2型糖尿病患者轻度认知功能障碍的危险因素分析

摘要

Objective To evaluate the degree of cognitive in resident Type 2 Diabetes mellitus(T2DM) from the age of 45 to 75 years and to analyze its related risk factors.Methods According to the MoCA score,the patients were divided into the group of mile cognitive dysfunction(MCI) and the group with normal cognitive function(NMCI).We compared participants with MCI and NMCI using the Inde-pendent t-test for continuous measures andχ2 test for categorical variables.The relations of T2DM and MCI were estimated using Spearman correlation analysis and multiple linear regression analysis.Results The differences in the educational level,HbA1 C,HOMA-islet,HO-MA-IR,25-OH-D had statistical significance.Spearman correlation analysis showed that MoCA scores were negatively correlated with HO-MA-IR(r=-0.60,P<0.001)and HbA1c(r=-0.59,P<0.001),positively correlated with the education-al level(r=0.31,P=0.02),HOMA-islet(C-peptide)(r=0.58,P<0.001)and 25-OH-D (r=0.72,P<0.001).Logistic regression analysis showed that HbA1 C was a risk factor for MCI,but vitamin D was a protective factor for MCI.Conclusion Many risk factors may play a part role in T2DM with MCI.Control of blood glucose and vitamin D supplements can prevent patients for the development of mild cognitive impairment.%目的：通过对80例45～75岁住院2型糖尿病（ T2DM）患者进行认知功能评估，探讨患者轻度认知功能障碍的影响因素。方法应用蒙特利尔认知评估量表（ MoCA量表）测评受试者的认知功能，并以26分为界将研究对象分为轻度认知功能障碍组（ MCI组，47例）、认知功能正常组（ NMCI组，33例），运用t检验或卡方检验、Spearman相关分析以及二分类Logistic逐步回归分析方法探讨T2DM患者轻度认知功能障碍的危险因素。结果相关分析显示，MCI组MoCA量表评分与胰岛素抵抗指数、糖化血红蛋白（HbA1c）呈负相关（分别为r＝－0．60，P＜0．001；r＝－0．59，P＜0．001），与文化程度、胰岛功能指数、维生素D水平呈正相关（r＝0．31，P＝0．02；r＝0．58，P＜0．001；r＝0．72，P＜0．001）；二分类Logistic逐步回归分析，HbA1C是T2DM患者轻度认知功能障碍的危险因素，而血清维生素D是其保护因素。结论 T2DM患者轻度认知功能障碍受多重因素影响，控制血糖及补充维生素D可能预防患者发展为轻度认知功能障碍。