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目的探讨2型糖尿病(T2DM)患者认知功能水平与血糖(Glu)、糖化血红蛋白(HbA1c)、胰岛素抵抗指数(HOMA-IR)、胰岛素(Ins)水平等代谢指标之间的关系。方法选取50例T2DM患者为T2DM组,47例年龄、性别构成比、文化程度、职业等方面相匹配的健康人作为对照组。应用多维度神经认知量表(连线测验、MoCA量表、数字广度测试、健康调查表)分别对两组人群进行认知功能检测,并将T2DM患者的认知功能评分与Glu、HbA1c、HOMA-IR、Ins水平进行相关性分析。结果 T2DM组的发散思维能力、短时记忆、空间与执行能力、注意能力、语言、抽象、延迟回忆、定向能力均低于对照组(P<0.05);焦虑、抑郁情绪重于对照组(P<0.05)。多因素线性逐步回归分析结果显示,在年龄、病程、教育程度、吸烟指数、血压、血脂作为混杂因素校正的情况下,Glu、HbA1c、HOMA-IR、体重指数(BMI)、Ins是导致认知功能评分下降的危险因素(P<0.05)。结论 T2DM患者认知功能减退,且Glu、HbA1c、HOMA-IR、BMI、Ins水平与认知功能减退呈明显的正相关性。
Objective To investigate the relationship between cognitive function and the metabolic parameters such as Glu, HbA1c, HOMA-IR and Ins in patients with type 2 diabetes mellitus (T2DM). Methods Fifty T2DM patients with T2DM were selected as healthy subjects, and 47 healthy subjects with matched age, sex ratio, educational level and occupation were selected as control group. Cognitive function tests were performed on two groups using the multidimensional neurocognitive scale (connection test, MoCA scale, digital breadth test, and health questionnaire). The cognitive function scores of T2DM patients were compared with those of Glu, HbA1c, HOMA-IR, Ins level correlation analysis. Results T2DM group had less divergent thinking ability, short-term memory, spatial and executive ability, attention ability, language, abstraction, delayed recall and orientation ability than those of the control group (P <0.05); anxiety and depression were heavier in the T2DM group than in the control group <0.05). The results of multivariate linear stepwise regression analysis showed that Glu, HbA1c, HOMA-IR, body mass index (BMI) and Ins were the main factors that led to cognitive changes in the age, disease course, educational level, smoking index, blood pressure and blood lipid as confounding factors Functional factors decreased risk factors (P <0.05). Conclusion The cognitive function of T2DM patients is diminished, and the levels of Glu, HbA1c, HOMA-IR, BMI and Ins are positively correlated with cognitive decline.