2020 年第 3 期 第 15 卷

老年2型糖尿病合并代谢综合征患者认知障碍的危险因素分析

Risk factors of cognitive impairment in elderly type 2 diabetic patients with metabolism syndrome

作者：孙丽娜修双玲王立穆志静韩青

英文作者：

单位：首都医科大学宣武医院内分泌科，北京100053

英文单位：

关键词：2型糖尿病；代谢综合征；认知障碍；握力

英文关键词：

• 摘要：

• 【摘要】目的    探讨老年2型糖尿病合并代谢综合征（MS）患者认知障碍的危险因素。方法    选取2018年3—12月首都医科大学宣武医院收治的老年2型糖尿病合并MS患者150例，其中蒙特利尔认知评估量表（MoCA）评分≥26分76例（认知功能正常组），<26分74例（认知障碍组）。比较2组患者一般资料、身体测量指标、实验室指标、肌肉质量及功能指标水平，分析MoCA评分与各变量的相关性和老年2型糖尿病合并MS患者认知障碍的危险因素。结果    认知障碍组年龄显著高于认知功能正常组［(68±8)岁比（66±7）岁］，高密度脂蛋白胆固醇、估算肾小球滤过率（eGFR）、握力低于认知功能正常组［(1.04±0.25)mmol/L比(1.15±0.31)mmol/L、(85±29)ml/（min·1.73 m2）比(97±29)ml/（min·1.73 m2）、(29±10)kg比(33±9)kg］,差异均有统计学意义（均P＜0.05）。MoCA评分与年龄呈显著负相关（r=-0.337,P＜0.001），与高密度脂蛋白胆固醇、eGFR、四肢骨骼肌质量指数、握力、步速呈显著正相关（均P＜0.05）。以MoCA评分为因变量，以年龄、高密度脂蛋白胆固醇、四肢骨骼肌质量指数、握力、eGFR、步速为自变量，进行多元线性回归分析结果表明，握力及eGFR为影响中老年2型糖尿病合并MS患者认知功能的危险因素（均P＜0.05）。结论    低握力和低eGFR是老年2型糖尿病合并MS患者认知障碍的危险因素。

  
  

• 【Abstract】Objective    To investigate the risk factors of cognitive impairment in elderly patients with type 2 diabetes and metabolic syndrome（MS）. Methods    A total of 150 elderly type 2 diabetic patients with MS admitted to Xuanwu Hospital, Capital Medical University from March to December 2018 were enrolled. They were divided into normal cognitive function group［Montreal Cognitive Assessment(MoCA) score≥26, 76 cases］ and cognitive impairment group（MoCA score<26, 74 cases）. General clinical data, physical measurements, laboratory results, muscle mass and functional indicators were recorded. Relation of MoCA score with above variables and risk factors of cognitive impairment were analyzed. Results    Patients with cognitive impairment had higher age［(68±8)years vs （66±7）years］, lower high-density lipoprotein cholesterol（HDL-C）, lower estimated glomerular filtration rate（eGFR） and grip strength［(1.04±0.25)mmol/L vs (1.15±0.31)mmol/L, (85±29)ml/（min·1.73 m2） vs (97±29)ml/（min·1.73 m2）, (29±10)kg vs (33±9)kg］ compared with the normal cognitive function group(all P<0.05). MoCA score was negatively correlated with age(r=-0.337, P<0.001) and positively correlated with HDL-C, eGFR, appendicular skeletal muscle mass index（ASMI）, grip strength and walking speed(all P<0.05). Multivariate linear regression analysis showed that grip strength and eGFR were risk factors of cognitive impairment(all P<0.05). Conclusion    Low grip strength and low eGFR are risk factors of cognitive impairment in elderly type 2 diabetic patients with MS.