The detection rate of cognitive impairment in Chinese patients with type 2 diabetes mellitus: a meta-analysis_Chinese Journal of Evidence-Based Medicine

Authors：

FAN Jin ¹ , ZHONG Dongling ¹ , LI Juan ¹ , LI Yuxi ² , ZHANG Huiling ¹ , LIU Xiaobo ¹ , HE Xia ³ , XIE Xiaolong ⁴ ,  JIN Rongjiang ¹

1. School of Health Preservation and Rehabilitation, Chengdu University of Traditional Chinese Medicine, Chengdu 610075, P.R.China;
2. School of Acupuncture-Moxibustion and Tuina, Chengdu University of Traditional Chinese Medicine, Chengdu 610075, P.R.China;
3. The Affiliated Rehabilitation Hospital of Chengdu University of Traditional Chinese Medicine, Sichuan Provincal Rehabilitation Hospital, Chengdu 610035, P.R.China;
4. The Affiliated Meishan Hospital of Chengdu University of Traditional Chinese Medicine, Meishan 620010, P.R.China;

Corresponding author：

JIN Rongjiang, Email: cdzyydxjrj@126.com

Keywords：

Type 2 diabetes mellitus; Cognitive impairment; China; Detection rate; Meta-analysis

DOI：

10.7507/1672-2531.202102001

Video：

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Objective To systematically review the detection rate of cognitive impairment in Chinese patients with type 2 diabetes mellitus (T2DM).Methods PubMed, EMbase, The Cochrane Library, CBM, CNKI, WanFang Data and VIP databases were searched to collect studies on the detection rate of cognitive impairment in Chinese patients with T2DM from inception to January 20^th, 2021. Two reviewers independently screened literature, extracted data and evaluated the risk of bias of included studies. Meta-analysis was then performed using Stata 12.0 software.Results A total of 27 studies involving 7 920 cases were included. Meta-analysis results showed that the total detection rate of cognitive impairment in Chinese patients with T2DM was 43.2% (95%CI 36.9% to 49.6%). The results of subgroup analysis showed that in T2DM patients, the detection rate of cognitive impairment in males was 42.4% (95%CI 34.4% to 50.4%), and that in females was 48.2% (95%CI 40.9% to 55.6%). The detection rate of cognitive impairment was 25.4% (95%CI 14.7% to 36.0%) in patients under the age of 60 years, and 47.0% (95%CI 30.0% to 64.0%) in patients aged 60 years or above. The detection rate of cognitive impairment among those with primary school education level or below was 67.1% (95%CI 48.9% to 85.3%). The detection rate of cognitive impairment was 37.1% (95%CI 27.3% to 46.8%) among those with education level of junior high school or above. The detection rate of cognitive impairment in patients with disease duration less than 10 years was 28.4% (95%CI 16.0% to 40.9%) and that in patients with disease duration more than 10 years was 50.6% (95%CI 33.2% to 68.0%). The detection rate of cognitive impairment in married individuals was 45.6% (95%CI 35.8% to 55.4%) and that in singles was 68.1% (95%CI 57.5% to 78.7%). The detection rate of cognitive impairment in smokers was 38.9% (95%CI 30.7% to 47.2%) and in non-smokers was 40.9% (95%CI 32.1% to 49.6%). The detection rate of cognitive impairment in drinkers was 35.6% (95%CI 27.3% to 44.0%) and that in non-drinkers was 41.8% (95%CI 32.2% to 51.4%).Conclusions The detection rate of cognitive impairment in Chinese patients with T2DM is high. Due to the quantity and quality of included studies, more high-quality studies are needed to verify the above conclusions.

Citation： FAN Jin, ZHONG Dongling, LI Juan, LI Yuxi, ZHANG Huiling, LIU Xiaobo, HE Xia, XIE Xiaolong, JIN Rongjiang. The detection rate of cognitive impairment in Chinese patients with type 2 diabetes mellitus: a meta-analysis. Chinese Journal of Evidence-Based Medicine, 2021, 21(7): 787-795. doi: 10.7507/1672-2531.202102001 Copy

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2.	中华医学会糖尿病分会. 中国 2 型糖尿病防治指南(2017 年版). 中国实用内科杂志, 2018, 38(4): 292-344.
3.	Moran C, Phan TG, Chen J, et al. Brain atrophy in type 2 diabetes: regional distribution and influence on cognition. Diabetes Care, 2013, 36(12): 4036-4042.
4.	Winkler A, Dlugaj M, Weimar C, et al. Association of diabetes mellitus and mild cognitive impairment in middle-aged men and women. J Alzheimers Dis, 2014, 42(4): 1269-1277.
5.	Profenno LA, Porsteinsson AP, Faraone SV. Meta-analysis of Alzheimer's disease risk with obesity, diabetes, and related disorders. Biol Psychiatry, 2010, 67(6): 505-512.
6.	Cheng PY, Sy HN, Wu SL, et al. Newly diagnosed type 2 diabetes and risk of dementia: a population-based 7-year follow-up study in Taiwan. J Diabetes Complications, 2012, 26(5): 382-387.
7.	赵丽华, 项颗. 从氧化应激途径分析养血清脑颗粒治疗老年糖尿病患者轻度认知功能障碍的临床研究. 中国中医药咨讯, 2011, 3(22): 20-21.
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10.	熊风, 赖玉清, 涂嘉欣, 等. 中国老年人群睡眠障碍流行特征的 Meta 分析. 中国循证医学杂志, 2019, 19(4): 398-403.
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21.	赵敏. 空巢老年 2 型糖尿病患者认知功能现状及其影响因素研究. 当代护士(下旬刊), 2019, 26(11): 18-20.
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31.	仰礼萍, 严腊梅, 王金霞, 等. 住院 2 型糖尿病病人认知功能障碍调查. 护理研究, 2012, 26(8): 693-694.
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33.	毛红玲. 2 型老年糖尿病患者认知功能水平及相关影响因素. 实用医院临床杂志, 2019, 16(4): 114-117.
34.	侯兴华, 王楚媛, 杜睿婷. 老年糖尿病患者认知功能现状及相关影响因素. 中国卫生工程学, 2019, 18(4): 543-545.
35.	王群, 张丽洁, 苏叶, 等. 中青年 2 型糖尿病住院患者的认知功能特点及影响因素研究. 中华护理杂志, 2018, 53(2): 190-194.
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37.	Whitmer RA. Type 2 diabetes and risk of cognitive impairment and dementia. Curr Neurol Neurosci Rep, 2007, 7(5): 373-380.
38.	Manschot SM, Brands AM, van der Grond J, et al. Brain magnetic resonance imaging correlates of impaired cognition in patients with type 2 diabetes. Diabetes, 2006, 55(4): 1106-1113.
39.	Luchsinger JA, Reitz C, Patel B, et al. Relation of diabetes to mild cognitive impairment. Arch Neurol, 2007, 64(4): 570-575.
40.	Bello-Chavolla OY, Aguilar-Salinas CA, Avila-Funes JA. Geriatric syndromes and not cardiovascular risk factors are associated with cognitive impairment among Mexican community-dwelling elderly with type 2 diabetes. Rev Invest Clin, 2017, 69(3): 166-172.
41.	张海水. 中美劳动人口受教育程度的现状比较与启示. 复旦教育论坛, 2014, 12(1): 35.
42.	王翔, 农晰婷, 赵琳晖. 2 型糖尿病轻度认知功能障碍危险因素相关性研究. 陕西医学杂志, 2015, 44(7): 839-841.
43.	Esiri MM, Chance SA. Cognitive reserve, cortical plasticity and resistance to Alzheimer's disease. Alzheimers Res Ther, 2012, 4(2): 7.
44.	Logroscino G, Kang JH, Grodstein F. Prospective study of type 2 diabetes and cognitive decline in women aged 70-81 years. BMJ, 2004, 328(7439): 548.
45.	傅松波, 胡安春, 梁譞, 等. 2 型糖尿病患者认知功能改变及其危险因素. 中国老年学杂志, 2017, 37(4): 995-996.
46.	苏琳, 张庆文, 李卫, 等. 病程对老年 2 型糖尿病患者认知功能及相关危险因素的影响. 中华老年心脑血管病杂志, 2015, 17(10): 1071-1075.
47.	张彦红, 梁伟雄, 朱磊, 等. 蒙特利尔认知评估量表与简易精神状态量表用于筛查血管性认知障碍的比较. 中国康复医学杂志, 2012, 27(5): 431-436.
48.	李格, 沈漁邨, 陈昌惠, 等. 老年痴呆简易测试方法研究——MMSE 在城市老年居民中的测试. 中国心理卫生杂志, 1988, 2(1): 13-18.
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1. 杨晓妍, 吴先萍. 2 型糖尿病危险因素研究进展. 预防医学情报杂志, 2001, 17(1): 12-13.
2. 中华医学会糖尿病分会. 中国 2 型糖尿病防治指南(2017 年版). 中国实用内科杂志, 2018, 38(4): 292-344.
3. Moran C, Phan TG, Chen J, et al. Brain atrophy in type 2 diabetes: regional distribution and influence on cognition. Diabetes Care, 2013, 36(12): 4036-4042.
4. Winkler A, Dlugaj M, Weimar C, et al. Association of diabetes mellitus and mild cognitive impairment in middle-aged men and women. J Alzheimers Dis, 2014, 42(4): 1269-1277.
5. Profenno LA, Porsteinsson AP, Faraone SV. Meta-analysis of Alzheimer's disease risk with obesity, diabetes, and related disorders. Biol Psychiatry, 2010, 67(6): 505-512.
6. Cheng PY, Sy HN, Wu SL, et al. Newly diagnosed type 2 diabetes and risk of dementia: a population-based 7-year follow-up study in Taiwan. J Diabetes Complications, 2012, 26(5): 382-387.
7. 赵丽华, 项颗. 从氧化应激途径分析养血清脑颗粒治疗老年糖尿病患者轻度认知功能障碍的临床研究. 中国中医药咨讯, 2011, 3(22): 20-21.
8. Li W, Sun L, Li G, et al. Prevalence, influence factors and cognitive characteristics of mild cognitive impairment in type 2 diabetes mellitus. Front Aging Neurosci, 2019, 11: 180.
9. 李瑾竹, 闫雅凤, 郝亚静, 等. 老年男性 2 型糖尿病患者认知功能损害的危险因素分析. 解放军护理杂志, 2012, 29(11): 40-42.
10. 熊风, 赖玉清, 涂嘉欣, 等. 中国老年人群睡眠障碍流行特征的 Meta 分析. 中国循证医学杂志, 2019, 19(4): 398-403.
11. 王燕, 丁志良, 闵寒, 等. 2 型糖尿病患者认知功能障碍筛查及高危因素分析. 临床和实验医学杂志, 2018, 17(23): 2560-2562.
12. 杨月嫦, 赵忠新, 黄流清, 等. 上海市社区老年 2 型糖尿病患者认知功能损害的发生率和危险因素分析. 中国临床神经科学, 2010, 18(5): 490-495, 519.
13. 丁文萃, 王丽晖, 杨洁, 等. 血糖波动与老年 2 型糖尿病患者并发认知功能障碍的关系研究. 解放军医药杂志, 2019, 31(9): 48-50, 59.
14. Zhang L, Yang J, Liao Z, et al. Association between diabetes and cognitive function among people over 45 years old in China: a cross-sectional study. Int J Environ Res Public Health, 2019, 16(7): 1294.
15. Guo D, Yuan Y, Huang R, et al. Association between plasma adipsin level and mild cognitive impairment in Chinese patients with type 2 diabetes: a cross-sectional study. BMC Endocr Disord, 2019, 19(1): 108.
16. 陶艳, 于卫华, 魏晓飞, 等. 2 型糖尿病住院病人认知障碍发病现况调查. 护理研究, 2013, 27(28): 3116-3118.
17. 孟宪海. 2 型糖尿病患者认知功能减退的危险因素和易感基因研究. 天津: 天津医科大学, 2009.
18. Liu S, Lu Y, Cai X, et al. Glycemic control is related to cognitive dysfunction in elderly people with type 2 diabetes mellitus in a rural Chinese population. Curr Alzheimer Res, 2019, 16(10): 950-962.
19. Gao Y, Xiao Y, Miao R, et al. The prevalence of mild cognitive impairment with type 2 diabetes mellitus among elderly people in China: a cross-sectional study. Arch Gerontol Geriatr, 2016, 62: 138-142.
20. 冯金玉, 陶树利, 张俊杰, 等. 北京市宣武区社区老年糖尿病患者认知功能障碍调查. 中国医师杂志, 2010, 12(5): 585-587.
21. 赵敏. 空巢老年 2 型糖尿病患者认知功能现状及其影响因素研究. 当代护士(下旬刊), 2019, 26(11): 18-20.
22. 夏彦, 许杨, 李军. 老年 2 型糖尿病合并认知功能障碍的相关因素分析. 国际医药卫生导报, 2016, (9): 1258-1261.
23. Cao W, Tian S, Zhang H, et al. Association of low-density lipoprotein receptor-related protein 1 and its rs1799986 polymorphism with mild cognitive impairment in Chinese patients with type 2 diabetes. Front Neurosci, 2020, 14: 743.
24. Huang X, Wang C, Tian S, et al. Higher plasma level of nampt presaging memory dysfunction in Chinese type 2 diabetes patients with mild cognitive impairment. J Alzheimers Dis, 2019, 70(1): 303-314.
25. 修双玲, 孙丽娜, 穆志静, 等. 老年 2 型糖尿病患者认知功能障碍影响因素分析. 中华老年多器官疾病杂志, 2019, 18(6): 439-442.
26. 刘琴. 老年 2 型糖尿病患者认知障碍情况调查及影响因素分析. 医学综述, 2014, 20(10): 1890-1892.
27. Sun L, Diao X, Gang X, et al. Risk factors for cognitive impairment in patients with type 2 diabetes. J Diabetes Res, 2020, 2020: 4591938.
28. 黄金, 胡进, 朱熊兆, 等. 社区 2 型糖尿病患者认知功能现状及其影响因素研究. 中国全科医学, 2016, 19(2): 135-141.
29. 郑红英, 宫娟, 孙小红, 等. 血糖控制不佳 2 型糖尿病患者轻度认知障碍影响因素研究. 中华老年多器官疾病杂志, 2017, 16(12): 915-920.
30. Yang J, Zhang Z, Zhang L, et al. Relationship between self-care behavior and cognitive function in hospitalized adult patients with type 2 diabetes: a cross-sectional study. Diabetes Metab Syndr Obes, 2020, 13: 207-214.
31. 仰礼萍, 严腊梅, 王金霞, 等. 住院 2 型糖尿病病人认知功能障碍调查. 护理研究, 2012, 26(8): 693-694.
32. 刘瑶霞, 张敏, 陈平, 等. 住院老年 2 型糖尿病患者认知功能障碍的特点及其危险因素调查分析. 中国糖尿病杂志, 2016, 24(8): 729-732.
33. 毛红玲. 2 型老年糖尿病患者认知功能水平及相关影响因素. 实用医院临床杂志, 2019, 16(4): 114-117.
34. 侯兴华, 王楚媛, 杜睿婷. 老年糖尿病患者认知功能现状及相关影响因素. 中国卫生工程学, 2019, 18(4): 543-545.
35. 王群, 张丽洁, 苏叶, 等. 中青年 2 型糖尿病住院患者的认知功能特点及影响因素研究. 中华护理杂志, 2018, 53(2): 190-194.
36. 董永海, 毛向群, 刘磊, 等. 中国老年期痴呆患病率 Meta 分析. 中国公共卫生, 2014, 30(4): 512-515.
37. Whitmer RA. Type 2 diabetes and risk of cognitive impairment and dementia. Curr Neurol Neurosci Rep, 2007, 7(5): 373-380.
38. Manschot SM, Brands AM, van der Grond J, et al. Brain magnetic resonance imaging correlates of impaired cognition in patients with type 2 diabetes. Diabetes, 2006, 55(4): 1106-1113.
39. Luchsinger JA, Reitz C, Patel B, et al. Relation of diabetes to mild cognitive impairment. Arch Neurol, 2007, 64(4): 570-575.
40. Bello-Chavolla OY, Aguilar-Salinas CA, Avila-Funes JA. Geriatric syndromes and not cardiovascular risk factors are associated with cognitive impairment among Mexican community-dwelling elderly with type 2 diabetes. Rev Invest Clin, 2017, 69(3): 166-172.
41. 张海水. 中美劳动人口受教育程度的现状比较与启示. 复旦教育论坛, 2014, 12(1): 35.
42. 王翔, 农晰婷, 赵琳晖. 2 型糖尿病轻度认知功能障碍危险因素相关性研究. 陕西医学杂志, 2015, 44(7): 839-841.
43. Esiri MM, Chance SA. Cognitive reserve, cortical plasticity and resistance to Alzheimer's disease. Alzheimers Res Ther, 2012, 4(2): 7.
44. Logroscino G, Kang JH, Grodstein F. Prospective study of type 2 diabetes and cognitive decline in women aged 70-81 years. BMJ, 2004, 328(7439): 548.
45. 傅松波, 胡安春, 梁譞, 等. 2 型糖尿病患者认知功能改变及其危险因素. 中国老年学杂志, 2017, 37(4): 995-996.
46. 苏琳, 张庆文, 李卫, 等. 病程对老年 2 型糖尿病患者认知功能及相关危险因素的影响. 中华老年心脑血管病杂志, 2015, 17(10): 1071-1075.
47. 张彦红, 梁伟雄, 朱磊, 等. 蒙特利尔认知评估量表与简易精神状态量表用于筛查血管性认知障碍的比较. 中国康复医学杂志, 2012, 27(5): 431-436.
48. 李格, 沈漁邨, 陈昌惠, 等. 老年痴呆简易测试方法研究——MMSE 在城市老年居民中的测试. 中国心理卫生杂志, 1988, 2(1): 13-18.
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Chinese Journal of Evidence-Based Medicine

The detection rate of cognitive impairment in Chinese patients with type 2 diabetes mellitus: a meta-analysis

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