糖化血红蛋白变异性与老年2型糖尿病病人认知功能障碍的相关性分析

doi:10.3969/j.issn.1003-9198.2024.09.016

摘要/Abstract

摘要： 目的探讨老年2型糖尿病病人HbA1c水平及变异性与认知功能障碍的相关性。方法回顾性选取在江苏省省级机关医院糖尿病中心建档并在建档后24个月内HbA1c测量次数≥3次的老年2型糖尿病病人477例。依据MMSE得分将病人分为认知功能正常组(332例)和认知功能障碍组(145例)。根据病人的HbA1c测量值计算HbA1c平均值(HbA1c-mean)和HbA1c变异指标,包括HbA1c标准差(HbA1c-SD)、HbA1c变异系数(HbA1c-CV)、校正测量次数的HbA1c标准差(Adj-HbA1c-SD)。分析HbA1c水平及变异性与认知功能障碍的相关性。结果 (1)认知功能障碍组HbA1c-mean和HbA1c变异指标均高于认知功能正常组(P＜0.05)。(2)Logistic回归分析结果显示,HbA1c-mean和HbA1c变异指标均为认知功能障碍发生的独立危险因素(P＜0.05)。(3)控制混杂因素后,限制性立方样条分析结果显示,HbA1c-mean与认知功能障碍发病呈线性剂量-反应关系,HbA1c-SD、HbA1c-CV、Adj-HbA1c-SD与认知功能障碍发病呈非线性剂量-反应关系。结论 HbA1c变异性与老年2型糖尿病认知功能障碍独立相关,临床上应予以关注。

关键词: 糖化血红蛋白变异性, 2型糖尿病, 认知功能障碍, 老年人

Abstract: Objective To evaluate the correlation of the level and variability of glycosylated hemoglobin (HbA1c) with cognitive dysfunction in the elderly patients with type 2 diabetes mellitus (T2DM). Methods A total of 477 elderly patients with T2DM were retrospectively selected from the Diabetes Center of Jiangsu Province Official Hospital who received more than 3 times of glycosylated hemoglobin measurement within 24 months.According to the score of Mini-Mental Status Exam (MMSE), the patients were divided into normal cognitive function group (332 cases) and cognitive dysfunction group (145 cases).Based on the levels of HbA1c, HbA1c-mean and HbA1c variation indicators, including HbA1c standard deviation(HbA1c-SD), HbA1c coefficient of variation (HbA1c-CV), HbA1c standard deviation corrected for measurement frequency (Adj HbA1c-SD) were calculated.The correlation of HbA1c level and variability with cognitive impairment was analyzed. Results The levels of HbA1c-mean and the HbA1c variation indicators in cognitive dysfunction group were significantly higher than those in normal cognitive function group (P＜0.05).Logistic regression analysis showed that HbA1c-mean and the variation indicators of HbA1c were independent risk factors for the occurrence of cognitive dysfunction (P＜0.05).After controlling confounding factors, the results of restricted cubic spline analysis showed that there was a linear dose-response relationship between the level of HbA1c-mean and cognitive impairment, and there was a nonlinear dose-response relationship between HbA1c-SD, HbA1c-CV,Adj-HbA1c-SD and cognitive impairment. Conclusions HbA1c variability is independently associated with cognitive impairment in the elderly patients with T2DM and it should be given attention in clinical practice.

Key words: glycated hemoglobin variability, type 2 diabetes mellitus, cognitive impairment, aged

中图分类号:

R587.2

戴静, 崔焱. 糖化血红蛋白变异性与老年2型糖尿病病人认知功能障碍的相关性分析[J]. 实用老年医学, 2024, 38(9): 931-935.

DAI Jing, CUI Yan. Correlation between glycosylated hemoglobin variability and cognitive dysfunction in elderly patients with type 2 diabetes mellitus[J]. Practical Geriatrics, 2024, 38(9): 931-935.

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