Abstract OBJECTIVE: To study the changes in cognitive function of children with type 1 diabetes and explore the possible factors influencing cognitive function. METHODS: Thirty-two children with type 1 diabetes (disease course equal to or more than one year) and aged from 6 to 16 years, were enrolled in this study. Cognitive function was evaluated by the Chinese Wechsler Intelligence Scale. Factors influencing cognitive function were investigated using multiple regression analysis. Thirty-two age- and gender-matched healthy children served as the control group. RESULTS: Verbal intelligence quotient in the diabetic group was significantly lower than in the control group (97±15 vs 118±13; P＜0.01). Full intelligence quotient in the diabetic group was also lower than in the control group (99±15 vs 113±12; P＜0.01). In the verbal scale test, a sub-test of the Wechsler Intelligence Scale, scores in knowledge, category, comprehension, arithmetics and vocabulary scale in the diabetic group were significantly lower than in the control group (P＜0.01). Multiple regression analysis showed that glycosylated hemoglobin level was significantly negatively with full, verbal and operation intelligence quotients in diabetic children (r=-5.64, -7.29, -3.00 respectively; P＜0.05). CONCLUSIONS: Type 1 diabetes may affect adversely children′s verbal intelligence quotient, resulting in a decreased full intelligence quotient. Glycosylated hemoglobin may be an independent risk factor for cognitive function in diabetic children.
［4］Frier BM. Hypoglycaemia and cognitive function in diabetes［J］. Int J Clin Pract Suppl, 2001, (123): 30-37.
［5］Northam EA, Anderson PJ, Jacobs R, Hughes M, Warne GL, Werther GA. Neuropsychological profiles of children with type 1 diabetes six years after disease onset［J］. Diabetes Care, 2001, 24(9): 1541-1546.
［6］Perantie DC, Lim A, Wu J, Weaver P, Warren SL, Sadler M, et al. Effects of prior hypoglycemia and hyperglycemia on cognition in children with type 1 diabetes mellitus［J］. Pediatr Diab, 2008, 9 (2): 87-95.
［7］Naguib JM, Kulinskaya E, Lomax CL, Garralda ME. Neuro-cognitive performance in children with type 1 diabetes—a meta-analysis［J］. J Pediatr Psychol, 2009, 34(3): 271-282.
［8］Gaudieri PA, Chen R, Greer TF, Holmes CS. Cognitive function in children with type 1 diabetes a meta-analysis ［J］. Diabetes Care, 2008, 31(9): 1892-1897.
［9］American Diabetes Association. Standards of medical care in diabetes-2011［J］. Diabetes Care, 2011, 34 (Suppl 1): S11-S61.
［12］Tandy A, Allan L, Shelli K, Sherry H, Jessica R, Yaena P, et al. The Feasibility of detecting neuropsychologic and neuroanatomic effects of type 1 diabetes in young children［J］. Diabetes Care, 2011, 34(7): 1458-1462.
［13］Muranyi M, Fujioka M, He Q, Han A, Yong G, Csiszar K, et al. Diabetes activates cell death pathway after transient focal cerebral ischemia［J］.Diabetes, 2003, 52(2): 481-486.
［14］Li P, He QP, Ouyang YB, Liu CL, Hu BR, Siesj-BK. Early release of cytochrome C and activation of caspase-23 in hyperglycemic rats subjected to transient forebrain ischemia［J］.Brain Res, 2001, 896(1-2): 69-76.
［15］Schmidt RE, Dorsey DA, Beaudet LN, Plurad SB, Parvin CA, Yarasheski KE, et al. Inhibition of sorbitol dehydrogenase exacerbates autonomic neuropathy in rats with streptozotocin-induced diabetes［J］. J Neuropathol Exp Neurol, 2001, 60(12): 1153-1169.
［16］Greenwood CE, Kaplan RJ, Hebblethwaite S, Jenkins DJ. Carbohydrate-induced memory impairment in adults with type 2 diabetes［J］. Diabetes Care, 2003, 26 (7): 1961-1966.
［17］Patino-Fernandez AM, Delamater AM, Applegate EB, Brady E, Eidson M, Nemery R, et al. Neurocognitive functioning in preschoolage children with type 1 diabetes mellitus［J］. Pediatr Diabet, 2010, 11(6): 424-430.
［18］Dabetes Control and Complications TrialResearch Group. Effects of intensive diabetes therapy on neuropsychological function in adults in the Diabetes Control and Complications Trial［J］. Ann Intern Med, 1996, 124(4): 379-388.
