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Diabetes Care:酮症酸中毒对新发或既往诊断1型糖尿病患儿认知功能的影响

2020-09-23 MedSci原创 MedSci原创

单次DKA发作与1型糖尿病诊断后记忆力轻度下降有关。在既往有糖尿病的儿童中可检测到IQ较大幅度的下降,这表明在慢性高血糖症儿童中,DKA的作用可能会加剧。

近日,糖尿病领域权威杂志Diabetes Care上发表了一篇研究文章,这项研究旨在评估单次糖尿病酮症酸中毒(DKA)发作是否与新诊断1型糖尿病儿童认知能力下降有关,考虑了血糖控制和其他相关因素的变化后,在既往被诊断的儿童情况是否也如此。

研究人员前瞻性招募了758名6-18岁的儿童,他们参加了一项评估静脉输液方案治疗DKA的随机多站点临床试验。430名儿童为中度/重度DKA,328名儿童为轻度DKA。该研究中共有392名DKA儿童为1型糖尿病新发病例,其余的患儿为既往被诊断的糖尿病患者。神经认知评估在DKA发作后2–6个月内进行。研究人员还纳入了376名1型糖尿病但没有DKA发作的儿童作为对照者。

在所有患者中,中度/重度DKA与较低的智商(IQ)(β=-0.12,P<0.001)、条目-颜色回忆(β=-0.08,P=0.010)和前向数字跨度(β=-0.06,P=0.04)相关。在新诊断的患者中,中度/重度DKA与较低的条目-颜色回忆有关(β=-0.08,P=0.04)。调整低血糖、糖尿病持续时间和社会经济状况之后,既往诊断的患者DKA反复发作和较高的HbA1c与较低的智商(分别为β=-0.10和β=-0.09,P<0.01)相关,而较高的HbA1c与较低的项目颜色记忆相关(β=-0.10,P=0.007)。

由此可见,单次DKA发作与1型糖尿病诊断后记忆力轻度下降有关。在既往有糖尿病的儿童中可检测到IQ较大幅度的下降,这表明在慢性高血糖症儿童中,DKA的作用可能会加剧。

原始出处:

Simona Ghetti,et al.Cognitive Function Following Diabetic Ketoacidosis in Children With New-Onset or Previously Diagnosed Type 1 Diabetes.Diabetes care.2020.https://doi.org/10.2337/dc20-0187

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  5. 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ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1043333, encodeId=2f0710433338b, content=谢谢MedSci提供最新的资讯, beContent=null, objectType=article, channel=null, level=null, likeNumber=93, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=misszhang, createdTime=Wed Sep 23 22:12:28 CST 2020, time=2020-09-23, status=1, ipAttribution=)]
  6. 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  7. 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content=<a href='/topic/show?id=ecbb9553661' target=_blank style='color:#2F92EE;'>#酮症酸中毒#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=84, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=95536, encryptionId=ecbb9553661, topicName=酮症酸中毒)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=346311, createdName=wgsun, createdTime=Fri Sep 25 10:12:28 CST 2020, time=2020-09-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=887867, encodeId=278d88e86762, content=一型糖尿病的病程长,并发症出现早,影响生活, beContent=null, objectType=article, channel=null, level=null, likeNumber=128, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20200925/4c573fa4d4584e158c9c5d8c8c12eb17/164193dac022418d9259695640b4e1bd.jpg, createdBy=a0ec2056748, createdName=1571ecfcf9m, createdTime=Thu Sep 24 09:44:29 CST 2020, time=2020-09-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1043333, encodeId=2f0710433338b, content=谢谢MedSci提供最新的资讯, beContent=null, objectType=article, channel=null, level=null, likeNumber=93, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=misszhang, createdTime=Wed Sep 23 22:12:28 CST 2020, time=2020-09-23, status=1, ipAttribution=)]
    2020-09-25 zhaojie88
  8. 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  9. 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ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1043333, encodeId=2f0710433338b, content=谢谢MedSci提供最新的资讯, beContent=null, objectType=article, channel=null, level=null, likeNumber=93, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=misszhang, createdTime=Wed Sep 23 22:12:28 CST 2020, time=2020-09-23, status=1, ipAttribution=)]
    2020-09-24 1571ecfcf9m

    一型糖尿病的病程长,并发症出现早,影响生活

    0

  10. 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    2020-09-23 misszhang

    谢谢MedSci提供最新的资讯

    0

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