Neuropsychological Outcomes in Individuals With Type 1 and Type 2 Diabetes.
Neuropsychological Outcomes in Individuals With Type 1 and Type 2 Diabetes.
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DOI：
10.3389/fendo.2022.834978
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发表时间：
2022
影响因子：
5.2
通讯作者：
Callaghan BC
中科院分区：
文献类型：
--
作者：
Putnam NM;Reynolds EL;Banerjee M;Mizokami-Stout K;Albright D;Lee J;Pop-Busui R;Feldman EL;Callaghan BC
确定1型糖尿病患者与2型糖尿病患者或无糖尿病患者神经心理结局的患病率，并评估糖尿病状态和微血管/大血管并发症与神经心理结局的关系。我们使用具有全国代表性的私人保险个人医疗索赔数据库（2001年1月1日至2018年12月31日）来识别1型糖尿病患者。倾向评分匹配作为一种准随机化技术，用于匹配1型糖尿病患者与2型糖尿病患者和对照组。使用ICD-9/10代码定义糖尿病状态、微血管/大血管并发症（视网膜病变、神经病变、肾病、中风、心肌梗死、周围血管疾病、截肢）和神经心理结局（心理健康、认知、慢性疼痛、成瘾、睡眠障碍）。逻辑回归确定了糖尿病状态、微血管/大血管并发症和神经心理结局之间的关联。我们确定了184,765名1型糖尿病患者与524,602名2型糖尿病患者和522,768名对照者相匹配。除认知障碍外，2型糖尿病患者的神经心理结果患病率最高，其次是1型糖尿病患者和对照组。在调整微血管/大血管并发症的存在后，1型糖尿病与神经心理结局的高风险无显著相关；然而，2型糖尿病仍然与心理健康、认知和睡眠障碍有关。微血管/大血管并发症的存在与每一种神经心理结果独立相关，与糖尿病状态无关。无论糖尿病状态如何，微血管/大血管并发症都与神经心理结局的高风险相关。因此，预防微血管和大血管并发症可能有助于减少神经心理结果的可能性，无论是由于类似的病理生理过程，还是通过预防这些并发症的直接和间接后果。对于2型糖尿病患者来说，并发症以外的风险因素（如肥胖）可能会导致神经心理学结果。
To determine the prevalence of neuropsychological outcomes in individuals with type 1 diabetes compared to individuals with type 2 diabetes or without diabetes, and to evaluate the association of diabetes status and microvascular/macrovascular complications with neuropsychological outcomes. We used a nationally representative healthcare claims database of privately insured individuals (1/1/2001-12/31/2018) to identify individuals with type 1 diabetes. Propensity score matching was used as a quasi-randomization technique to match type 1 diabetes individuals to type 2 diabetes individuals and controls. Diabetes status, microvascular/macrovascular complications (retinopathy, neuropathy, nephropathy, stroke, myocardial infarction, peripheral vascular disease, amputations), and neuropsychological outcomes (mental health, cognitive, chronic pain, addiction, sleep disorders) were defined using ICD-9/10 codes. Logistic regression determined associations between diabetes status, microvascular/macrovascular complications, and neuropsychological outcomes. We identified 184,765 type 1 diabetes individuals matched to 524,602 type 2 diabetes individuals and 522,768 controls. With the exception of cognitive disorders, type 2 diabetes individuals had the highest prevalence of neuropsychological outcomes, followed by type 1 diabetes, and controls. After adjusting for the presence of microvascular/macrovascular complications, type 1 diabetes was not significantly associated with a higher risk of neuropsychological outcomes; however, type 2 diabetes remained associated with mental health, cognitive, and sleep disorders. The presence of microvascular/macrovascular complications was independently associated with each neuropsychological outcome regardless of diabetes status. Microvascular/macrovascular complications are associated with a high risk of neuropsychological outcomes regardless of diabetes status. Therefore, preventing microvascular and macrovascular complications will likely help reduce the likelihood of neuropsychological outcomes either as the result of similar pathophysiologic processes or by preventing the direct and indirect consequences of these complications. For individuals with type 2 diabetes, risk factors beyond complications (such as obesity) likely contribute to neuropsychological outcomes.
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影响因子：
2.7
作者：
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通讯作者：
Xie J
影响因子：
7.2
作者：
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