Introduction:Connective tissue diseases (CTDs), which include systemic lupus erythematosus (SLE), rheumatoid arthritis (RA), Sjogren's syndrome (SS), and so on, represent a group of autoimmune disorders that predominantly affect the body's connective tissues. Aim:This study aimed to investigate the clinical efficacy of sirolimus in patients with connective tissue disease complicated with refractory thrombocytopenia (CTD-RTP) and its effect on immune regulation. Material and methods:A retrospective study was conducted on 13 patients diagnosed with CTD-RTP who were treated with oral sirolimus for 6 months, starting with a daily dose of 1 mg. Changes in platelet counts, T cell lymphocyte subsets, regulatory T cells (Tregs), B cells, and cytokine levels were assessed from baseline to the end of the 6-month treatment. From November 2020 to December 2023, 13 patients with CTD-RTP were consecutively enrolled and monitored. Results:The treatment was well tolerated with no severe drug-related toxicities were reported. After 3 months of sirolimus treatment, 7 patients exhibited a positive response (PR), with 1 patient achieving complete response (CR), resulting in an overall response rate of 61.5%. Continued treatment for 6 months led to further improvements, with the total effective rate reaching 76.9%. Importantly, there was a significant increase in peripheral blood Tregs after treatment compared with the baseline level. Conclusions:Sirolimus is an effective and safe treatment option for CTD-RTP patients, and its effect may be related to its ability to increase the level of regulatory T cells in peripheral blood.

Importance:A recent study reported that methotrexate may reduce joint pain in patients with inflammatory hand osteoarthritis (OA). However, it remains unknown whether methotrexate has similar effects on inflammatory knee OA. Objective:To examine whether methotrexate has symptom-relieving and disease-modifying effects for participants with knee OA and effusion-synovitis. Design, Setting, and Participants:This multicenter, placebo-controlled randomized clinical trial was conducted at 11 sites in China between July 18, 2019, and January 15, 2023. Community-dwelling patients with inflammatory knee OA with effusion-synovitis on magnetic resonance imaging were included. Interventions:Participants were randomly assigned (1:1) to receive methotrexate, up to 15 mg weekly, or placebo using block randomization, stratified by study site. Main Outcomes and Measures:The primary outcomes were knee visual analog scale (VAS) pain change and effusion-synovitis maximal area change, over 52 weeks in the intention-to-treat population. Results:Of 278 participants screened, 215 participants (mean [SD] age, 60.4 [7.4] years; 191 [89%] female) were randomized (108 to the methotrexate group; 107 to the placebo group), and 175 (81%) completed the trial. Changes in VAS pain and effusion-synovitis maximal area were not significantly different between the methotrexate and placebo group over 52 weeks (between-group difference, 0.3 mm [95% CI, -6.7 to 7.3 mm] for VAS pain; 0.1 cm2 [95% CI, -0.8 to 1.0 cm2] for effusion-synovitis maximal area). No significant between-group differences were found for any of the prespecified secondary outcomes. At least 1 adverse event occurred in approximately 32 participants (29.6%) in the methotrexate group and 26 participants (24.3%) in the placebo group. Conclusions and Relevance:The results of this randomized clinical trial show that, compared to placebo, low-dose methotrexate did not reduce pain or effusion-synovitis over 52 weeks in patients with knee OA and effusion-synovitis. Trial Registration:ClinicalTrials.gov Identifier: NCT03815448.

IntroductionThis study aimed to evaluate the prevalence of frailty and to identify its associated risk factors in hospitalized patients with Sjögren’s disease (SjD).MethodsA cross-sectional study was conducted among hospitalized SjD patients at Xuanwu Hospital between August 2022 and October 2024. Frailty was evaluated using the Fried Frailty Phenotype, which comprises five components: unintentional weight loss, self-reported exhaustion, low physical activity, slowness, and weakness. Based on established criteria, patients were categorized as frail (≥3 criteria), pre-frail (1–2 criteria), or robust (0 criteria).ResultsA total of 180 patients were included in the final analysis. The prevalence of frailty and pre-frailty was 27% and 49%, respectively. Multivariate logistic regression analyses identified higher c-reactive protein (OR = 1.080, 95% CI: 1.020-1.144, P = 0.008), the EULAR Sjögren’s Syndrome Disease Activity Index (OR = 1.082, 95% CI: 1.027-1.140, P = 0.003), and EULAR Sjögren’s Syndrome Patient Reported Index (OR = 1.271, 95% CI: 1.064-1.518, P = 0.008) as independent risk factors for frailty.ConclusionsFrailty is commonly observed among hospitalized patients with SjD and is independently associated with systemic inflammation and disease activity. These findings underscore the need for routine frailty assessment in clinical practice, particularly among patients with elevated inflammatory markers and more severe disease manifestations.

As few cerebral venous thrombosis (CVT) patients with primary Sjögren’s syndrome (pSS) have been reported, little is known about the characteristics of this rare complication. This study is aimed at describing the clinical features, treatment, and outcome of CVT combined with pSS. We reported five patients of CVT and pSS admitted to our hospital and searched the relevant case reports in PubMed for literature review. We reviewed a total of twelve patients with pSS and CVT. Among them, five patients were from our report in the present paper, and seven other patients were from the case reports searched in PubMed. In total twelve patients, eleven patients were female. The twelve patients had an average age of 43.7 ± 8.3 years (age range, 26–57 years). The symptoms of pSS included multiple caries (50

结缔组织病合并难治性血小板减少( CTD-RP)是指存在明确的结缔组织病( CTD)同时合并难治性血小板减少( RP) ,是结缔组织病最严重的血液学受累形式之一, CTD-RP 的范围从PLT计数的轻微下降到重要脏器出血,常经过糖皮质激素治疗无效或减量后复发,是临床治疗的难点. 难治性血小板减少经过传统糖皮质激素和免疫抑制剂治疗无效,可给予二线治疗方案包括PLT生成素受体激活剂、立妥昔单抗和脾切除等[1-2]. 尽管费用昂贵,然而仍有部分治疗无效,死亡率极高. Feng等[3]报道西罗莫司治疗难治性特发性血小板减少( ITP)有效,3个月的总有效率为85％. 基于上述研究结果,本文对我院6例接受西罗莫司治疗CTD-RP患者的疗效和安全性进行回顾性分析,总结其临床特点、治疗效果与不良反应,以期更好地指导临床治疗和用药.

OBJECTIVES:We aimed to investigate the clinical features of Takayasu arteritis with cerebral infarction, and the risk factors for cerebral infarction.METHODS:The study analysed 122 consecutive patients with Takayasu arteritis retrospectively. The clinical characteristics of Takayasu arteritis patients with and without cerebral infarction were compared. Binary logistic regression analysis was performed to determine risk factors for cerebral infarction in Takayasu arteritis patients.RESULTS:Cerebral infarction was present in 42 (34.4%) of 122 patients with Takayasu arteritis. There were 33 patients with ischaemic stroke and 11 with asymptomatic lacunar infarction, including two patients with both types of infarction. The cerebral infarction group had a significantly higher proportion of males, higher prevalence of blurred vision, and higher Indian Takayasu Clinical Activity Score (ITAS) 2010 than the non-cerebral infarction group. Binary logistic regression analysis indicated that hyperlipidaemia [odds ratio (OR) 5.549, P=0.021], ITAS 2010 (OR 1.123, P= 0.023), number of involved arteries (OR 1.307, P=0.018), and middle cerebral artery (MCA) involvement (OR 4.013, P=0.029) were significantly associated with cerebral infarction in patients with Takayasu arteritis. Receiver operating characteristic curves indicated fair performance of the ITAS 2010 (>6) and number of involved arteries (> 7) for distinguishing Takayasu arteritis patients at risk of cerebral infarction from those without such risk.CONCLUSION:Hyperlipidaemia, higher ITAS 2010, larger number of involved arteries, and MCA involvement are independent risk factors for cerebral infarction in Takayasu arteritis patients.

目的 分析三甲医院规范化培训住院医师(住培医师)职业倦怠的现状,并分析其危险因素.方法 选择2019年某三甲医院住培医师196名为研究对象,采用电子问卷形式对住培医师的性别、年龄、婚姻状况、教育程度、规培年限、在职状态和专业情况等基线资料及职业倦怠程度进行调查,并采用多因素Logistic回归分析住培医师职业倦怠的危险因素.结果 住培医师的职业倦怠率为19.9％,其中出现重度情感耗竭、重度低成就感、重度去人格化的比例分别为13.8％、23.0％、71.4％.在读研究生是发生重度情感耗竭(P=0.034,OR=4.346,95％CI:1.12-16.856)、重度低成就感(P=0.039,OR=3.67,95％CI:1.156-12.741)、重度去人格化(P=0.01,OR=4.571,95％CI:1.935-10.798)的危险因素;26岁～30岁组(P=0.031,OR=2.995,95％CI:1.106-8.11)、31岁～36岁(P=0.018,OR=7.451,95％CI:1.416-39.221)、未婚(P=0.008,OR=2.684,95％CI:1.296-5.558)、硕士(P=0.002,OR=3.864,95％CI:1.624-9.194)及本科学历(P=0.008,OR=3.308,95％CI:1.363-8.031)、其他医院医师(P=0.024,OR=2.688,95％CI:1.141-6.33)均是住培医师发生重度去人格化倦怠的危险因素.结论 三甲医院住培医师职业倦怠发生率较高,研究生住陪医师是发生职业倦怠的高危人群,培训组织者及培训专科应给予足够的关注.

目的 调查分析某三甲医院风湿科老年住院患者风湿病分布情况.方法 选取首都医科大学宣武医院风湿科住院患者2360例,将所有患者按照年龄不同分为2组.<60岁为中青年组(1293例),≥60岁为老年组(1067例),记录患者性别、年龄、出院诊断以及合并症情况.采用SPSS 21.0软件进行数据分析,用四格表χ2检验分析不同疾病组之间的差异.结果 在系统性红斑狼疮、类风湿关节炎中老年男性患者的比例较中青年组高;在痛风中老年女性患病的比率较中青年组高;在皮肌炎及重度骨关节炎中老年组男女患病比例与中青年组相反;在大动脉炎及系统性硬化症中无老年男性病例.结论 老年人患风湿病与中青年不同,不同性别患病分布情况有其自身特点.在临床工作中,应注意老年风湿病患者的患病分布情况,有助于临床的诊断及治疗.

目的 分析白塞综合征(BS)并发颅内静脉窦血栓(CVST)患者的临床表现、影像学特征、治疗及预后.方法 回顾性分析2013年1月 ～2020年9月于首都医科大学宣武医院住院的BS患者临床资料,并比较并发和没有CVST的BS患者之间的区别.结果 在89例BS患者中,有13例(14.6％,7例女性,平均年龄31.2±8.7岁)被诊断为CVST.多为慢性起病(76.9％),头痛、恶心、呕吐是最常见的症状,脑脊液压力升高10例(76.9％),血栓形成部位多见于横窦(100％)、乙状窦(92.3％).与没有CVST的BS患者比较,并发CVST患者颅外血管受累的发生率(P=0.038)、纤维蛋白原(P=0.034)、D-二聚体(P=0.000)和BDCAF2006评分(P=0.024)更高.所有患者均予糖皮质激素、免疫抑制剂及抗凝治疗.在23个月的中位随访期(3～60个月)中,所有患者病情缓解,没有死亡病例.结论 CVST是BS罕见的并发症,发病年龄偏年轻化,头痛是最常见的临床症状,横窦、乙状窦是血栓最常见的部位,易合并其他部位血栓,糖皮质激素和免疫抑制剂治疗有效,早期识别和积极治疗CVST可获得很好的疗效.

Incentive system is an indispensable means in the process of standardized residency training, which plays an important role in improving the work efficiency and service quality of residents, teachers and other participants. Based on the analysis of the problems existing in the holistic incentive system, we have implemented a set of personalized incentive measures for the training of residents in department rotation and achieved preliminary results, which provides ideas for exploring personalized incentive system for standardized residency training.

患者,男,17岁,因"咳嗽25天,发热3周"于2019年9月17日收入我科.患者25天前无明显诱因出现咳嗽,4天后出现发热,体温最高达38. 5℃,伴畏寒,夜间咳少量白痰,伴胸骨旁疼痛,自行口服抗生素、复方甲氧那明胶囊和孟鲁司特,咳嗽及发热症状均未见明显好转,后来我院就诊.既往史、个人生活史无特殊.家族史:母亲患大动脉炎.体格检查:T 38. 5 ℃, P 100次/分,R 22次/分,Bp 120/80 mmHg;咽部充血,双侧扁桃体Ⅰ°肿大;双肺呼吸音粗,未闻及明显干、湿啰音,胸骨旁肋骨轻压痛;心律齐,心音正常,未闻及杂音及额外心音,无血管杂音;腹软,无压痛、反跳痛;四肢关节无肿胀及压痛.

目的 分析实质性神经白塞综合征(parenchymal neuro-Beh?et syndrome,p-NBS)的临床表现、影像学特征、治疗及预后.方法 回顾性分析2013年1月-2020年9月首都医科大学宣武医院收治的p-NBS患者的临床资料,选择年龄和性别与p-NBS匹配的无神经白塞综合征(neuro-Beh?et syndrome,NBS)的白塞综合征(Beh?et syndrome,BS)患者为对照组,比较p-NBS组与对照组之间临床特征、实验室指标(红细胞沉降率、CRP、纤维蛋白原)、2006版白塞综合征疾病活动度量表(Beh?et's disease current activity form 2006,BDCAF2006)评分的差异.结果 p-NBS组和对照组各纳入22例患者.与对照组相比,p-NBS组患者眼部受累的比例(31.8％?vs.4.5％,P=0.046)更高,BDCAF2006评分(4.5±0.9分vs.?2.8±0.9分,P<0.001)更高.头颅MRI检查显示p-NBS最常见的受累部位是脑桥(45.5％,10/22).22例p-NBS患者中,男性13例(59.1％),平均年龄34.8±9.9岁;锥体束征(54.5％,12/22)、肌无力(50.0％,11/22)和共济失调(45.5％,10/22)是最常见的神经系统症状;11例(50.0％)患者脑脊液中细胞总数增加,5例(22.7％)蛋白含量增加.所有p-NBS患者均予以糖皮质激素、免疫抑制剂治疗,在24(3～72)个月的中位随访期中,2例(9.1％)死亡.结论 p-NBS好发于青年男性,临床表现多样,最常见的受累部位是脑桥.糖皮质激素和免疫抑制剂是主要的治疗方法.与无NBS的BS患者相比,更易出现眼部受累,疾病活动性更高.

目的 总结和分析风湿免疫科的规范化培训医师病历书写中的缺陷,为提高病历书写水平提供对策依据.方法 随机抽取120份某院风湿免疫科2019年1月～12月的入院记录,进行缺陷总结和原因分析.结果 现病史书写缺陷率最高(59.2％),其中阴性症状缺乏最常见,其次是诊疗过程记录不完整和症状记录或采集错误;主诉缺陷第二多见(54.2％),其中主要症状不准确最常见,其次是主诉不简练;体格检查部分缺陷也较为多见(36.7％),最常见的是症状体征混淆以及体格检查和专科查体前后不一致.对所有缺陷进行原因分析,发现52.3％的缺陷是因为专科知识缺乏,25.1％是因为基本功不扎实,17.7％是因为工作态度不认真,还有4.9％的缺陷是对于病案书写规范不了解造成.结论 风湿免疫科规培医师书写的入院记录,缺陷率高达50％以上,病案缺陷最主要的原因是专科知识缺乏,其次是基本功不扎实,需针对发生缺陷的原因提出对策,提高规培医师病历书写水平.

Objective: The coexistence of myasthenia gravis (MG) and primary Sjögren's syndrome (pSS) is rarely reported. This study aims to describe the clinical features, treatment and outcome of MG coexisting with pSS. Materials and Methods: Herein we reported three cases with the two coexisting diseases, and also searched the PubMed, Medline databases, and China Wanfang databases for the relevant case reports written in English, Chinese, or Japanese with detailed data. Results: We reviewed a total of 17 patients with both diseases. Fifteen patients were female. The median age at onset was 48 years (range 28–78 years). MG was the initial disease in nine of 17 cases. The median interval between the onsets of the two diseases was 30 months (range 7 months to 20 years). The symptoms of MG included fatigable ptosis (64.7%), bulbar symptoms (58.8%), muscle fatigability (64.7%), diplopia (64.7%), dyspnea (23.5%), and facial paralysis (5.9%). Anti-acetylcholine receptor antibody was positive in 70.6% patients. All the patients had sicca symptoms. Manifestations of pSS also included swollen exocrine glands (23.5%), joint pain (23.5%), hair loss (11.8%), leukopenia (11.8%), recurrent oral ulcers (5.9%), Raynaud phenomenon (5.9%), and fever (5.9%). ANA positivity was present in 70.6% patients, anti-SSA positivity in 47.1%, and double positivity of anti-SSA and anti-SSB in 17.6%. There were 12 patients (70.6%) with two autoimmune diseases (pSS and MG), and five patients with more than two autoimmune diseases. Cholinesterase inhibitors were the most commonly prescribed drugs (82.4%). Seven patients received thymectomy and one patient improved after the operation. Two patients were given intravenous methylprednisolone pulse therapy, and four patients oral steroids combined with immunosuppressants initially. Intravenous immunoglobulin and plasma exchange were used in two patients, respectively, for the respiratory failure. All the patients improved following treatment except one patient who died of MG crisis due to medication withdrawal. Conclusion: The coexistence of SS with MG is quite rare. The onset of MG may occur before or after the diagnosis of SS. Co-morbidity with MG does not seem to adversely affect the course of SS. Thus, controlling the progress of MG is the critical aspect of treatment.

目的 总结大动脉炎合并脑梗死患者的临床特点,分析此类患者脑梗死复发的相关因素.方法 回顾性分析2010年1月-2020年6月随访超过3年的大动脉炎合并脑梗死患者的临床资料,对此类患者脑梗死复发的相关因素进行分析.结果 共纳入49例患者,首次脑梗死中位年龄30.0(22.0～45.0)岁,中位随访时间3.4(3.2～3.7)年.11例(22.4％)出现复发性脑梗死,两次脑梗死间隔中位时间8.0(5.0～88.0)个月.与脑梗死无复发患者相比,复发性脑梗死患者合并糖尿病比例(27.3％?vs?2.6％,P=0.031)以及首次脑梗死后随访期间平均TG水平(3.65±0.96?mmol/L?vs?1.14±0.54?mmol/L,P=0.001)升高.大动脉炎受累动脉以颈总动脉最为常见(48/49,98％),其次是椎动脉(40/49,81.6％),受累血管病变性质以狭窄(49/49,100％)和闭塞(36/49,73.5％)最常见.脑梗死复发组动脉闭塞比例(100％?vs?65.8％,P=0.024)和动脉血栓发生率(45.5％?vs?13.2％,P=0.033)均高于脑梗死无复发组.治疗方面,脑梗死复发组抗血小板治疗患者比例(63.6％?vs?97.4％,P=0.007)及接受血管重建术的患者比例(27.3％?vs?68.4％,P=0.033)均低于脑梗死无复发组.结论 大动脉炎合并脑梗死的患者,如合并糖尿病、血脂控制欠佳、主动脉弓分支动脉有闭塞、血栓形成者,脑梗死复发风险高.

Aim: The aim of this study was to investigate the risk factors for cognitive impairment in older people with diabetes. Methods: This cross-sectional study included 2626 community-dwelling participants with diabetes aged ⩾55 years, living in Beijing, China. The participants were screened for risk factors, including smoking, obesity, hypertension, stroke, coronary heart disease, dyslipidemia, depression, apolipoprotein E (APOE) genotype, and low physical activity. Cognitive function was assessed with the scholarship-adjusted Mini-Mental State Examination (MMSE): MMSE ⩽17 for iliterate participants; MMSE ⩽20 for primary school graduates (⩾6 years of education); and MMSE ⩽24 for junior school graduates or above (⩾9 years of education). Results: The prevalence of cognitive impairment in older people with diabetes was 9.90%. Multiple logistic regression analysis demonstrated that stroke [odds ratio (OR) = 1.71, 95% confidence interval (CI) = 1.20–2.43], less than 0.5 h exercise per day (OR = 1.89, 95% CI = 1.37–2.61), and depression (OR = 1.64, 95% CI = 1.06–2.54), but not smoking, obesity, hypertension, dyslipidemia, and coronary heart disease, were independent risks for cognitive impairment in older people with diabetes. In addition, being married (OR = 0.66, 95% CI = 0.47–0.93) and urban living (OR = 0.33, 95% CI = 0.22–0.48) could decrease the risk of cognitive impairment. Conclusions: Stroke, depression, and less than 0.5 h exercise per day were independent risks for cognitive impairment in older people with diabetes, whereas being married and urban living were protective.

患者,男,44岁. 主因"间断性双下肢水肿3年,加重伴外生殖器肿胀15 d"入院. 患者3年前出现间断性双下肢可凹陷水肿,休息后可缓解. 15 d前劳累后再次出现双下肢可凹陷水肿,伴阴茎及阴囊肿胀,夜尿增多,5～6次/d,100～150 ml/次.既往史:吸烟30年,约40支/d,偶尔饮酒. 个人史、婚育史、家族史无特殊. 查体:T 36. 7℃, P 82 次/min, R 20 次/min, BP 192/110 mmHg. 神志清,自主体位,皮肤、黏膜、淋巴结、头颅、五官,颈部、胸廓、心肺查体无异常. 腹部柔软,无压痛及反跳痛,未触及包块,双侧中输尿管点有压痛,双肾区叩痛阳性,阴茎及阴囊肿大、有压痛. 实验室检查:血肌酐239 μmol/L,血尿酸481 μmo/L;免疫球蛋白:IgG 6. 07 g/L,肿瘤标志物示癌胚抗原(CEA) 5. 15 ng/ml,CA-12543. 7 U/ml,神经元特异性烯醇化酶(NSE) 17.66 ng/ml,血清骨胶素(CYFRA21-1)3. 59 ng/ml.血常规、尿常规、IgM、IgA、类风湿因子、C反应蛋白均未见异常.辅助检查:泌尿系统彩超提示腹膜后低回声包块,双侧肾盂扩张,右侧输尿管上段扩张,腹主动脉硬化斑块形成;腹部CT和MR提示"腹膜后广泛软组织阴影,包绕腹主动脉、下腔静脉、部分髂血管和输尿管"(见图1、2). 入院后初步诊断为腹膜后纤维化,双侧肾盂、输尿管积水,肾功能不全,高血压病3级(极高危). 由于患者血肌酐和血压进行性升高,考虑输尿管梗阻导致急性肾功能不全,请泌尿科会诊后予以双侧输尿管扩张术和左侧输尿管D-J管置入术解除输尿管压迫症状,但患者血肌酐和血压无明显下降,考虑与肿物压迫有关. 于是在腹腔镜下进行腹部探查,并对腹膜后肿物进行组织活检,病理诊断为弥漫大B细胞淋巴瘤(图3见插页Ⅱ) ,给予规范R-CHOP方案(美罗华375 mg/m2 +环磷酰胺750 mg/m2 +多柔比星50 mg/m2 +长春新碱1. 4 mg/m2 +泼尼松60 mg/m2 ,每3周化疗1次)治疗8个疗程后腹膜后肿物明显减小(见图4),并于2018年4月11日泌尿外科行D-J管取出术,目前患者肌酐恢复正常,仍需要口服降压药治疗.

老年人衰弱程度可反映身体状况,发现其相关危险因素则有助于干预衰弱,改善老年人预后及生活质量.研究发现肥胖与老年衰弱相关,而体质量指数(BMI)和腰围(WC)可用来评估肥胖程度,BMI代表人体肥胖程度,WC与代谢障碍关系密切.本文通过BMI和WC两个指标综述了肥胖和老年人衰弱的研究进展,旨在阐明三者关系,为临床干预衰弱提供新思路.

Aim: The aim of this study was to investigate whether elderly people with impaired fasting glucose (IFG) or diabetes mellitus (DM) share the common risk factors for cognitive impairment as compared to normal blood glucose population. Methods: This cross-sectional study assessed 10,039 community-dwelling participants aged >= 55 years in Beijing, China. According to the glycemic status, subjects were classified into three groups: normal fasting plasma glucose (NG, n=6399), impaired fasting glucose (IFG, n=873) and DM (n=2626). The Mini-Mental State Examination (MMSE) was applied to evaluate the cognitive function status of the study population. Potential demographic, clinical, and genetic risk factors for cognitive impairment were collected and compared across the three groups. Multivariate logistic regression model was performed to explore the risk factors associated with cognitive impairment. Results: Education-modified MMSE scores in the participants with NG, IFG, and DM were 26.91 +/- 3.94, 26.67 +/- 4.00, and 26.58 +/- 4.11, respectively (P=0.0008). In the age-and sex-adjusted comparisons, the MMSE scores in subjects with DM and IFG were significantly lower than that in subjects with normal glucose (P=0.01 and P=0.02, respectively). The logistic regression analysis showed that risk factors only in the NG population were older age, female, apoE epsilon 4 carrier, normal or lower uric acid (UA) levels. Hypertension was an independent risk factor only in IFG group, and the history of stroke and depression were the risk factors associated with cognitive impairment only in the DM group. Conclusion: Subjects with DM or IFG had a lower performance on the MMSE test compared with subjects who had normal blood glucose. The elderly with diabetes and IFG have some different risk factors for cognitive impairment as compared to those with normal blood glucose.