Objective To develop a new, alternative sarcopenia risk score to screen for sarcopenia in type 2 diabetes patients in China and to demonstrate its validity. Research design and methods The data for this study came from a multicenter, cross-sectional study that had been designed to estimate the prevalence of sarcopenia among adults with type 2 diabetes and had been conducted in several hospitals in Beijing, China. A total of 1125 participants were randomly divided into two groups: an exploratory population and a validation population. A multivariable logistic regression model using the backward stepwise likelihood ratio method to estimate the probability of sarcopenia was fitted with candidate variables in the exploratory population. A new, alternative sarcopenia risk score was developed based on the multivariable model. The internal and external validations were performed in the exploratory and validation populations. The study was registered at Chinese Clinical Trial Registry (ChiCTR-EOC-15006901). Results The new, alternative sarcopenia risk score included five variables: age, gender, BMI, total energy intake per day, and the proportion of calories supplied by protein. The score ranged from − 2 to 19. The area under the receiver operating characteristic (ROC) curve of the risk score for the prediction of sarcopenia in type 2 diabetes patients was 0.806 (95% CI 0.741–0.872) and 0.836 (95% CI 0.781–0.892) in the exploratory and validation populations, respectively. At the optimal cutoff value of 12, the sensitivity and specificity of the score for the prediction of sarcopenia were 70.9% and 81.0% in the exploratory population and 53.7% and 88.8% in the validation population, respectively. The Hosmer–Lemeshow goodness-of-fit test showed a good calibration with the risk score in external validation ( χ 2 = 4.459, P = 0.813). Conclusions The new, alternative sarcopenia risk score appears to be an effective screening tool for identification of sarcopenia in Chinese patients with type 2 diabetes in clinical practice. Clinical trial registration Chinese Clinical Trial Registry, ChiCTR-EOC-15006901.

Sarcopenia is considered to be a new complication of type 2 diabetes (T2DM) leading to increased risk of adverse outcome. We performed a survey to evaluate glucose metabolism and nutritional status in sarcopenia patients with T2DM. Diabetic participants aged ≥50 years were grouped into a probable sarcopenia group with low muscle strength (n=405) and a nonsarcopenia group with normal muscle strength (n=720) according to the revised recommendations from EWGSOP2 (2018). Compared to the controls, the probable sarcopenia participants were older and had lower waist-to-hip ratio and BMI, longer diabetes duration, higher fasting plasma glucose level and glycosylated hemoglobin (HbA1c), decreased estimated glomerular filtration rate and lower bone mineral content, lower fatless upper arm circumference, lower appendicular skeletal muscle mass index (ASMI), and muscle quality in both genders. Multivariable logistic regression analysis showed increased age, male, low BMI, and increased HbA1c, combined with diabetic nephropathy and decreased serum albumin levels, were risk factors associated with low muscle strength in diabetes patients. In conclusion, diabetic patients with sarcopenia had worse glucose metabolism and nutritional status, decreased renal function and reduced muscle quality ,and muscle mass with a greater likelihood of osteoporosis, who need an overall health management to improve outcomes. This clinical trial registration is registered with the Chinese Clinical Trial Registry, ChiCTR-EOC-15006901.

目的 比较糖尿病前期患者与健康人群前庭温度试验的差异,了解糖尿病前期是否存在前庭功能受损,并探讨糖尿病前期前庭功能受损的影响因素.方法 通过口服葡萄糖耐量试验连续入组糖尿病前期患者62例,男性30例,女性32例,平均年龄(52.21±9.78)岁,对照组选取同期年龄、性别构成接近的血糖结果正常的健康体检人群44例,男性19例,女性25例,平均年龄(49.55±7.20)岁.收集受试者身高、体质量等一般资料,进行内分泌相关检查及前庭温度试验,记录双眼慢相角速度.在糖尿病前期组中分析前庭功能损害的影响因素.结果 糖尿病前期组44例(71.0％)存在前庭功能损害,对照组为17例(38.6％),差异有统计学意义(P =0.001);与对照组比较,糖尿病前期组双眼慢相角速度下降,差异有统计学意义(右眼P=0.026,左眼P=0.016);在糖尿病前期组中,Logistic回归分析显示,随着年龄增大,糖化血红蛋白浓度升高,糖尿病前期患者出现前庭功能损害的危险性增大(年龄P=0.013,糖化血红蛋白P=0.040).结论 糖尿病前期患者前庭功能损害检出率高,表现为双侧受损.年龄、糖化血红蛋白是糖尿病前期前庭功能损害的可能危险因素.

Objective To investigate the prevalence of sarcopenia in middle aged and elderly patients with type 2 diabetes (T2DM) and clarify the associated risk factors. Methods From January 2016 to March 2018, 1125 T2DM patients over 50 years old in endocrinology departments of nine hospitals in Beijing were enrolled in this study with system random sampling method. All patients, including 586 males and 539 females, were grouped into middle aged group (50-59 years), young elderly group (60-74 years) and elderly group (over 75 years) by age. Body composition was measured with bioimpedance analysis. Low muscle mass was defined as the appendicular skeletal muscle mass index below 7.18 kg/m2 in men and 5.73 kg/m2 in women. Low muscle strength was defined as grip strength below 29.5 kg in men and 21.2 kg in women. Sarcopenia was defined with low muscle mass coexisted with low grip strength. Chi-square test was used to compare the prevalence difference between groups. Multivariate Logistic regression was used for correlation analysis. Results (1) The detection rate of low muscle mass in all participants was 14.0％(157/1125),which was significantly higher in male than that in female(18.3％vs 9.3％,χ2=18.867,P<0.05). (2) The detection rate of low grip strength in all participants was 36％(405/1125), which was significantly higher in male than that in female (50.3％ vs 20.4％,χ2=109.183, P<0.05). (3) The prevalence of sarcopenia in all participants was 8.5％(96/1125), which was significantly higher in male than that in female (12.8％vs 3.9％,χ2=28.509, P<0.05). The prevalence of sarcopenia were 4.4％(21/475), 8.9％(49/548), 25.5％(26/102) in middle aged group, young elderly group and elderly group, respectively (χ2=47.984, P<0.05). The sarcopenic prevalence in male was obviously higher than that in female in young elderly and elderly group (χ2=9.872-16.325, all P<0.05). (4) Logistic regression analysis showed that men, aging, low body mass index (BMI) and high glycated hemoglobin A1c (HbA1c) were risk factors associated with sarcopenia. The risk of sarcopenia increased obviously in patients older than 75 years (OR=4.992, 95％CI:2.448-10.179) or whose HbA1c was over 10％(OR=3.563, 95％CI:1.526-8.322). Conclusions The risk of low muscle mass and low muscle strength increases in aged and elderly patients with T2DM. Low BMI, aging, high HbA1c were risk factors associated with sarcopenia in elderly patients with T2DM.

目的 对2型糖尿病患者的静态平衡功能进行分析.方法 纳入符合2型糖尿病诊断标准的患者30例,同时选取年龄、性别匹配的正常人30名作为对照组.收集受试者一般基线资料及内分泌相关生物化学检验结果,应用PC708型静态平衡仪,分别进行睁眼、闭眼站立于硬平台时的平衡功能测试,比较轨迹图面积、轨迹总长度、单位面积轨迹长及Romberg率.结果 糖尿病组在睁眼站立于硬平台时,轨迹图面积、轨迹总长度及Romberg率大于对照组,差异有统计学意义(P＜0.05).糖尿病组在闭眼站立于硬平台时,轨迹图面积、轨迹总长度均大于对照组,差异有统计学意义(P＜0.05).糖尿病组单位面积轨迹长小于对照组,Romberg率大于对照组,差异有统计学意义(P＜0.05).结论 2型糖尿病患者出现静态平衡功能下降:睁眼情况下,糖尿病患者站立位维持静态平衡稳定能力降低;闭眼情况下,糖尿病患者站立位维持静态平衡稳定能力及平衡控制能力下降;Romberg率增大,提示糖尿病患者维持站立位静态平衡功能更多依赖视觉代偿.

Objective To evaluate the static balance function in patients with impaired glucose regulation. Methods Twenty-nine patients [13 males and 16 females, mean age (49.69±6.13) years] with impaired glucose regulation (IGR group) were recruited from Fuxing Hospital of Capital Medical University between July 2016 and August 2017, and 24 healthy controls [5 males and 19 females, (46.37±7.19) years, Con group] were recruited in the same period. General baseline data and endocrine-related test results were collected. Static balancing apparatus was used to evaluate the balance function of the subjects. The evaluation indexes include the unit area statokinesigram length (UAL), total length of the track, maximum amplitudes, the surface of statokinesigram area (SSKG) and Romberg quotient. Two independent samples t test was used to compare the mean of the two groups with normal distribution, Mann-Whitney U test was used to compare the data with non-normal distribution, and χ2 test was used to compare the rates. Results (1) When standing on the hard platform with eyes opened, there was no statistically significant differences in SSKG, total length of the track, maximum amplitudes and UAL between IGR group and Con group (t=1.302-1.583, P>0.05); (2) When standing on the hard platform with eyes closed, SSKG, total length of the track, maximum amplitudes and Romberg quotient were all higher in IGR group than those in Con group [(829.22±299.48) vs (337.23±161.69) mm; (1 035.17±354.77) vs (835.75±299.48) mm; (55.38±21.89) vs (39.71±9.22) mm; (1.83±0.98) vs (1.25±0.58)%, respectively], and the UAL in IGR group was lower than that in Con group [(1.79±0.87) vs (2.76±1.22) mm, t=-3.332, P=0.002]. Conclusion When eyes open, there is no difference in the static balance function between IGR group and control group. under the condition of visual deprivation, the static balance function in IGR group is lower than that in con group; the increase of Romberg quotient indicates that the maintenance of standing static balance function in IGR patients depends more on visual compensation. Key words: Impaired glucose regulation; Static balance function; Falls

Objective: The goal was to study auditory function in prediabetes. Pure Tone Audiometry (PTA), Distortion Product Otoacoustic Emission (DPOAE) and Auditory Brainstem Response (ABR) were used to detect whether there is early hearing deterioration in the prediabetes. Methods: 168 participants underwent the Oral Glucose Tolerance Test (OGTT). 58 prediabetes patients younger than 60 years old, and 50 controls, age and sex matched, were enrolled. All subjects underwent PTA, DPOAE and ABR examinations. All relevant parameters including air and bone conduction pure tone audiometry, DPOAE amplitude and ABR latencies were collected. Results: (1) There were 25 cases with hearing loss in prediabetes (43%), while 6 cases in the control group (12%) by PTA; the difference was statistically significant (P <0.001). The hearing thresholds at each frequency (0.25kHz, 0.5kHz, 1kHz, 2kHz, 4kHz and 8kHz) in the prediabetes were higher than those in controls but only statistically significant at 4kHz and 8kHz (P < 0. 001). Air- and bone-conduction pure-tone thresholds synchronization increased. The difference between air conduction and bone conduction checked by PTA was less than 10dB. (2) DPOAE amplitude at each frequency in the prediabetes group was lower than control group; there were statistically significant differences at 1, 1.5, 2, 3, 4, 6 kHz (P < 0. 001). (3) There were no significant differences of neuron response latencies in ABR measurements between prediabetes and the control group. Conclusions: (1) Loss of auditory function began in the prediabetes stage. Sub-clinical presentations were more pronounced in the prediabetes stage. (2) Bilateral symmetry sensorineural hearing loss, especially at high frequencies, is very characteristic in prediabetic patients. (3)The preliminary findings are that DPOAE is needed to detect the usually slight hearing loss in prediabetes whereas PTA was less sensitive and did not detect such losses. (4) The damage is mainly cochlear, not in the central nervous system. Disclosure Y. Meng: None. X. Zhuang: None. B. Lu: None. X. Wu: None. Funding Capital Health Research and Development of Special Fund (2016-2-7022, 2019-1-1091); Science and Technology Plan of Beijing Municipal Education Commission (KM201610025020)

目的 比较糖尿病前期患者与健康人群间纯音测听、畸变产物耳声发射(DPOAE)和听性脑干反应(ABR)的差异,了解糖尿病前期患者是否存在听力损失,并分析糖尿病前期患者听力损失特点.方法 根据口服葡萄糖耐量试验(OGTT)连续入组年龄小于60岁的糖尿病前期患者50例,并选取50例同期年龄、性别匹配,OGTT血糖结果正常的健康体检人群作为对照组.收集受试者身高、体重等一般资料,并记录OGTT空腹及糖负荷后2h血糖、糖化血红蛋白、尿白蛋白/肌酐比值、血脂和眼底像等结果.于耳鼻喉科检查室行纯音测听、声导抗、DPOAE和ABR检查,并记录相关参数,包括气、骨导纯音听阈、DPOAE反应幅值及ABR潜伏期.结果 纯音测听检查中,糖尿病前期组25例(50％),对照组6例(12％)患者存在听力损失,两组差异有统计学意义(P＜0.001).各频率(250、500、1 000、2 000、4 000、8 000Hz)纯音听阈糖尿病前期组均较对照组升高,在4 000、800Hz频率两组差异有统计学意义(P＜0.001).听力损失表现为双侧对称性气、骨导听阈同步升高,气、骨导差异小于10dB.DPOAE检查显示糖尿病前期组全频率反应幅值下降,与对照组比较在1 000、1 500、2 000、3 000、4 000、6000 Hz差异有统计学意义(P ＜0.001).ABR检查中,糖尿病前期组与对照组比较未见潜伏期延长,差异无统计学意义.结论 糖尿病前期患者存在听力损失,呈亚临床表现;糖尿病前期患者的听力损失表现为双侧对称性感音神经性听力损失,以高频听力受损为主;糖尿病前期听力损失主要部位为耳蜗,表现为外周听觉器官障碍,尚未发现听觉中枢异常.

目的 观察纯音听阈正常的糖尿病前期(pre-diabetic)患者畸变产物耳声发射(distortion product otoacoustic emission,DPOAE)情况,探讨其变化特点.方法 根据口服葡萄糖耐量试验(oral glucose tolerance test,OGTT)和纯音测听结果连续入组年龄＜60岁的纯音听阈正常的糖尿病前期患者30例,其中,男性13例,女性17例,平均年龄(49.80±8.23)岁,对照组为同期年龄、性别构成接近、血糖结果正常的健康体检人群30例,其中,男性9例,女性21例,平均年龄(46.55±5.09)岁.所有受试者进行内分泌相关检查(包括空腹血糖、2h血糖、糖化血红蛋白、血脂、尿白蛋白/肌酐等)及畸变产物耳声发射检查,比较两组受试者各频率畸变产物耳声发射反应幅值及异常检出率.结果 糖尿病前期组左、右耳DPOAE反应幅值均低于对照组,其中左耳在0.7、1、1.5、2、3、4 kHz差异有统计学意义(P＜0.05),右耳在1.5、2、3、4、6 kHz差异有统计学意义(P＜0.05).在异常检出率方面,糖尿病前期组各频率均高于对照组,在3 kHz差异有统计学意义(P =0.037).结论 糖尿病前期在纯音测听正常时就已出现耳蜗外毛细胞功能受损,以右耳受损更为显著,存在右耳优势减弱,畸变产物耳声发射较纯音测听敏感性更高.

Background: This study explores the prevalence of subthreshold depression (SubD) and its association with factors in type 2 diabetes mellitus (T2DM) patients. Methods: This cross-sectional study involved 808 outpatients with T2DM from ten hospitals in Beijing between September 2015 and January 2016. All participants completed the Patient Health Questionnaire 9-item (PHQ-9) to evaluate depressive status, with scores between 5 and 14 considered SubD. Conditional logistic regression was conducted to investigate the variables associated with SubD in T2DM patients. Results: T2DM patients with SubD comprised 11.6% (n= 94) of the sample. The odd ratios for the variables having significant positive associations with SubD were: being a women (OR= 1.90; 95% CI: 1.09-3.32), divorced/widowed (OR= 3.27; 95% CI: 1.46-7.30), comorbidity of cerebrovascular disease (OR= 2.00; 95% CI: 1.06-3.76), more diabetic complications (OR= 8.04; 95% CI: 2.77-23.31), and higher HbA1c in men (OR= 2.41; 95% CI: 1.25-4.64). Being older (OR= 0.78; 95% CI: 0.62-0.98), exercising more (OR= 0.44; 95% CI: 0.22-0.91) and poverty (OR= 0.36; 95% CI: 0.19-0.69) were negatively related to SubD. Limitations: The sample was mainly recruited from hospital settings, which limits generalization. The study's cross-sectional design precludes making causal inferences. Conclusions: The proportion of SubD was estimated to be 11.6% among T2DM patients in Beijing. Having more diabetic complications and being divorced/widowed made the odds of having SubD 8-fold and 3-fold higher than not having it, respectively. The relationship between SubD and diabetes necessitates early screening for milder forms of depression, which can alleviate the social burden and individual impairment from major depression or other chronic diseases.

目的:探讨高压氧(hyperbaric oxygen therapy,HBOT)对2型糖尿病大血管病变血管内皮功能的影响.方法:选取雌性2型糖尿病kkay小鼠26只,随机分为高压氧治疗组(H)和模型对照组(M),同龄雌性C57BL/6J纯系正常小鼠为正常对照组(N),每组13只.建立2型糖尿病大血管病变动物模型,H组给予HBOT,M组和N组无特殊处理.各组小鼠测定血栓调节蛋白、内皮素-1、血管性假血友病因子的含量;各组小鼠测定血浆和肝脏组织中超氧化物歧化酶活性和丙二醛的含量;并观察各组小鼠腹主动脉的组织形态学变化.结果:(1)血管内皮因子:TM和ET-1:H组较M组均明显降低(P＜0.05),vWF:H组较M组非常明显降低(P＜0.01);(2)氧化应激指标:H组较M组血的SOD活性显著升高(P＜0.05),H组较M组肝脏的SOD活性有所升高但没有统计学差异(P＞ 0.05);H组较M组血和肝脏组织中的MDA含量均没有统计学差异(P＞0.05);3、组织形态学:H组较M组腹主动脉平滑肌细胞和成纤维细胞增殖和排列紊乱程度减轻,未见泡沫细胞.结论:HBOT可以减轻2型糖尿病小鼠大血管病变血管内皮损伤程度和促进血管内皮组织修复,同时并不加重氧化应激损伤.

BackgroundPersistent proteinuria is an important factor contributing to the progression of diabetic nephropathy. The present randomized double-blind placebo-controlled multicenter clinical study evaluated the efficacy and safety of telmisartan combined with the antioxidant probucol in reducing urinary protein levels in patients with type 2 diabetes (T2D).MethodsPatients with T2D and 24-h proteinuria 0.5-3 g were enrolled in the study and randomly assigned to one of two groups: a telmisartan or a probucol + telmisartan group. Both groups were given telmisartan 80 mg q.d. for 48 weeks. The probucol + telmisartan group was given probucol 500 mg b.i.d. for the first 24 weeks, with the dosage then reduced to 250 mg b.i.d. for the remaining 24 weeks. The telmisartan group was given probucol placebo.ResultsIn all, 160 patients were enrolled in the present study. The 24-h proteinuria levels were significantly reduced in the probucol + telmisartan compared with telmisartan group. For patients with baseline 24-h proteinuria levels <1.0 g, both treatments resulted in significant reductions in 24-h proteinuria levels after 48 weeks treatment. However, in patients with baseline 24-h proteinuria levels 1.0 g, 24-h proteinuria levels after 48 weeks treatment were only reduced in the probucol + telmisartan group. There was no significant difference between the two groups for either adverse cardiovascular or other events.ConclusionsIn patients with diabetic nephropathy, probucol combined with telmisartan more effectively reduces urinary protein levels than telmisartan alone.

目的 探讨并分析糖耐量减低(IGT)中年患者与糖耐量正常(NGT)受试者的记忆功能及工作记忆任务下的脑区激活改变.方法 对13例IGT患者和19名NGT受试者进行相关实验室检查、记忆评估和工作记忆任务下的功能性磁共振检查,比较两组间记忆功能及脑激活图.结果 IGT患者的视觉再生、触觉、理解等短时记忆功能较NGT受试者减低,差异有统计学意义(P ＜0.05);IGT患者右侧颞叶、颞上回(brodmann area22,BA22区)、豆状核、壳核、尾状核体激活较NGT受试者减弱.结论 IGT患者可能存在早期短时记忆功能障碍,与相关脑区激活的减弱有关.

目的 通过对糖尿病前期(pre-diabetes)患者畸变产物耳声发射(DPOAE)的筛查,了解糖尿病前期患者是否存在早期听力损失.方法 通过口服葡萄糖耐量试验入选＜ 60岁的糖尿病前期患者40例,同时选取年龄、性别匹配的血糖正常者40例为对照组,对入选人群进行纯音测听、DPOAE检查.结果 糖尿病前期组40例中17例存在纯音测听异常,对照组40例中仅3例纯音测听异常(x2=13.067,P＜0.001).糖尿病前期组DPOAE幅值在各频率点均较对照组降低,其中在1.5,2,3,4,6 kHz差异有统计学意义(P＜0.05).在1,2,4 kHz相同频率下DPOAE较纯音测听异常检出率升高(P＜0.001).结论 糖尿病前期存在听力损失,DPOAE检测可在纯音测听出现异常之前发现耳蜗外毛细胞功能状态的改变,敏感性较纯音测听高,临床上可作为糖尿病前期患者耳蜗功能早期变化的有效客观检测方法.

Objective Study was carried on the necessity, objective and speciifc action of implementing tutorial system during clinical undergraduate education. Methods Questionnaires were delivered to five-year clinical undergraduate students of 2013 Clinical Medicine Department of the Eighth Clinical Hospital Afifliated to Capital Medical University and outcomes were analyzed. Results 97.3%of the students think that it is necessary to implement tutorial system in the course of clinical teaching;the main objective of the tutorial system is to improve students’ clinical skills;As for the implementation of the program, the students hope to choose tutors by either two-way selection or random assignment, teacher-student ratio is supposed to be 1: 1; guidance and content of tutoring is in diversity, students take initiative to meet with tutors and to study clinical knowledge and skills under the guidance of tutors. At the same time, some students hope to improve communication skills with patients and to carry out research activities. Conclusion It is necessary to adopt tutorial system for undergraduates in the process of clinical teaching. It is recommended the establishment of clinical undergraduate tutorial system by optimal allocation of resources tutor, lfexibility of teaching time, a typical case-based clinical teaching method to improve clinical skills.

Objective To investigate the coverage rate of the antidiabetic drugs in national essential medicine list and the status of glycemic control among patients with type 2 diabetes mellitus (T2DM) in Beijing communities.Methods A total of 904 patients with T2DM were selected from 4 community health service centers of Beijing.They were Pingguoyuan,Yuetan,Huaxiang and Longshan community health service centers,respectively.Questionaires and chemical examination were used among them.Chi-square test was used for data analysis.Results (1) The coverage rate of metformin (40.5％,366/904) was the highest in the 4 national essential antidiabetic drugs,which in Longshan community (48.6％,121/249) was significantly higher than that of the other 3 communities (x2 =9.86,P ＜ 0.05).(2) The coverage rate of glypizide was 3.1％ (28/904),which in Huaxiang community (14.3％,16/112) was the highest (x2 =56.14,P ＜ 0.05).(3) The coverage rate of glybenclamide was 0.6％,the difference among the 4 communities had no significance(x2 =0.33,P ＞ 0.05).(4) The coverage rate of animal insulin was 0.2％ (2/904),which in Huaxiang community (1.8％,2/112) was more than those of the other communities(0).(5) The proportion of patients reaching the goal of glycated hemoglobin A1c(HbA1c) ＜7％ was 33.2％ (300/904),which in Yuetan community (55.1％,114/207) was more than that in Pingguoyuan(33.0％),Longshan (24.1％,60/249) and Huaxiang(13.4％,15/112) commumties (x2 =73.79,P ＜ 0.05).Conclusion The coverage rate of antidiabetic drugs in national essential medicine list is low in Beijing.Though the total proportion of patients reaching the goal of HbA1 c ＜ 7％ is not satisfied,the proportion in Yuetan and Pingguoyuan communities where the two-way referral between community health service centers and general hospitals has been established for a long time are satisfied.

暴发性1型糖尿病(FT1DM)是一种T1DM的新亚型,不同于经典的自身免疫性T1DM,该病起病急骤,代谢异常严重,早期可合并多器官受损,从出现症状到死亡可在24 h内发生,且妊娠是FT1DM的重要危险因素,一旦发生即可能出现死胎、孕妇死亡.本文综合我院收治的3例FT1DM患者临床资料,并复习相关文献,总结FT1DM的临床特征及治疗策略,旨在提高临床医师对FT1DM的认识,改善该类患者的预后.

葡萄糖代谢异常包括糖尿病、糖耐量减低(IGT)和空腹糖耐量(IFG)受损.研究发现糖代谢异常与认知障碍相关,增加罹患阿尔茨海默病的风险.糖代谢异常相关的认知障碍可能与胰岛素抵抗、血脑屏障转运葡萄糖障碍、高糖毒性有关.表观遗传学是研究在基因脱氧核糖核酸(DNA)编码序列不改变的情况下,各种因素如何影响基因DNA蛋白质表达和功能.最新研究发现,通过改善胰岛素抵抗及表观遗传学方面的干预可防治糖代谢异常相关性认知障碍.