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OGNITIVE DYSFUNCTION IN PATIENTS WITH DIABETES
MELLITUS
Safarov S.S.
Bukhara State Medical Institute
https://doi.org/10.5281/zenodo.14325179
Diabetes mellitus is a significant risk factor for cognitive impairment. The
severity of the latter is influenced by the indications of glycosylated hemoglobin,
the presence of concomitant somatic pathology, the prescription of diabetes
mellitus (DM) and its type, premorbid personality traits, etc. It is of practical
interest to analyze and systematize the causes that determine the change in
cognitive activity of pa patients with DM.
The purpose
of this study was to determine the predictors of the
appearance of cognitive disorders in people with diabetes.
Materials and methods
of research A comprehensive clinical and
neurological examination of 47 patients with type 2 diabetes aged 47-68 years
(average age 57.5±8.1 years) was conducted, as a control, persons (20 people) of
similar age with initial manifestations of cerebral circulatory insufficiency with
normal glycemic indicators were examined.
In the course of observation, general clinical laboratory (glycemia level,
glycosylated hemoglobin, lipidogram, coagulogram, renal samples, cystatin C
level), neuro-psychological (DSST digital sim replacement test, short mental
status assessment scale, MMSE, Stroop tests), statistical research methods were
used.
The results obtained and their discussion. As a result of the survey, the
following results were obtained: the average HbA level in the subjects averaged
8.7±1.9%, the average duration of diabetes was 10.5±2.7 years. Diabetic
nephropathy was diagnosed in 52% of patients, diabetic sensorimotor
polyneuropathy in 81%, and signs of diabetic encephalopathy were present in
39% of cases. lbuminuria (albumin/creatinine ratio ≥ 30±4.9 mg) was
accompanied by the worst results of all cognitive tests. An increase in the level of
cystatin C (up to 2.1±0.7 mg/l) (control 0.71± 0.90 mg/l) (P <0.01 ) was
associated with low performance of the executive function test. Increased
concentration of glycosylated hemoglobin > 8.7% =1.4 (P <0.05), as well as
hyperglycemia >12±2.3 (P <0.01) were closely related to the negative indicators
of the information processing speed test.
Elevated cystatin C levels correlated
with worse DSH and Scab test results. According to the literature, cystatin C was
not only an indicator of renal function, the polymorphism of the cystatin C gene is
CURRENT APPROACHES AND NEW RESEARCH IN
MODERN SCIENCES
International scientific-online conference
9
associated with the risk of Alzheimer's disease, lacunar infarcts, and lesions of the
white matter of the brain, which are often observed in patients with diabetes.
It
can be assumed that cerebral disorders and impaired renal function are parallel
links in the pathogenesis of many angiitis, angiopathies. On the one hand,
endothelial dysfunction in the vessels of the brain is manifested by defects in the
hemato-encephalic barrier, increased processes of transportation and formation
of amyloid, as well as a predisposition to lacunar infarctions. In the kidneys,
impaired endothelial function in glomeruli leads to albuminuria, which in turn
causes the development of tubulointerstitial inflammation, secondary
nephrosclerosis.
Conclusions
Our observations revealed a link between hypercysatinemia and albuminuria in
patients with type 2 diabetes and impaired verbal memory. Therefore, the
determination of these renal biomarkers in people with diabetes is of prognostic
importance, as it allows to diagnose cognitive disorders at an early stage and
timely carry out their prevention.
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