老年2型糖尿病患者轻度认知功能障碍与胰岛素抵抗的关系研究

目的探讨老年2型糖尿病患者轻度认知功能障碍(MCI)与胰岛素抵抗的关系。方法选择老年2型糖尿病患者合并MCI患者86例为研究组,匹配无MCI的2型糖尿病患者86例为对照组,检测比较空腹血糖(FPG)、总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)、糖化血红蛋白(HbA1c)、空腹胰岛素(FINS)等指标,评估胰岛素抵抗指数(HOMA-IR),并分为胰岛素抵抗(IR)组和非IR组,分析影响患者MCI发生的因素。结果研究组FPG、LDL-C、FINS、HbA1c、HOMA-IR显著高于对照组。IR组MMSE评分、CMS评分显著低于非IR组,CMS评分中的各项目也显著低于非IR组。结论 HOMA-IR、FINS、FPG、LDL-C是老年2型糖尿病患者MCI发生的重要独立影响因素。IR是老年2型糖尿病患者MCI发生的重要影响因素,应采取治疗措施,降低其认知功能障碍的发生率。

Study on relationship between mild cognitive dysfunction and insulin resistance in elderly patients with type 2 diabetes

Objective To explore the relationship between mild cognitive impairment（ MCI）and insulin resistance in elderly patients with type 2 diabetes. Methods A total of 86 elderly patients with type 2 diabetes and MCI were allocated in study group,and 86 patients with type 2 diabetes without MCI were enrolled in control group. The levels of fasting glucose（FPG）,total cholesterol（TC）,low - density lipoprotein cholesterol（LDL - C）,glycosylated hemoglobin（HbA1c）,fasting insulin（FINS）and other indicators were detected. In accordance with the assessment of insulin resistance index（HOMA - IR）,they were divided into IR group and non - IR group. The factors affecting the occurrence of MCI had been analyzed. Results Levels of FPG,LDL - C,FINS,HbA1c and HOMA - IR were significantly higher in study group. MMSE scores and CMS scores in patients of IR group were significantly lower than those of patients in non - IR group,and CMS scores in patients of IR group were also significantly lower than those of patients in non - IR group. Levels of HOMA - IR,FINS,FPG and LDL - C were important independent risk factors for MCI in elderly patients with type 2 diabetes. Conclusion Insulin resistance is an important factor in elderly patients with type 2 diabetes associated with MCI. Measures for treatment of ths condition should be taken in order to reduce the incidence of cognitive dysfunction in patients with type 2 diabetes.