The Relationship between Type-2 Diabetes and HbA1c Levels, and Postoperative Cognitive Dysfunction in Elderly Patients_West China Medical Journal

Authors：

 XIALe-qiang , WANGYing , CHENWen-ya , WANGYan

Department of Anesthesiology, People's Hospital of Deyang, Deyang, Sichuan 618000, P. R. China;

Corresponding author：

Keywords：

Postoperative cognitive dysfunction; Type-2 diabetes; Glycosylated hemoglobin

DOI：

10.7507/1002-0179.20140082

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Objective To study the correlation of postoperative cognitive dysfunction (POCD) with type-2 diabetes and glycosylated hemoglobin (HbA1c) levels in elderly patients. Methods A total of 140 elderly patients who were going to undergo non-cardiothoracic surgery in our hospital between January 2011 and February 2013 were included in this study.ASA classification was between I and Ⅲ.There were 78 males and 62 females,aged between 65 and 86 years old.Group A had 70 patients with diabetes,while group B had another 70 corresponding patients without diabetes.One day before surgery and a week after surgery,Mini-mental State Examination (MMSE) and Montreal Cognitive Functioning Scale (MoCA) were used to test patients'cognitive function,and the incidence of POCD was compared between the two groups.Group A patients,according to HbA1c levels,were divided into group AH (HbA1c>7.5%) and group AL (HbA1c<7.5%).And we compared the relationship between group AL and group B,and the relationship between group AH and group B. Results The incidence of POCD in group A was significantly higher than that in group B (P<0.05).Group AH had a significantly higher incidence of POCD than group AL (P<0.05).No significant difference was found in fasting plasma glucose among the groups. Conclusion Elderly diabetic patients with poor glycemic control is a risk factor for POCD occurrence,but fasting glucose as a predictor of POCD is not as good as HbA1C.

Citation： XIALe-qiang, WANGYing, CHENWen-ya, WANGYan. The Relationship between Type-2 Diabetes and HbA1c Levels, and Postoperative Cognitive Dysfunction in Elderly Patients. West China Medical Journal, 2014, 29(2): 266-268. doi: 10.7507/1002-0179.20140082 Copy

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1. Sendelbach S,Lindquist R,Watanuki S,et al.Correlates of neurocognitive function of patients after off-pump coronary artery bypass surgery[J].Am J Crit Care,2006,15(3):290-298.
2. Selnes OA,McKhann GM.Neurocognitive complications after coronary artery bypass surgery[J].Ann Neurol,2005,57(5):615-621.
3. Nasreddine ZS,Phillips NA,Bédirian V.The Montreal Cognitive Assessment,MOCA:a brief screening tool for Mild Cognitive Impairment[J].J Am Geriatr Soc,2005,53(4):695-699.
4. Zadikof C,Fox SH,Tang-Wai DF,et al.A comparison of the mini mental state exam to the Montreal Cognitive Assessment in identifying cognitive deficits in Parkinson's disease[J].Mov Disord,2008,23(2):297-299.
5. Duro D,Simões MR,Ponciano E,et al.Validation studies of the Portuguese experimental version of the Montreal Cognitive Assessment (MoCA):confirmatory factor analysis[J].J Neurol,2010,257(5):728-734.
6. 李兴,闻大翔,陈杰,等.老年患者术后认知功能障碍发生率及相关因素的多中心研究[J].临床麻醉学杂志,2009,25(8):652-654.
7. 疏树华,方才,潘建辉,等.老年全麻患者围术期血清兴奋性氨基酸浓度的变化及临床意义[J].临床麻醉学杂志,2011,27(1):9-11.
8. 张挺杰,皋源,江燕,等.老年病人术后精神障碍的发生率和病因分析[J].临床麻醉学杂志,2003,2(19):98-99.
9. 张巧俊,谢璇,向丽,等.糖尿病患者认知功能障碍及其相关因素的分析[J].临床神经病学杂志,2004,17(3):175-177.
10. Rasgon N,Jarvik L.Insulin resistance,affective disorders,and Alzheimer's disease:review and hypothesis[J].J Gerontol A Biol Sci med Sci,2004,59(2):178-183.
11. Selwood A,Orell M.Long term cognitive dysfunction in older people after non-cardiac surgery[J].BMJ,2004,328(7432):120-121.
12. 余霆,黄志刚.果糖胺与血糖、糖化血红蛋白的关系研究[J].华西医学,2010,25(7):1325-1327.

West China Medical Journal

The Relationship between Type-2 Diabetes and HbA1c Levels, and Postoperative Cognitive Dysfunction in Elderly Patients

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