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目的观察2型糖尿病(T2DM)老年患者HbA1c对其认知功能纵向变化速度的影响。方法采用前瞻性病例对照研究,排除死亡病例,共纳入82例T2DM患者为T2DM组及90例体检者为对照组。对两组基线认知水平与临床状况进行评估。随访期限2年,评估简易智能状态检查量表(MMSE)、词语学习、延迟回忆、动物流畅性及符号数字转换测验。采用随机效应模型分析T2DM对基线认知功能及认知功能变化速度的影响。结果与对照组相比,T2DM组高血压比例升高,词语学习、动物流畅性、符号数字转换评分降低(P<0.05)。T2DM组MMSE、词语学习及延迟回忆、动物流畅性及符号数字转换评分的下降速度在调整高血压的影响后,较对照组加快(P<0.05)。结论 T2DM患者的认知功能减退速度较HbA1c正常人群明显加快。
Objective To investigate the effect of HbA1c on the longitudinal changes of cognitive function in elderly patients with type 2 diabetes mellitus (T2DM). Methods A prospective case-control study was conducted to exclude deaths. A total of 82 T2DM patients and 90 healthy controls were enrolled as control group. Two groups of baseline cognitive level and clinical status were evaluated. The follow-up period was 2 years, and the MMSE, word learning, delayed recall, animal fluency and sign-to-symbol conversion test were evaluated. Random effects model was used to analyze the effect of T2DM on baseline cognitive function and cognitive function change rate. Results Compared with the control group, the proportion of hypertension in T2DM group was significantly lower than that in control group (P <0.05). The decreasing speed of MMSE, word learning and delayed recall, animal fluency and symbolic digit conversion score of T2DM group was faster than that of control group after adjusting for the influence of hypertension (P <0.05). Conclusions The rate of cognitive decline in patients with T2DM is significantly faster than that in HbA1c normal subjects.