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CJASN:糖尿病患者白蛋白尿或可预测认知功能减退

2013-09-17 佚名 丁香园

糖尿病与认知障碍风险增加有关。为了探讨基线估算肾小球滤过率(eGFR)正常(每1.73m2大约90ml/min)的糖尿病个体中,3.3年随访期间微血管病变(通过白蛋白尿和eGFR下降判断)是否与认知功能减退有关,来自美国凯撒医疗机构Joshua Barzilay教授及其团队进行了一项研究,该研究发现eGFR正常、相对年轻的糖尿病个体持续性白蛋白尿和进行性白蛋白尿与认


糖尿病与认知障碍风险增加有关。为了探讨基线估算肾小球滤过率(eGFR)正常(每1.73m2大约90ml/min)的糖尿病个体中,3.3年随访期间微血管病变(通过白蛋白尿和eGFR下降判断)是否与认知功能减退有关,来自美国凯撒医疗机构Joshua Barzilay教授及其团队进行了一项研究,该研究发现eGFR正常、相对年轻的糖尿病个体持续性白蛋白尿和进行性白蛋白尿与认知功能的下降相关。该研究结果在线发表在2013年8月29日的Clinical Journal of the American Society of Nephrology 杂志上。【原文阅读】

该研究中,受试者来自控制糖尿病心血管风险行动–糖尿病记忆(ACCORD–MIMD)研究(2977例,平均年龄62.5±5.8岁,从2003年8月至2005年12月期间招募,随访至2009年6月),验证强化血糖控制和标准血糖控制与认知功能的关系。受试者在基线、第20月和第40月接受三种神经生理测试。测试包括信息处理速度、非文字记忆和执行功能。使用混合效应模型评估白蛋白尿和eGFR与每个测试下降百分比的关系。

该研究结果表明,基线和随访期间都有白蛋白尿受试者和基线没有白蛋白尿、随访期间有白蛋白尿受试者的信息处理速度下降百分比高于基线和随访期间没有白蛋白尿的受试者。非文字记忆测试变化的百分比处于临界线。Logistic回归分析中,持续性白蛋白尿和进行性白蛋白尿与信息处理速度得分下降≥5%相关,但与非文字记忆或执行功能操作无关。每年eGFR下降1ml/min/1.73 m2与认知功能测试下降临界相关。

该研究发现,eGFR正常、相对年轻的糖尿病个体持续性白蛋白尿和进行性白蛋白尿与认知功能的下降相关。这些发现没有排除其他因素导致认知功能减退的可能性。

原文阅读

Barzilay JI, Lovato JF, Murray AM, Williamson J, Ismail-Beigi F, Karl D, Papademetriou V, Launer LJ.Albuminuria and Cognitive Decline in People with Diabetes and Normal Renal Function.Clin J Am Soc Nephrol. 2013 Aug 29.

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    2014-01-10 ay2000fy
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    2013-11-15 chenhongpeng
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    2013-09-19 珙桐
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