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【Diabetes Care】1型糖尿病的认知功能：糖尿病控制
Control and Complications Trial (DCCT) revisited
1型糖尿病的认知功能：糖尿病控制和并发症研究（DCCT）更新
B. M. Frier
Abstract The Diabetes Control and Complications Trial
(DCCT)/Epidemiology of Diabetes Interventions and
Complications (EDIC) study has allowed an examination
of the long-term effects of type 1 diabetes and intensity of
treatment on cognitive function. The association observed
between chronic hyperglycaemia and mild cognitive dys-
function, affecting motor speed and psychomotor efficien-
cy, has been re-evaluated by Jacobson et al. (Diabetologia
doi: 10.1007/s00125-010-1883-9) to determine the possible
contribution of macrovascular risk factors, subclinical
macrovascular disease and microvascular complications
(retinopathy and nephropathy).
摘要 糖尿病控制和并发症试验（DCCT）/糖尿病干预与并发症的流行病学（EDIC）研究使观察1型糖尿病及强化治疗对认知功能的长期影响成为可能。Jacobson等（Diabetologiadoi: 10.1007/s00125-010-1883-9）再次评估了慢性高血糖和轻度认知功能异常的关系、对运动速度和心理运动功效的影响，以确定大血管危险因素、亚临床大血管病变和微血管并发症（视网膜病变和肾病）的可能影响。
This has revealed associations between mild impairment of psychomotor efficiency
and hypertension, glycaemic control and the presence of
retinopathy and nephropathy, while smoking history was
associated with modest abnormalities in several cognitive
domains. Neither macrovascular risk factors nor a history
of severe hypoglycaemia was associated with the cognitive
decrements; cerebral microangiopathy has been proposed as
apossibleunderlyingcause.Althoughthedegreeofcognitive
impairment was mild and limited to a few domains, these
decrements may influence the performance of everyday
activities, such as driving.
该研究显示，轻度精神运动障碍和高血压、血糖控制和视网膜病变和糖尿病肾病之间存在相关性，而吸烟史与多个认知功能域的异常之间存在相关性。无论大血管病变的危险因素还是严重低血糖病史均和认知功能减退无关；推测脑微血管病变可能是潜在的发病原因。虽然认知功能损害的程度较轻且仅限于几个域，但这些损害或许影响驾驶等日常活动。
Keywords Cognitive function.Hypoglycaemia.
Psychomotor efficiency.Type 1 diabetes.Vascular risk
关键词 认知功能 ? 低血糖 ? 心理运动功效 ? 1型糖尿病 ? 血管危险因素
Abbreviations
EDIC Epidemiology of Diabetes Interventions andComplications
SDIS Stockholm Diabetes Intervention Study
缩略语
EDIC 糖尿病干预与并发症的流行病学
SDIS Stockholm糖尿病干预研究 By providing indisputable evidence for the importance of
glycaemic control to prevent and limit the severity of
microvascular complications, the Diabetes Control and
Complications Trial (DCCT) [1] caused a global sea-
change in the clinical management of type 1 diabetes. This
landmark study, in conjunction with its long-term follow-
up, the Epidemiology of Diabetes Interventions and
Complications (EDIC) study, continues to generate a wealth
of informative data about type 1 diabetes. The paper by
Jacobson et al. in this issue of presents further Diabetologia valuable findings [2].
因为其提供了血糖控制预防在延缓微血管并发症重要性方面的可靠证据，糖尿病控制和并发症试验（DCCT）使全球改变了1型糖尿病的临床治疗。这项里程碑式的研究，及其长期随访，糖尿病干预与并发症的流行病学（EDIC）研究，对1型糖尿病而言是一个信息财富。Jacobson等人在本期Diabetologia发表的论文进一步提供了有价值的信息。 In the original trial the long-term effects of type 1
diabetes and the intensity of its treatment on cognitive
function were evaluated to address the unresolved question
of whether exposure to recurrent severe hypoglycaemia, an
almost inevitable consequence of intensive therapy and
strict glycaemic control [1], led to intellectual decline [3].
The analysis of cognitive data in the DCCT after a mean
follow-up period of 6.5 years did not demonstrate any
adverse effect of recurrent severe hypoglycaemia on several
domains of cognitive function [4, 5]. This finding was
supported by a smaller contemporaneous Swedish trial, the
Stockholm Diabetes Intervention Study (SDIS), in which
the cognitive function of participants was reviewed after
10 years [6].
在以前的试验中评估了1型糖尿病和强化治疗对认知功能的长期作用，以回答是否反复发生严重低血糖（这是在强化治疗和严格控制血糖中不可避免的问题）可导致智力下降。对DCCT中认知功能数据的分析发现经过平均随访6.5年后没有显示反复发生的低血糖对认知功能的几个域具有不良效应。这一研究结果在一个同期的小型瑞典研究中也是如此，在这个研究中，受试者在10年后分析了其认知功能。
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作者:admin@医学,生命科学 2011-02-12 00:42
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