2型糖尿病对主观认知下降患者认知功能及海马结构的影响

关键词：主观认知下降  糖尿病  海马  海马亚区  执行功能  注意力

Keywords:subjective cognitive decline  type 2 diabetes  hippocampus  hippocampal subfields  executive function  attention

摘要：

      摘要 目的：探讨2型糖尿病（type 2 diabetes mellitus，T2DM）疾病状态对主观认知下降（subjective cognitive decline， SCD）患者认知功能的影响，并基于海马结构特征探讨可能机制。 方法：招募福建省福州市社区内自愿参加且符合要求的SCD受试者，按照T2DM疾病状态分为合并T2DM的SCD患者和不伴T2DM的SCD患者。比较不同糖尿病疾病状态对SCD患者认知功能表现评分、海马体积、海马亚区体积及旁海马表面积的影响，并将具有显著差异的认知功能表现评分与海马体积、海马亚区体积及旁海马表面积进行相关性分析。 结果：与不伴T2DM的SCD患者相比，合并T2DM的SCD患者的Stroop促进效应（SFE）反应时更长、SFE正确数更少，Go/No go错误数更多，分散性注意力视觉反应时更长，差异有显著性意义（P＜0.05）。磁共振数据分析发现合并T2DM的SCD患者的左侧海马亚区海马伞的体积和旁海马表面积较不伴T2DM的SCD患者显著减小。相关性分析结果显示SCD患者旁海马表面积与SFE正确数显著正相关（P＜0.001）。 结论：T2DM疾病状态加重SCD患者Stroop促进效应、执行抑制控制功能和视觉分散性注意力认知加工领域认知功能损害，且可能与海马系统部分脑区灰质结构萎缩有关。

Abstract:

      Abstract Objective：To investigate the effect of type 2 diabetes mellitus（T2DM） disease status on cognitive function in patients with subjective cognitive decline （SCD）， and to explore possible mechanisms based on the structural features of the hippocampus. Method：According to their T2DM disease status, voluntary and eligible SCD subjects in the community of Fuzhou city， Fujian province were recruited and divided into SCD patients with T2DM and SCD patients without T2DM. The effects of different T2DM disease status on cognitive performance scores， hippocampal volume， hippocampal subregion volume and parahippocampal surface area in patients with SCD were compared, and the correlation analysis was performed between the significantly different cognitive performance scores and the hippocampal volume， hippocampal subregion volume and parahippocampal surface area. Result：Compared with SCD patients without T2DM， SCD patients with T2DM had a longer Stroop facilitation effect（SFE） response time， fewer SFE correct numbers， more Go/No go errors， and distracted visual response time was longer. The difference was statistically significant （P<0.05）. Analysis of MRI data showed that the volume and parahippocampal surface area of the left hippocampal subregion of SCD patients with T2DM were significantly lower than those of SCD patients without T2DM. The results of correlation analysis showed that the parahippocampal surface area of SCD patients was significantly positively correlated with the correct number of SFE （P<0.001）. Conclusion：T2DM aggravates cognitive impairment in Stroop facilitation effect， executive inhibitory control function， and cognitive processing domains of visual distraction in SCD patients， and may be related to the atrophy of gray matter structure in some brain regions of the hippocampus.