GLUCOSE-INTOLERANCE, HYPERINSULINEMIA AND COGNITIVE FUNCTION IN A GENERAL-POPULATION OF ELDERLY MEN
GLUCOSE-INTOLERANCE, HYPERINSULINEMIA AND COGNITIVE FUNCTION IN A GENERAL-POPULATION OF ELDERLY MEN
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DOI：
10.1007/s001250050397
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发表时间：
1995-09-01
期刊：
影响因子：
8.2
通讯作者：
KROMHOUT, D
中科院分区：
文献类型：
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作者：
KALMIJN, S;FESKENS, EJM;KROMHOUT, D
认知障碍在老年人中非常普遍。糖代谢紊乱的受试者可能有认知功能受损的风险，因为这些障碍可以通过动脉粥样硬化、血栓形成和高血压影响认知。因此，我们研究了认知功能与高胰岛素血症、糖耐量受损和糖尿病的横断面关联，研究对象为462名年龄在69岁至89岁之间的男性。认知功能采用30分迷你精神状态检查。结果表示为该指数与参照组相比在迷你精神状态检查中给出的错误答案的比率（95%置信区间）。经年龄、职业、吸烟等混杂因素校正后，已知糖尿病患者与糖耐量正常者的比值为1.23(1.04-1.46)，新诊断糖尿病患者的比值为1.16(0.91-1.48)，糖耐量异常者的比值为1.18 (0.98-1.41)（p-trend = 0.01）。非糖尿病受试者胰岛素曲线下面积最高四分位数与最低四分位数的比值为1.24(1.03-1.50)，经混杂校正（p-trend = 0.02）。当考虑到潜在的中介因素，包括心血管疾病和与胰岛素抵抗综合征相关的风险因素时，结果没有明显变化。这些结果表明，糖尿病以及非糖尿病受试者的糖耐量受损和高胰岛素血症与认知障碍有关。
Cognitive impairment is highly prevalent among the elderly. Subjects with disturbed glucose metabolism may be at risk of impaired cognitive function, as these disturbances can influence cognition through atherosclerosis, thrombosis and hypertension, We therefore studied the cross-sectional association of cognitive function with hyperinsulinaemia, impaired glucose tolerance and diabetes mellitus in a population-based cohort of 462 men aged 69 to 89 years. Cognitive function was measured by the 30-point Mini-Mental State Examination. Results were expressed as the rate ratio (95 % confidence interval) of the number of erroneous answers given on the Mini-Mental State Examination by the index compared to the reference group. Compared to subjects with normal glucose tolerance, known diabetic patients had a rate ratio of 1.23 (1.04-1.46), newly-diagnosed diabetic patients of 1.16 (0.91-1.48) and subjects with impaired glucose tolerance of 1.18 (0.98-1.41), after adjustment for confounding due to age, occupation and cigarette smoking (p-trend = 0.01). Non-diabetic subjects in the highest compared to the lowest quartile of the area under the insulin curve had a rate ratio of 1.24 (1.03-1.50), after adjustment for confounding (p-trend = 0.02). The results did not change appreciably when potentially mediating factors, including cardiovascular diseases and risk factors associated with the insulin resistance syndrome, were taken into account. These results suggest that diabetes, as well as impaired glucose tolerance and hyperinsulinaemia in non-diabetic subjects are associated with cognitive impairment.