{"title":"日本2型糖尿病患者连续血糖监测时间范围与认知功能测试分数变化相关","authors":"Maki Inoue, Yoshiki Kusunoki, Mana Ohigashi, Keiko Osugi, Chikako Inoue, Akihito Otsuka, Daisuke Azuma, Hiroki Ikeda, Daisuke Tamada, Tadahiro Inagaki, Nobuaki Watanabe, Akio Miyoshi, Akinori Kanzaki, Manabu Kadoya, Kosuke Konishi, Hidenori Koyama","doi":"10.1111/dom.16511","DOIUrl":null,"url":null,"abstract":"<p><strong>Aims: </strong>Type 2 diabetes mellitus (T2DM) is known to be a risk factor for cognitive dysfunction and dementia. Time in range (TIR), which is derived from continuous glucose monitoring (CGM), has been widely used as an indicator of the quality of glycemic control. While cross-sectional studies have reported an association between CGM-derived TIR and cognitive function scores, few studies have longitudinally investigated the relationship between the two. This study aimed to prospectively investigate the association between CGM-derived TIR and changes in multiple cognitive function scores.</p><p><strong>Materials and methods: </strong>The present study used baseline and 2-year data from an ongoing multicenter cohort study. This study included 197 T2DM patients aged ≥60 years with undiagnosed dementia. Participants were examined with the mini-mental state examination (MMSE), the Japanese version of the Montreal cognitive assessment (MoCA-J) and the digit symbol substitution test (DSST) at both baseline and 2 years. Multiple regression analyses were performed to investigate the association between TIR and changes in cognitive function test scores over 2 years.</p><p><strong>Results: </strong>Multivariate regression analysis showed that there was a significant association between TIR and changes in MMSE (ΔMMSE) over 2 years (standard partial regression coefficient [β] = 0.187, p = 0.005). Similarly, multivariate regression models showed a significant association between TIR and ΔMoCA-J (β = 0.218, p = 0.001) and ΔDSST (β = 0.164, p = 0.036).</p><p><strong>Conclusions: </strong>In patients with T2DM with undiagnosed dementia, CGM-derived TIR might be associated with overall cognitive decline and reduced processing speed.</p>","PeriodicalId":158,"journal":{"name":"Diabetes, Obesity & Metabolism","volume":" ","pages":""},"PeriodicalIF":5.4000,"publicationDate":"2025-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Continuous glucose monitoring-derived time in range is associated with changes in cognitive function test scores in Japanese patients with type 2 diabetes mellitus.\",\"authors\":\"Maki Inoue, Yoshiki Kusunoki, Mana Ohigashi, Keiko Osugi, Chikako Inoue, Akihito Otsuka, Daisuke Azuma, Hiroki Ikeda, Daisuke Tamada, Tadahiro Inagaki, Nobuaki Watanabe, Akio Miyoshi, Akinori Kanzaki, Manabu Kadoya, Kosuke Konishi, Hidenori Koyama\",\"doi\":\"10.1111/dom.16511\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Aims: </strong>Type 2 diabetes mellitus (T2DM) is known to be a risk factor for cognitive dysfunction and dementia. Time in range (TIR), which is derived from continuous glucose monitoring (CGM), has been widely used as an indicator of the quality of glycemic control. While cross-sectional studies have reported an association between CGM-derived TIR and cognitive function scores, few studies have longitudinally investigated the relationship between the two. This study aimed to prospectively investigate the association between CGM-derived TIR and changes in multiple cognitive function scores.</p><p><strong>Materials and methods: </strong>The present study used baseline and 2-year data from an ongoing multicenter cohort study. This study included 197 T2DM patients aged ≥60 years with undiagnosed dementia. Participants were examined with the mini-mental state examination (MMSE), the Japanese version of the Montreal cognitive assessment (MoCA-J) and the digit symbol substitution test (DSST) at both baseline and 2 years. Multiple regression analyses were performed to investigate the association between TIR and changes in cognitive function test scores over 2 years.</p><p><strong>Results: </strong>Multivariate regression analysis showed that there was a significant association between TIR and changes in MMSE (ΔMMSE) over 2 years (standard partial regression coefficient [β] = 0.187, p = 0.005). Similarly, multivariate regression models showed a significant association between TIR and ΔMoCA-J (β = 0.218, p = 0.001) and ΔDSST (β = 0.164, p = 0.036).</p><p><strong>Conclusions: </strong>In patients with T2DM with undiagnosed dementia, CGM-derived TIR might be associated with overall cognitive decline and reduced processing speed.</p>\",\"PeriodicalId\":158,\"journal\":{\"name\":\"Diabetes, Obesity & Metabolism\",\"volume\":\" \",\"pages\":\"\"},\"PeriodicalIF\":5.4000,\"publicationDate\":\"2025-06-16\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Diabetes, Obesity & Metabolism\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1111/dom.16511\",\"RegionNum\":2,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"ENDOCRINOLOGY & METABOLISM\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Diabetes, Obesity & Metabolism","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1111/dom.16511","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"ENDOCRINOLOGY & METABOLISM","Score":null,"Total":0}
引用次数: 0
摘要
目的：2型糖尿病（T2DM）是认知功能障碍和痴呆的危险因素。范围内时间（Time in range， TIR）是由连续血糖监测（continuous glucose monitoring， CGM）衍生而来，作为血糖控制质量的指标已被广泛应用。虽然横断面研究报告了cgm衍生的TIR与认知功能评分之间的关联，但很少有研究对两者之间的关系进行纵向调查。本研究旨在前瞻性地探讨cgm衍生的TIR与多种认知功能评分变化之间的关系。材料和方法：本研究使用了一项正在进行的多中心队列研究的基线和2年数据。本研究纳入197例年龄≥60岁伴有未确诊痴呆的T2DM患者。参与者在基线和2年分别接受了迷你精神状态检查（MMSE）、日本版蒙特利尔认知评估（MoCA-J）和数字符号替代测试（DSST）。采用多元回归分析来调查2年内TIR与认知功能测试分数变化之间的关系。结果：多因素回归分析显示，TIR与2年内MMSE （ΔMMSE）的变化有显著相关性（标准偏回归系数[β] = 0.187, p = 0.005）。同样，多变量回归模型显示，TIR与ΔMoCA-J （β = 0.218, p = 0.001）和ΔDSST （β = 0.164, p = 0.036）之间存在显著相关性。结论：在伴有未确诊痴呆的T2DM患者中，cgm衍生的TIR可能与整体认知能力下降和处理速度降低有关。
Continuous glucose monitoring-derived time in range is associated with changes in cognitive function test scores in Japanese patients with type 2 diabetes mellitus.
Aims: Type 2 diabetes mellitus (T2DM) is known to be a risk factor for cognitive dysfunction and dementia. Time in range (TIR), which is derived from continuous glucose monitoring (CGM), has been widely used as an indicator of the quality of glycemic control. While cross-sectional studies have reported an association between CGM-derived TIR and cognitive function scores, few studies have longitudinally investigated the relationship between the two. This study aimed to prospectively investigate the association between CGM-derived TIR and changes in multiple cognitive function scores.
Materials and methods: The present study used baseline and 2-year data from an ongoing multicenter cohort study. This study included 197 T2DM patients aged ≥60 years with undiagnosed dementia. Participants were examined with the mini-mental state examination (MMSE), the Japanese version of the Montreal cognitive assessment (MoCA-J) and the digit symbol substitution test (DSST) at both baseline and 2 years. Multiple regression analyses were performed to investigate the association between TIR and changes in cognitive function test scores over 2 years.
Results: Multivariate regression analysis showed that there was a significant association between TIR and changes in MMSE (ΔMMSE) over 2 years (standard partial regression coefficient [β] = 0.187, p = 0.005). Similarly, multivariate regression models showed a significant association between TIR and ΔMoCA-J (β = 0.218, p = 0.001) and ΔDSST (β = 0.164, p = 0.036).
Conclusions: In patients with T2DM with undiagnosed dementia, CGM-derived TIR might be associated with overall cognitive decline and reduced processing speed.
期刊介绍：
Diabetes, Obesity and Metabolism is primarily a journal of clinical and experimental pharmacology and therapeutics covering the interrelated areas of diabetes, obesity and metabolism. The journal prioritises high-quality original research that reports on the effects of new or existing therapies, including dietary, exercise and lifestyle (non-pharmacological) interventions, in any aspect of metabolic and endocrine disease, either in humans or animal and cellular systems. ‘Metabolism’ may relate to lipids, bone and drug metabolism, or broader aspects of endocrine dysfunction. Preclinical pharmacology, pharmacokinetic studies, meta-analyses and those addressing drug safety and tolerability are also highly suitable for publication in this journal. Original research may be published as a main paper or as a research letter.
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