1型糖尿病对儿童认知功能的影响

Cognitive function in children with type 1 diabetes

摘要:

目的：研究1型糖尿病患儿认知功能变化，并探讨其可能的影响因素。方法：选择年龄6~16岁且病程≥1年的32例1型糖尿病患儿为研究对象，采用中国韦氏儿童智力量表对其认知功能进行研究和分析，并应用多元回归分析法探讨认知功能的影响因素。同性别、同年龄健康儿童32例作为对照组。结果：糖尿病组言语智商显著低于对照组（97±15 vs 118±13，P＜0.01），总智商亦显著低于对照组（99±15 vs 113±12，P＜0.01）。在分测验中，糖尿病组的言语量表中的知识、分类、领悟、算术、词汇量表分低于对照组，差异均有统计学意义（P＜0.01）。多元回归分析显示糖尿病儿童的糖化血红蛋白与总智商、言语智商及操作智商呈显著负相关（分别r=-5.64、-7.29、-3.00；均P＜0.05）。结论：1型糖尿病可能对患儿言语智商产生影响，进而影响患儿总智商水平。糖化血红蛋白可能为影响糖尿病患儿认知功能的独立危险因素。

Abstract:

OBJECTIVE: To study the changes in cognitive function of children with type 1 diabetes and explore the possible factors influencing cognitive function. METHODS: Thirty-two children with type 1 diabetes (disease course equal to or more than one year) and aged from 6 to 16 years, were enrolled in this study. Cognitive function was evaluated by the Chinese Wechsler Intelligence Scale. Factors influencing cognitive function were investigated using multiple regression analysis. Thirty-two age- and gender-matched healthy children served as the control group. RESULTS: Verbal intelligence quotient in the diabetic group was significantly lower than in the control group (97±15 vs 118±13; P＜0.01). Full intelligence quotient in the diabetic group was also lower than in the control group (99±15 vs 113±12; P＜0.01). In the verbal scale test, a sub-test of the Wechsler Intelligence Scale, scores in knowledge, category, comprehension, arithmetics and vocabulary scale in the diabetic group were significantly lower than in the control group (P＜0.01). Multiple regression analysis showed that glycosylated hemoglobin level was significantly negatively with full, verbal and operation intelligence quotients in diabetic children (r=-5.64, -7.29, -3.00 respectively; P＜0.05). CONCLUSIONS: Type 1 diabetes may affect adversely children′s verbal intelligence quotient, resulting in a decreased full intelligence quotient. Glycosylated hemoglobin may be an independent risk factor for cognitive function in diabetic children.