Biomedical risk factors for decreased cognitive functioning in type 1 diabetes: an 18 year follow-up of the Diabetes Control and Complications Trial (DCCT) cohort.
Biomedical risk factors for decreased cognitive functioning in type 1 diabetes: an 18 year follow-up of the Diabetes Control and Complications Trial (DCCT) cohort.
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DOI：
10.1007/s00125-010-1883-9
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发表时间：
2011-02
期刊：
影响因子：
8.2
通讯作者：
Dahms, W.
中科院分区：
文献类型：
--
作者：
Jacobson, A. M.;Ryan, C. M.;Cleary, P. A.;Waberski, B. H.;Weinger, K.;Musen, G.;Dahms, W.
在1型糖尿病患者中，人们一直关注复发性低血糖和慢性高血糖对认知功能的影响。由于其他生物医学因素也可能增加认知功能下降的风险，本研究考察了大血管危险因素（高血压、吸烟、高胆固醇血症、肥胖）、亚临床大血管疾病（颈动脉内膜-中膜增厚、冠状动脉钙化）和微血管并发症（视网膜病变、肾病）是否与认知功能下降有长期相关性。1型糖尿病患者（n= 1144）在进入糖尿病控制和并发症试验时完成了全面的认知测试，在平均18.5年（范围：15-23年）后重新评估。单变量和多变量模型检验了认知变化与微、大血管并发症和危险因素之间的关系。单变量模型显示，吸烟史与学习、记忆、空间信息处理和精神运动效率的下降有一定的相关性；高血压仅与精神运动性减慢有关。多变量模型显示，HbA1c水平、视网膜和肾脏并发症都与精神运动效率的下降独立相关。相比之下，校正多重比较后，没有大血管危险因素是显著的。这些预测因子与性别、严重低血糖事件或APOE ε4等位基因的存在之间没有相互作用。在相对健康的中年1型糖尿病患者中，平均随访18.5年，长期代谢控制和微血管因素与认知功能下降独立相关，特别是影响精神运动效率的测量。
In patients with type 1 diabetes, there has been concern about the effects of recurrent hypoglycaemia and chronic hyperglycaemia on cognitive function. Because other biomedical factors may also increase the risk of cognitive decline, this study examined whether macro-vascular risk factors (hypertension, smoking, hypercholesterolaemia, obesity), sub-clinical macrovascular disease (carotid intima–media thickening, coronary calcification) and microvascular complications (retinopathy, nephropathy) were associated with decrements in cognitive function over an extended time period. Type 1 diabetes patients (n=1,144) who had completed a comprehensive cognitive test battery at entry into the Diabetes Control and Complications Trial were reassessed at a mean of 18.5 (range: 15–23) years later. Univariate and multivariable models examined the relationship between cognitive change and the presence of micro-and macrovascular complications and risk factors. Univariate modelling showed that smoking history was modestly associated with decrements in learning, memory, spatial information-processing and psychomotor efficiency; hypertension was associated with only psychomotor slowing. Multivariable modelling demonstrated that HbA1c level, and retinal and renal complications were each independently associated with decrements in psychomotor efficiency. In contrast, no macrovascular risk factors were significant after correcting for multiple comparisons. No interactions were found between these predictors and sex, severe hypoglycaemic events or presence of the APOE ε4 allele. In relatively healthy, middle-aged adults with type 1 diabetes who had been followed for an average of 18.5 years, long-term metabolic control and microvascular factors are independently associated with a decline in cognitive function specifically affecting measures of psychomotor efficiency.
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影响因子：
7.7
作者：
Kodl CT;Franc DT;Rao JP;Anderson FS;Thomas W;Mueller BA;Lim KO;Seaquist ER
通讯作者：
Seaquist ER
影响因子：
8.2
作者：
Manschot, S. M.;Biessels, G. J.;de Valk, H.;Algra, A.;Rutten, G. E. H. M.;van der Grond, J.;Kappelle, L. J.
通讯作者：
Kappelle, L. J.
DOI：
10.1111/j.1532-5415.2007.01592.x
发表时间：
2008-03-01
影响因子：
6.3
作者：
Obisesan, Thomas Olabode;Obisesan, Odunayo Abiodun;Gillum, Richard Frank
通讯作者：
Gillum, Richard Frank
影响因子：
7.7
作者：
通讯作者：
--
DOI：
10.1111/j.2517-6161.1995.tb02031.x
发表时间：
1995-01-01
影响因子：
5.8
作者：
BENJAMINI, Y;HOCHBERG, Y
通讯作者：
HOCHBERG, Y