摘要
背景2型糖尿病和轻度认知功能障碍(MCI)是社区老年人常见的健康问题,目前缺乏参与社区管理的老年2型糖尿病患者合并MCI的状况及其影响因素研究。目的探究社区管理的老年2型糖尿病患者并发MCI的认知特点及相关影响因素。方法于2022年7—10月,采用系统抽样法选取上海市某社区卫生服务中心在管的≥60岁2型糖尿病患者399例,收集患者的一般人口学资料和健康问题、体格检查及实验室检查结果[空腹血糖(FBG)、总三酰甘油(TG)、总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)、糖化血红蛋白(HbA_(1c))],并采用蒙特利尔认知评估基础量表(Mo CA-B)中文版进行认知功能评估,以是否伴发MCI分为MCI组(n=157)和非MCI组(n=242),采用二分类Logistic回归分析探讨社区管理的老年2型糖尿病患者并发MCI的影响因素。结果社区管理的老年2型糖尿病患者MCI患病率39.3%(157/399)。MCI组执行功能、定向、计算、抽象、延迟记忆、视知觉、命名、注意的异常率高于非MCI组(P<0.05),以延迟记忆受损(92.4%)最常见。两组年龄、婚姻、受教育年限、饮酒、FBG、HbA_(1c)、TC、LDL-C比较,差异有统计学意义(P<0.05);二分类Logistic回归分析结果显示,年龄≥80岁(OR=3.002,95%CI=1.379~6.534)、FBG≥7.0 mmol/L(OR=2.432,95%CI=1.436~4.119)、HbA_(1c)为7%~9%(OR=2.349,95%CI=1.380~3.997)、HbA_(1c)>9%(OR=5.106,95%CI=2.150~12.130)、LDL-C(OR=2.451,95%CI=1.266~4.743)、受教育年限7~12年(OR=0.419,95%CI=0.183~0.960)和>12年(OR=0.243,95%CI=0.086~0.692)是老年2型糖尿病患者并发MCI的影响因素(P<0.05)。结论社区管理的老年2型糖尿病患者MCI患病率较高,存在多认知领域损害,年龄≥80岁、FBG≥7.0 mmol/L、HbA_(1c)为7%~9%、HbA_(1c)>9%、高LDL-C并发MCI风险增加,高受教育年限是社区管理的老年2型糖尿病患者并发MCI的保护性因素,开展早期认知功能障碍筛查,长期血糖控制,降低L
Background Type 2 diabetes mellitus(T2DM)and mild cognitive impairment(MCI)are common health problems in the elderly in the community.Research on the status and influencing factors of MCI in the elderly with T2DM who participate in community management is needed.Objective To explore the cognitive characteristics and related factors of elderly patients with T2DM complicated with MCI under community management.Methods From July to October 2022,a total of 399 patients with type 2 diabetes over 60 years of age in a community health service center in Shanghai were selected by systematic sampling method.General demographic data and health problems,physical examination and laboratory test results,including fasting blood glucose(FBG),total triglyceride(TG),total cholesterol(TC),low density lipoprotein cholesterol(LDL-C),high density lipoprotein cholesterol(HDL-C),glycosylated hemoglobin(HbA_(1c))were collected.They were divided into MCI group(n=157)and non-MCI group(n=242)according to the presence or absence of MCI.Binary Logistic regression analysis was used to explore the influencing factors of MCI in elderly patients with type 2 diabetes under community management.Results The prevalence of MCI was 39.3%(157/399)in community-managed elderly patients with type 2 diabetes.The comparison of cognitive characteristics between MCI group and non-MCI group showed that the MCI group had higher abnormality rates in executive function,orientation,calculation,abstraction,delayed memory,visual perception,naming and attention than the non-MCI group,and the differences were statistically significant(P<0.05),and delayed memory impairment(92.4%)was the most common.There were significant differences in age,marriage,years of education,drinking,FBG,HbA_(1c),TC,LDL-C between the two groups(P<0.05);Binary Logistic regression analysis showed that age≥80 years old(OR=3.002,95%CI=1.379-6.534),FBG≥7.0 mmol/L(OR=2.432,95%CI=1.436-4.119),HbA_(1c)7%-9%(OR=2.349,95%CI=1.380-3.997),HbA_(1c)>9%(OR=5.106,95%CI=2.150-12.130),LDL-C(OR=2.451,95%CI=1.
作者
马佳
张敏珏
张韶伟
于海燕
陈慎
古丽拜尔·马木提
洪娟
陆媛
MA Jia;ZHANG Minjue;ZHANG Shaowei;YU Haiyan;CHEN Shen;Gulibaier MAMUTI;HONG Juan;LU Yuan(Dinghai Community Health Service Center,Yangpu District,Shanghai 200090,China;Department of General Medicine,Yangpu Hospital,Tongji University,Shanghai 200090,China)
出处
《中国全科医学》
CAS
北大核心
2024年第16期1984-1989,共6页
Chinese General Practice
基金
上海市卫健委资助项目(20190495)
上海市杨浦区科学技术委员会杨浦区卫生健康委员会科研项目(YPM202116)。
