障碍与内脏脂肪素的相关性研究[J].中华老年医学杂志,2017,36(8):836-839.
[21]Gao Y,Xiao Y,Miao R,et al.The prevalence of mild cognitive impairment with type 2 diabetes mellitus among elderly people in China:a cross-sectional study[J].Arch Gerontol Geriatr,2016,62:138-142.
[22]沈芳芳,谢云,赵霞,等.TNF-α基因多态性与2型糖尿病患者轻度认知功能障碍的相关性[J].天津医药,2010,38(2):94-96.
[23]郜振红,刘媛,王新平,等.2型糖尿病患者血糖及相关危险因素与认知功能障碍的关系[J].吉林医学,2012,33(8):1 603-1 605.
[24]Muranyi M,Fujioka M,He Q,et al.Diabetes activates cell death pathway after transient focal cerebral ischemia[J].Diabetes,2003,52(2):481-486.