Abstract
Objective To explore the cognitive impairment of type 2 diabetes mellitus(DM) patients with acute cerebral infarction and the influencing factors.Methods A total of 145 patients with acute cerebral infarction were divided into 2 groups:simple cerebral infarction group(SCI group,n= 60) and diabetes combined with cerebral infarction(DCI group,n = 85).According to Oxfordshire Community Stroke Project(OCSP) classification,cerebral infarctions were classified as following subtypes:total or partial anterior circulation infarct(TACI/PACI),posterior circulation infarct(POCI) and lacunar infarct (LACI).Plasma homocysteine(Hcy) concentration was determined by enzyme amplified chemiluminometry. Mini-Mental State Examination(MMSE) was used to assess cognitive status.Results Plasma Hcy level in DCI group[(17.06±4.41)μmol/LJ was significantly higher than that in SCI group[(15.49±4.11)μmol/L;t= 2.185,P= 0.031].MMSE score in DCI group(25.36 + 3.11) was lower than that in SCI group(26.48 + 2.26; t= 2.502,P= 0.013).Plasma Hcy level was the highest,and MMSE score was the lowest in TACI/PACI patients,and were followed by POCI and LACI patients in successive order.In DCI group MMSE score was significantly negatively correlated with age(r=-0.696,P=0.000),systolic blood pressure(r=-0.406, P = 0.000),diastolic blood pressure(r = - 0.371,P = 0.000),total cholesterol(r =-0.477,P= 0.000), triglyceride(r=-0.384,P=0.000),low density lipoprotein-cholesterol(r=-0.487,P=0.000),plasma Hcy (r =-0.923,P= 0.000),DM duration(r = - 0.653,P = 0.000),and glycosylated hemoglobin(HbAlc;r = -0.663,P = 0.000);but was positively correlated with smoking(r,= 0.238,P = 0.028),cardiovascular disease (r,= 0.626,P = 0.000),years of education(r = 0.426,P = 0.000),and high density lipoprotein-cholesterol(r = 0.360,P = 0.001).MMSE score was also related to the stroke subtypes(r,= - 0.557,P = 0.000). Conclusion Cognitive impairment of DCI patients may be closely related to homocysteinemia - induced neurotoxicity,stroke subtype,related risk factors for cerebrovascular disease,diabetic duration and glycemic control status.
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