Biomarkers of renal function and cognitive impairment in patients with diabetes.
Biomarkers of renal function and cognitive impairment in patients with diabetes.
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DOI：
10.2337/dc11-0186
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发表时间：
2011-08
期刊：
影响因子：
16.2
通讯作者：
Action to Control Cardiovascular Risk in Diabetes Memory in Diabetes (ACCORD-MIND) Substudy Investigators
中科院分区：
文献类型：
--
作者：
Murray AM;Barzilay JI;Lovato JF;Williamson JD;Miller ME;Marcovina S;Launer LJ;Action to Control Cardiovascular Risk in Diabetes Memory in Diabetes (ACCORD-MIND) Substudy Investigators
在非糖尿病成人研究中发现肾脏疾病与认知功能障碍相关。我们在糖尿病记忆控制心血管风险行动（ACCORD-MIND）研究中检查了三项肾功能指标与四项认知功能指标之间的横截面关系。估计肾小球滤过率（eGFR）<60 mL/min/1.73 m2（n = 2，968），白蛋白/肌酐比值（ACR）≥30 μg/mg（n = 2，957），和胱抑素C水平>1.0 mg/L（n = 532），在简易精神状态检查、雷伊听觉语言学习测试（RAVLT）上的表现为三分位数，采用数字符号替代测验（DSST）和Stroop测验进行执行功能测试。在校正的logistic回归模型中，与RAVLT上最高的两个三分位数相比，ACR ≥30 μg/mg与最低三分位数的性能相关（比值比1.30，95%CI 1.09-1.56，P = 0.006），相当于老化3.6年，并且在DSST上（1.47，1.20-1.80，P = 0.001），相当于老化3.7年。在校正模型中，胱抑素C >1.0 mg/L与DSST（1.81，0.93-3.55，P = 0.08）和Stroop（1.78，0.97-3.23，P = 0.06）上的最低三分位数呈边界相关。eGFR与任何认知表现指标无关。在HbA 1c>7.5%的心血管疾病高风险糖尿病患者中，认知功能下降与肾脏疾病相关，这是通过ACR（微血管内皮病理学指标）和cystatin C（eGFR标志物）测量的。
Kidney disease is associated with cognitive impairment in studies of nondiabetic adults. We examined the cross-sectional relation between three measures of renal function and performance on four measures of cognitive function in the Action to Control Cardiovascular Risk in Diabetes Memory in Diabetes (ACCORD-MIND) study. The relationships among estimated glomerular filtration rate (eGFR) <60 mL/min/1.73 m2 (n = 2,968), albumin/creatinine ratio (ACR) ≥30 μg/mg (n = 2,957), and cystatin C level >1.0 mg/L (n = 532) with tertile of performance on the Mini-Mental State Examination, Rey Auditory Verbal Learning Test (RAVLT), Digit Symbol Substitution Test (DSST), and Stroop Test of executive function were measured. In adjusted logistic regression models, ACR ≥30 μg/mg was associated with performance in the lowest tertile, compared with the highest two tertiles, on the RAVLT (odds ratio 1.30, 95% CI 1.09–1.56, P = 0.006), equivalent to 3.6 years of aging, and on the DSST (1.47, 1.20–1.80, P = 0.001), equivalent to 3.7 years of aging. Cystatin C >1.0 mg/L was borderline associated with the lowest tertile on the DSST (1.81, 0.93–3.55, P = 0.08) and Stroop (1.78, 0.97–3.23, P = 0.06) in adjusted models. eGFR was not associated with any measure of cognitive performance. In diabetic people with HbA1c >7.5% at high risk for cardiovascular disease, decreased cognitive function was associated with kidney disease as measured by ACR, a measure of microvascular endothelial pathology, and cystatin C, a marker of eGFR.
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影响因子：
4.4
作者：
Knopman, David S.;Mosley, Thomas H., Jr.;Turner, Stephen T.
通讯作者：
Turner, Stephen T.
影响因子：
8.3
作者：
Wardlaw, JM;Sandercock, PAG;Starr, J
通讯作者：
Starr, J
影响因子：
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作者：
Petersen, Ronald C.;Roberts, Rosebud O.;Knopman, David S.;Boeve, Bradley F.;Geda, Yonas E.;Ivnik, Robcrt J.;Smith, Glenn E.;Jack, Clifford R., Jr.
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Jack, Clifford R., Jr.
影响因子：
6
作者：
Deng, A;Irizarry, MC;Rebeck, GW
通讯作者：
Rebeck, GW
影响因子：
13.2
作者：
Barzilay, Joshua I.;Fitzpatrick, Annette L.;Kuller, Lewis H.
通讯作者：
Kuller, Lewis H.