Cognitive efficiency declines over time in adults with Type 1 diabetes: effects of micro- and macrovascular complications
Cognitive efficiency declines over time in adults with Type 1 diabetes: effects of micro- and macrovascular complications
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DOI：
10.1007/s00125-003-1128-2
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发表时间：
2003-07-01
期刊：
影响因子：
8.2
通讯作者：
Orchard, TJ
中科院分区：
文献类型：
--
作者：
Ryan, CM;Geckle, MO;Orchard, TJ
目标/假设。轻度认知功能障碍在成人1型糖尿病患者中并不少见，但其发病机制尚不清楚。此前的横断面研究表明，微血管病变可能会影响大脑的完整性，并导致“中枢神经病变”。为了评估认知能力改变与新的微血管和大血管并发症发生率之间的关系，对103名患有儿童期起病的1型糖尿病的中青年(平均年龄：40岁)进行了长达7年的跟踪调查，并与57名人口统计学上相似的非糖尿病成年人进行了比较。所有受试者在两个场合完成了一系列全面的神经认知测试。糖尿病受试者还接受了重复的医学评估，以诊断临床上重大并发症的发生。与对照组相比，成年糖尿病患者在精神运动效率方面表现出显著的下降；在学习、记忆或解决问题的任务上没有明显的组间差异。在随访期内发生增殖性视网膜病变和自主神经病变预示精神运动速度下降(p
Aims/hypothesis. Mild cognitive dysfunction is not uncommon in adults with Type 1 diabetes, but its pathogenesis remains unclear. Previous cross-sectional studies had suggested that microangiopathy might affect brain integrity and lead to 'central neuropathy.' To assess the relationship between changes in cognitive performance and the incidence of new micro- and macrovascular complications, 103 young and middle-aged adults (mean age: 40 yrs) with childhood-onset Type 1 diabetes were followed over a 7-year period, and were compared to 57 demographically-similar adults without diabetes.Methods. All subjects completed a comprehensive battery of neurocognitive tests on two occasions. Diabetic subjects also received repeated medical assessments to diagnose the onset of clinically significant complications.Results. Relative to control subjects, diabetic adults showed significant declines on measures of psychomotor efficiency; no between-group differences were evident on learning, memory, or problem-solving tasks. The development of proliferative retinopathy and autonomic neuropathy during the follow-up period predicted decline in psychomotor speed (p