Hypothalamic-pituitary-adrenal axis dysregulation and memory impairments in type 2 diabetes
Hypothalamic-pituitary-adrenal axis dysregulation and memory impairments in type 2 diabetes
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DOI：
10.1210/jc.2006-2540
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发表时间：
2007-07-01
影响因子：
5.8
通讯作者：
Convit, Antonio
中科院分区：
文献类型：
--
作者：
Bruehl, Hannah;Rueger, Melanie;Convit, Antonio
背景：有证据表明 2 型糖尿病 (T2DM) 存在下丘脑-垂体-肾上腺皮质 (HPA) 轴和认知功能障碍。然而，这些异常之间的确切性质和关联仍不清楚。 目的：本研究的目的是描述 T2DM 中 HPA 失调的性质，并确定 T2DM 认知受损是否可归因于这些异常。设计：进行了一项横断面研究，通过使用组合数据对比匹配组的 HPA 轴功能和认知。 地塞米松 (DEX)/CRH 测试和评估陈述性记忆和工作记忆、注意力和执行功能的神经心理学电池。 背景：该研究在学术医疗中心的研究诊所进行。 参与者：参与者是认知正常范围内的志愿者。我们研究了 30 名患有 T2DM 的中年患者（平均诊断糖尿病时间为 7.5 年），以及 30 名年龄、性别和教育程度相匹配的对照者。主要指标：测量基础皮质醇水平、DEX/CRH 测试期间的皮质醇水平以及神经心理学测试的表现。结果：T2DM 个体的基础血浆皮质醇水平升高，DEX 抑制后水平更高，对 CRH 的反应更大（所有 P
Context: There is evidence of both hypothalamic-pituitary-adrenocortical (HPA) axis and cognitive dysfunction in type 2 diabetes mellitus (T2DM). However, the exact nature and the associations between these abnormalities remain unclear.Objectives: The aim of the study was to characterize the nature of the HPA dysregulation in T2DM and ascertain whether impaired cognition in T2DM could be attributed to these abnormalities.Design: A cross-sectional study was performed, contrasting matched groups on HPA axis function and cognition by using the combined dexamethasone (DEX)/CRH test and a neuropsychological battery assessing declarative and working memory, attention, and executive function.Setting: The study was conducted in a research clinic in an academic medical center.Participants: Participants were volunteers functioning in the cognitively normal range. We studied 30 middle-aged individuals with T2DM, on average 7.5 yr since diabetes diagnosis, and 30 age-, gender, and education-matched controls. Main Outcome Measures: Basal cortisol levels, cortisol levels during the DEX/CRH test, and performance on neuropsychological tests were measured.Results: Individuals with T2DM had elevated basal plasma cortisol levels, higher levels after DEX suppression, and a larger response to CRH (all P