The Study Of Cognitive Impairment And Influencing Factors In Patients With Type 2 Diabetic Nephropathy

BackgroundThe patients with diabetic nephropathy are more and more with the expansion of diabetic patients worldwide. It accounts for a large proportion in the chronic kidney disease. A large proportion of it is the type 2 diabetic nephropathy. From 2009-2012, the incidence of type 2 diabetic nephropathy was 30%-50% in the community residents with type 2 diabetes mellitus in our country. With the growing population aging in China, the number of people with cognitive impairment and dementia is increasing significantly. Mild cognitive impairment is a stage between normal aging and dementia. It is reversible. More and more researchers focus on it. Studies have shown that the combination of cognitive impairment is common in the patients with CKD. More research will be needed to study the status of cognitive function in people with diabetic nephropathy and the influencing factors.ObjectivesTo investigate the cognitive function and look for influencing factors of MCI in patients with type 2 diabetic nephropathy through the collection and analysis of the clinical data.MethodsThe study involved 135 participants aged from 50-80 years old. They were recruited from General Hospital of An Gang in this cross-sectional study. The study used Chinese version of Montreal Cognitive Assessment to assess the cognitive function. The participants with type 2 diabetic nephropathy were assigned into two groups:normal cognition group(NC)and cognitive impairment group(CI) in accordance with the published criteria. Collected all the patients’age, blood pressure, body mass index and biochemical measurements including glycosylated hemoglobin, serum creatinine, C reaction protein and Urinary albumin excretion rate. The glomerular filtration rate was estimated by modified MDRD equation. The clinical date were analyzed by t test and logistic regression analysis.Results1135 participants were sampled into the study. In accordance with the classification standard of cognitive impairment, there were 79 patients(58.5%) with cognitive impairment (MoCAscore<26).2 Results of the T test:Age, BMI and DBP between NC group and CI group had no significant statistical difference(F>0.05). SBP, HbA1C, CRP, eGFR and UAER between the two groups had significant statistical difference (P<0.05).3 Results of logistic regression analysis:SBP, CRP, UAER, HbA1C and eGFR were the main influencing factors (P<0.05). Among these factors, eGFR was a protective one, Odds ratio was less than 1.Conclusions1 The combination of cognitive impairment was common in the patients with type 2 diabetic nephropathy. SBP, CRP, UAER, HbA1C and eGFR were the main influencing factors. SBP, CRP, UAER and HbA1C were the risk factors and eGFR was a protective factor. Cognitive impairment associated with the deterioration of renal function.2 There were many factors related to the cognitive function of the patients with type 2 diabetic nephropathy. It was appropriate to take intervention measures to deal with these influencing factors.