日前出版的《糖尿病护理杂志》（Diabetes Care）发表了由英国医学研究理事会资助的一项有关糖尿病的研究论文，由爱丁堡大学研究人员完成的研究表明，压力会增加糖尿病患病老人记忆丧失的风险。该研究是4年前爱丁堡大学进行的二型糖尿病研究中的一部分，此项研究有助于解释糖尿病患者有记忆力问题的原因。
研究者调查了900名60～75岁的二型糖尿病患者，对他们进行了记忆功能和信息处理速度等一系列评估测试，将测试结果与正常智力水平进行对比，并用单词测试来检验参与者的大脑运转是否会随着时间推移而减弱。研究发现，随着压力增大，应激激素皮质醇分泌增多，大脑运转速度会随之下降。爱丁堡大学心血管研究中心Rebecca Reynolds博士说：“这项研究表明，患有糖尿病的老年人在应激激素分泌过多的情况下的认知能力更容易下降。我们可以通过调节皮质醇含量提高二型糖尿病患者的认知能力。”40岁以后患二型糖尿病更为普遍，但其与记忆力有关的问题目前还不清楚。研究人员正在组织新一轮的记忆力测试，以探索影响记忆力问题的其他因素。
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《糖尿病护理杂志》发表论文摘要（英文）
Published online before print January 22, 2010, doi: 10.2337/dc09-1796
Diabetes Care April 2010 vol. 33 no. 4 714-720
Morning Cortisol Levels and Cognitive Abilities in People With Type 2 Diabetes
The Edinburgh Type 2 Diabetes Study
Rebecca M. Reynolds, PHD1, Mark W.J. Strachan, MD2, Javier Labad, MD1, Amanda J. Lee, PHD3, Brian M. Frier, MD4,5, F. Gerald Fowkes, PHD6, Rory Mitchell, PHD6, Jonathan R. Seckl, PHD1,5, Ian J. Deary, PHD5,7, Brian R. Walker, MD1 and Jackie F. Price, MD5,6 on behalf of the Edinburgh Type 2 Diabetes Study Investigators
Abstract
OBJECTIVE People with type 2 diabetes are at increased risk of cognitive impairment but the mechanism is uncertain. Elevated glucocorticoid levels in rodents and humans are associated with cognitive impairment. We aimed to determine whether fasting cortisol levels are associated with cognitive ability and estimated lifetime cognitive change in an elderly population with type 2 diabetes.
RESEARCH DESIGN AND METHODS This was a cross-sectional study of 1,066 men and women aged 60–75 years with type 2 diabetes, living in Lothian, Scotland (the Edinburgh Type 2 Diabetes Study). Cognitive abilities in memory, nonverbal reasoning, information processing speed, executive function, and mental flexibility were tested, and a general cognitive ability factor, g, was derived. Prior intelligence was estimated from vocabulary testing, and adjustment for scores on this test was used to estimate lifetime cognitive change. Relationships between fasting morning plasma cortisol levels and cognitive ability and estimated cognitive change were tested. Models were adjusted for potential confounding and/or mediating variables including metabolic and cardiovascular variables.
RESULTS In age-adjusted analyses, higher fasting cortisol levels were not associated with current g or with performance in individual cognitive domains. However, higher fasting cortisol levels were associated with greater estimated cognitive decline in g and in tests of working memory and processing speed, independent of mood, education, metabolic variables, and cardiovascular disease (P & 0.05).
CONCLUSIONS High morning cortisol levels in elderly people with type 2 diabetes are associated with estimated age-related cognitive change. Strategies targeted at lowering cortisol action may be useful in ameliorating cognitive decline in individuals with type 2 diabetes.
Footnotes
The costs of publication of this article were defrayed in part by the payment of page charges. This article must therefore be hereby marked “advertisement” in accordance with 18 U.S.C. Section 1734 solely to indicate this fact.
Received September 24, 2009. Accepted January 16, 2010.
