Cognitive ability and brain structure in type 1 diabetes - Relation to microangiopathy and preceding severe hypoglycemia
Cognitive ability and brain structure in type 1 diabetes - Relation to microangiopathy and preceding severe hypoglycemia
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DOI：
10.2337/diabetes.52.1.149
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发表时间：
2003-01-01
期刊：
影响因子：
7.7
通讯作者：
Frier, BM
中科院分区：
文献类型：
--
作者：
Ferguson, SC;Blane, A;Frier, BM
1型糖尿病与慢性高血糖和间歇性严重低血糖有关。糖尿病的这些后果对大脑的长期影响尚不清楚。在这项研究中，在对74名1型糖尿病年轻人的横断面评估中，研究了既往严重低血糖病史和背景视网膜病变与认知能力(神经心理测试组合)和脑结构(磁共振成像)的关系。参与者因严重低血糖暴露和糖尿病视网膜病变程度而不同，没有人有既往的神经心理病理。严重低血糖不影响认知能力或脑结构。背景：糖尿病视网膜病变与基底节局灶性白质高信号相关(校正年龄后为33.3vs.4.7%，P=0.005)和明显的认知缺陷，影响液体智力(P=0.008，Eta(2)=0.14)，信息处理(P=0.001，Eta(2)=0.22)，以及注意力和注意力能力(P=0.03，Eta(2)=0.09)。总而言之，在接受检查的糖尿病期间，青年1型糖尿病患者仅反复暴露于严重低血糖并不会对大脑结构或功能产生有害影响。慢性高血糖(由背景糖尿病视网膜病变的存在推断)可能会影响大脑结构和功能。
Type 1 diabetes is associated with chronic hyperglycemia and exposure to intermittent severe hypoglycemia. The long-term cerebral effects of these consequences of diabetes are ill defined. In this study, the history of preceding severe hypoglycemia and the presence of background retinopathy were examined in relation to cognitive ability (neuropsychological test battery) and brain structure (magnetic resonance imaging) in a cross-sectional evaluation of 74 young people with type 1 diabetes. Participants differed by their severe hypoglycemia exposure and degree of diabetic retinopathy and none had previous neuropsychological pathology. Severe hypoglycemia did not influence cognitive ability or brain structure. Background diabetic retinopathy was associated with small focal white-matter hyperintensities in the basal ganglia (33.3 vs. 4.7%, after correction for age, P = 0.005) and significant cognitive disadvantage, affecting fluid intelligence (P = 0.008, Eta(2) = 0.14), information processing (P = 0.001, Eta(2) = 0.22), and attention and concentration ability (P = 0.03, Eta(2) = 0.09). In conclusion, recurrent exposure to severe hypoglycemia alone in young people with type 1 diabetes had no detrimental impact on brain structure or function over the duration of diabetes examined. Chronic hyperglycemia (inferred by the presence of background diabetic retinopathy) may affect brain structure and function.