肾功能
医学
全国健康与营养检查调查
数字符号替换试验
肌酐
糖尿病
内科学
口语流利性测试
肾脏疾病
人口
2型糖尿病
试制试验
认知
认知测验
内分泌学
神经心理学
疾病
认知障碍
病理
精神科
环境卫生
替代医学
安慰剂
作者
Yanhua Xiao,Veda Devakumar,Liyan Xu,Lei Liu,Han‐You Mo,Xiumei Hong
标识
DOI:10.3389/fendo.2023.1149084
摘要
Background The brain and kidney have similar microvascular structure, which makes them susceptible to certain common pathophysiological processes. In this study, we examined several indicators of kidney injury/function associated with cognitive function in older diabetic patients in the hope of finding effective markers for detecting cognitive impairment (CI). Methods A total of 2209 older participants (aged ≥60 years) from the 2011-2014 National Health and Nutrition Examination Survey (NHANES) were analyzed for the association between diabetes and CI using a multiple linear regression analysis model. Using the same approach, we also analyzed the relationship between indicators of kidney injury/function and cognitive function (Animal Fluency Test, Digit Symbol Substitution Test) in the diabetic population. Results Diabetes was associated with CI. In age-adjusted model, older diabetics performed significantly poorer on tests of cognitive function compared to normoglycaemic individuals (1.145 points lower on the Animal Fluency Test ( P = 0.005) and 7.868 points reduced on the Digit Symbol Substitution Test ( P < 0.001)). In diabetics, we found elevated serum creatinine (SCr) (especially at SCr≥300uM) was associated with lower scores on cognitive function tests after strict adjustment for potential influences on cognitive function. While, albumin/creatinine ratio (ACR) was only associated with Digit Symbol Substitution score (DSS) not Animal Fluency score (AFS), and estimated glomerular filtration rate (eGFR) was only associated with CI (AFS and DSS) at the end-stage renal disease. Conclusion SCr, as a sensitive indicator of kidney injury, was significantly associated with CI and can potentially be used as an effective marker for screening CI in older diabetics.
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