| Objective: Based on studying the executive function(EF)on type 2 diabetes mellitus with mild cognitive impairment(T2DM-MCI),find the characteristics of executive function and the detect EF impairment(IEF)on T2DM-MCI in early stage.To explore the relative risk factors for direction of intervention at early stage.Methods: Used the Mini Mental State Scale(MMSE)and Montreal cognitive assessment(Mo CA)to test global cognitive function on T2 DM patients who conformed to inclusion and exclusion criterions.Which is included 132 subjects of T2DM-MCI patients and 115 subjects of T2 DM with normal cognitive(T2DM-NC).Besides,the study collected 132 subjects of non diabetic with normal cognition patients as the normal control group(NC).All patients were examined with Stroop color word test(SCWT)and shape trail test(STT).At the same time,the study collected the demographic data and other possible risk factors of subjects,including blood lipid,blood glucose,hypertension,sleep,smoking,drinking and so on.SPSS 22.0 software was used for statistical analysis.Two independent samples t test was used for the normal continuous variable,Mann-Whitney U test was used for non-normal continuous variable,Chi square test or Mann-Whitney U test were used for categorical data analysis.Linear regression analysis and logistic regression analysis were used to adjust and analyze the relative factors.All statistical results were statistically significant with P < 0.05.Results: In STT: There was significant difference between T2DM-MCI and T2DM-NC on time consuming of card A(t=2.685,P=0.008),time consuming of card B(t=2.286,P=0.023).The difference between card A and B on time consuming was no significant differences(t=8.825,P =0.330).There was significant difference between T2DM-NC and NC on time consuming of card B(t=2.288,P=0.023),difference between card A and B(t=2.974,P=0.003).The results were statistically significant after adjusting.The time consuming of card A was no significant differences(t=-0.813,P=0.417).Set shifting factor: It was expressed by time consuming of interference in STT.The score of T2DM-MCI(119.71±24.76 seconds)was higher than that of T2DM-NC(116.65±24.39 seconds)(P<0.05),The results were statistically significant after adjusting.The score of T2DM-NC was higher than that of NC(107.82±22.28 seconds)(P<0.05).In SCWT: There was significant statistical difference between T2DM-MCI and T2DM-NC on time consuming of card B(t=2.403,P=0.017)and card C(t=2.113,P=0.036),the correct number of card C(t=-3.40,P<0.001),difference on correct number between card B and C(t=4.436,P=0.016).The results were statistically significant after adjusting.Other test results were no statistical difference between T2DM-MCI and T2DM-NC.There was no significantly statistical difference in SCWT between T2DM-NC and NC(P > 0.05).Inhibition factor: It was expressed by time consumed and the correct number of interference in SCWT card C and B.The correct number of interference of T2DM-MCI(-3.58±2.87)was lower than that of T2DM-NC(-2.81±2.11),the results were statistically significant after adjusting.There was no significantly statistical difference between T2DM-NC and NC(-2.70±2.06)(P >0.05).Time consumed of interference in SCWT were no statistical difference(P>0.05).After regression analysis,duration of diabetes(OR=0.640(0.381,1.075)),smoking(OR=0.343(0.163,0.720)),sleeping(OR=0.446(0.239,0.832)),(OR=0.594(0.344,1.026))and BMI(OR=0.894(0.805,0.993))were negative correlation with global cognition on T2 DM patients,HDL-C(OR=4.569(1.298,16.084))was a positively correlated factor.Longer duration of diabetes,higher glycosylated hemoglobin(Hb A1c)and older ages were negative correlation with executive function on T2DM-MCI patients,which the longer duration of diabetes(B=-0.980,P=0.012)was negative effects on the inhibition factor,older age(B=0.832,P=0.005)and Hb A1c(B=3.174,P=0.008)were negative effects on the set shifting factor.HDL-C and educational level were positively correlated factor for executive function.Conclusions: 1.The characteristics of IEF on T2DM-MCI patients:(1)The set shifting factor decreased on T2 DM without MCI,and more likely to decline on T2 DM combined with MCI;(2)In the inhibition factor,T2DM-MCI patients tend to sacrifice the correct number to make up for the time consuming.(3)With the decline of global cognitive function,EF decline in more indicators.2.The risk factors of T2DM-MCI include disease duration,sleeping,weight,smoking;risk factors of executive function inlcude age,disease duration,poor glycemic control.HDL-C and education are protective factors for EF.The control of risk factors may be effective intervention in early stage. |
