Type 1 diabetes-associated cognitive impairment and diabetic peripheral neuropathy in Chinese adults: results from a prospective cross-sectional study
Type 1 diabetes-associated cognitive impairment and diabetic peripheral neuropathy in Chinese adults: results from a prospective cross-sectional study
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中国成人 1 型糖尿病相关认知障碍和糖尿病周围神经病变：前瞻性横断面研究结果
DOI：
10.1186/s12902-019-0359-2
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发表时间：
2019-03-27
影响因子：
2.7
通讯作者：
Zhang, Xia
中科院分区：
文献类型：
--
作者：
Ding, Xin;Fang, Chen;Zhang, Xia
目的比较1型糖尿病（T1 DM）患者与健康成人的神经认知功能，探讨T1 DM患者认知功能障碍的危险因素，特别是认知功能障碍与糖尿病周围神经病变（DPN）的关系。病程8.99 ± 7.02年）和48名健康志愿者。所有受试者均接受MMSE和莫卡量表评定。在不同认知领域评价T1 DM患者的认知功能。结果3例受教育程度≤ 6年的患者被排除在最终分析之外。T1 DM组MMSE评分（28.4 ± 1.7）和莫卡评分（25.9 ± 2.7）均低于对照组（29.1 ± 1.0，P = 0.005）和（27.1 ± 2.4，P = 0.017）。T1 DM组的定向力（9.60 ± 0.79）分和语言功能（8.56 ± 0.65）分均低于对照组（9.87 ± 0.39，P <0.001）。对于莫卡量表，注意力和专注力得分（2.30 ± 0.74 vs.2.57 ± 0.58，P < 0.001），视空间/执行功能记忆力（4.32 ± 0.91 vs.4.64 ± 0.63，P < 0.001）语言功能（2.96 ± 1.50 vs.3.66 ± 1.28，P < 0.001）T1 DM组的血糖（5.71 ± 0.69vs.5.87 ± 0.39，P = 0.007）和空腹血糖（1.55 ± 0.68vs.1.82 ± 0.42，P < 0.001）低于对照组。Logistic回归分析显示年龄、空腹C肽、文化程度和神经传导速度（NCV）与1型糖尿病患者莫卡评分诊断的认知功能障碍相关。除了年龄、空腹C肽水平和教育水平外，DPN作为糖尿病并发症，被确定与认知障碍相关。
BackgroundTo compare neurocognitive functioning of Type 1 diabetic mellitus (T1DM) and healthy adults, and explore risk factors of cognitive dysfunction of T1DM patients, especially the association between cognitive impairment and diabetic peripheral neuropathy (DPN).MethodsSeventy T1DM (age: 32.17 ± 9.57 yr., duration: 8.99 ± 7.02 yr) patients and 48 healthy volunteers were included. All subjects received evaluation of MMSE and MoCA scales. Cognitive function of T1DM patients was evaluated in different cognitive domains. Risk factors affecting cognitive function were further explored.ResultsThree patients with educational level ≤ 6-year were excluded from final analysis. Scores of both MMSE (28.4 ± 1.7 vs. 29.1 ± 1.0,P= 0.005) and MoCA scales (25.9 ± 2.7 vs.27.1 ± 2.4,P= 0.017) in T1DM group were lower than that in control group. For MMSE scale, scores of orientation (9.60 ± 0.79 vs.9.87 ± 0.39,P< 0.001) and language function (8.56 ± 0.65 vs.8.83 ± 0.38,P< 0.001) in T1DM groups were lower than that in control group. For MoCA scale, scores of attention and concentration (2.30 ± 0.74 vs.2.57 ± 0.58,P< 0.001), visuospatial/executive function (4.32 ± 0.91 vs.4.64 ± 0.63,P< 0.001), memory (2.96 ± 1.50 vs.3.66 ± 1.28,P< 0.001), language function (5.71 ± 0.69 vs.5.87 ± 0.39,P= 0.007), and abstraction (1.55 ± 0.68 vs.1.82 ± 0.42,P< 0.001) were lower in T1DM group than that in control group. Logistic regression showed age, fasting C peptide, educational level and nerve conduction velocity (NCV) were associated with cognitive dysfunction diagnosed by MoCA scores for the patients with type 1 diabetes.ConclusionsT1DM adults had mild to moderate cognitive impairment, mainly presenting as dysfunctions of attention and concentration, visuospatial/executive, language, and abstraction. In addition to age, fasting C peptide level, and educational level, DPN, as a diabetic complication, was identified to be associated with cognitive impairments.