A Study About The Risk Factors Of Type2Diabetes Mellitus With Mild Cognitive Impairment

ObjectiveTo investigate the risk factors of diabetes mellitus with mild cognitive impairment for possible diagnosis and intervention in early stage of dementia.MethodsBased on the neuropsychological evaluation of cognitive function, a randomly selected sample of62type2diabetes subjects from department of geriatrics in our hospital were divided into two groups:MCI group and normal cognition (NC) group. Participants who did not receive a diagnosis of MCI or dementia were considered cognitively normal (controls) in accordance with published criteria. Date of birth, sex, educational status, blood pressure, duration of diabetes and complications were assessed by interview and confirmed from the medical records. Biochemical measurements including HbAlc、IMT、TC、TG、LDL-C、FPG and Fins were measured from the fresh samples from the baseline fasting blood draw using standard methods. All subjects underwent carotid ultrasound evaluation for intimal-medial thickness. We compared participants with and without MCI using the Independent t-test for continuous measures and a X2test for categorical variables. The relations of DM and MCI were estimated using multiple linear stepwise regression.Results1. The diabetic patients with MCI showed the higher levels of HbAlc, TC, TG, LDL-C, HOMA-IR and IMT except the level of HDL-C which was lower compared with NC(P<0.01). The incidence of DR in MCI was higher than that in NC cases.2. A multiple linear regression model was developed by stepwise method, with the score of MoCA as response variable. IMT, HOMA-IR and TC were closely associated with the cognitive scores of MoCA, and the standardized regression coefficients were0.335,0.408,0.305respectively. Coefficient of determination suggested that the three independent variables could explain76.7%variation of MoCA, indicating that the model fit the data well.Conclusions1. Vascular lesions, insulin resistance, blood glucose and lipids metabolic disorder in diabetic patients with MCI are more serious than those with normal cognitive function, may increase the risk of cognitive dysfunction.2. IMT, HOMA-IR and HDL-C are the main risk factors of MoCA score. With the increase of IMT, HOMA-IR and the reduction of HDL-C, the cognitive function test score lower, suggesting that IMT, HOMA-IR and HDL-C are predictors of cognitive function, and early detection of them can assist in making the diagnosis of MCI. Early interventions to improve the above indicators, may slow the progress of cognitive dicline, to prevent the occurrence of clinical dementia.