Abstract:The incidence rate of vascular dementia is increasing year by year, and there is still no effective treatment at present, so it is very important to reduce the risk of developing vascular dementia. Research shows that diabetes is associated with vascular dementia. Based on the research literature related to diabetes and vascular dementia from January 1995 to April 2023, This article reviews the relationship between diabetes and vascular dementia, pathological mechanism and prevention and control strategies. It is found that diabetes can promote the occurrence and development of vascular dementia by inducing cerebrovascular disease, oxidative stress and inflammatory reaction, using hypoglycemic drugs, removing the incentives of cerebrovascular disease, maintaining the stability of blood-brain barrier and adhering to a healthy lifestyle are the main measures for the prevention and control of vascular dementia at this stage. Future research needs to further explore the mechanism of vascular dementia induced by diabetes, and seek economic and effective prevention targets.
[1] 曹晴. 痴呆患病率的研究[D].南京:南京医科大学,2020. [2] 曲艳吉,卓琳,王华丽,等.1980—2011年中国社区55岁及以上人群中血管性痴呆流行病学的Meta分析[J].中国卒中杂志,2013,8(7):533-543. [3] BIESSELS G J,DESPA F.Cognitive decline and dementia in diabetes mellitus:mechanisms and clinical implications[J].Nat Rev Endocrinol,2018,14(10):591-604. [4] European Association for the Study of Diabetes(EASD)Annual Meeting.Study suggests heightened risk of dementia in individuals with type 2 diabetes varies by type of dementia[EB/OL].[2023-06-28].https://www.eurekalert.org/news-releases/599417. [5] ZHENG B,SU B,PRICE G,et al.Glycemic control,diabetic complications,and risk of dementia in patients with diabetes:results from a large U.K. cohort study[J].Diabetes Care,2021,44(7):1556-1563. [6] 王惠琴. 探讨糖尿病对血管性痴呆认知功能影响[J].现代实用医学,2013,25(12):1349-1350. [7] 刘季红. 糖尿病对血管性痴呆认知功能的影响[J].糖尿病新世界,2015(2):95. [8] 史云聪,郭艺芳.2型糖尿病和动脉粥样硬化性心血管病的关系[J].心血管病学进展,2020,41(5):485-490. [9] MATSUMOTO L,SUZUKI K,MIZUNO Y,et al.Association of subclinical carotid atherosclerosis with immediate memory and other cognitive functions[J].Geriatr Gerontol Int,2018,18(1):65-71. [10] DOUX J D,YUN A J.The link between carotid artery disease and ischemic stroke may be partially attributable to autonomic dysfunction and failure of cerebrovascular autoregulation triggered by Darwinian maladaptation of the carotid baroreceptors and chemoreceptors[J].Med Hypotheses,2006,66(1):176-181. [11] 王志鹏,高仲磊,卫孟佳.脑小血管疾病磁共振成像表现与血管性认知功能障碍[J].中国临床医生杂志,2019,47(7):814-817. [12] 刘杨颖秋. 2型糖尿病患者脑小血管疾病对认知相关结构和功能影响的多参数MRI研究[D].大连:大连医科大学,2022. [13] DAULATZAI M A.Cerebral hypoperfusion and glucose hypometabolism:key pathophysiological modulators promote neurodegeneration,cognitive impairment,and Alzheimer's disease[J].J Neurosci Res,2017,95(4):943-972. [14] QIN X,AKTER F,QIN L,et al.Adaptive immunity regulation and cerebral ischemia[J/OL].Front Immunol,2020,11[2023-06-28].https://doi.org/10.3389/fimmu.2020.00689. [15] 李晶莹,赵伟东.糖尿病引发血脑屏障结构与功能失调机制的研究进展[J].中国老年学杂志,2022,42(9):2276-2282. [16] CORNFORD E M,HYMAN S,CORNFORD M E,et al.Down-regulation of blood-brain glucose transport in the hyperglycemic nonobese diabetic mouse[J].Neurochem Res,1995,20(7):869-873. [17] FERNANDS V,CHOUDHARY M,KUMAR A,et al.Proteotox-icity and mitochondrial dynamics in aging diabetic brain[J/OL].Pharmacol Res,2020,159[2023-06-28].https://doi.org/10.1016/j.phrs.2020.104948. [18] GORSKA-CIEBIADA M,SARYUSZ-WOLSKA M,BORKOWSKA A,et al.Adiponectin,leptin and IL-1β in elderly diabetic patients with mild cognitive impairment[J].Metab Brain Dis,2016,31(2):257-266. [19] ZHOU Y,ZHANG J,WANG L,et al.Interleukin-1β impedes oligodendrocyte progenitor cell recruitment and white matter repair following chronic cerebral hypoperfusion[J].Brain Behav Immun,2017,60:93-105. [20] 谢小莉,李燕,霍敏,等.老年2型糖尿病患者轻度认知功能障碍与胰岛素抵抗、白介素-6的相关性研究[J].医学信息,2019,32(15):97-98,108. [21] YANG X,CHEN Y,ZHANG W,et al.Association between inflammatory biomarkers and cognitive dysfunction analyzed by mri in diabetes patients[J].Diabetes Metab Syndr Obes,2020,13:4059-4065. [22] BELKHELFA M,BEDER N,MOUHOUB D,et al.The involvement of neuroinflammation and necroptosis in the hippocampus during vascular dementia[J].J Neuroimmunol,2018,320:48-57. [23] DYER A H,MCKENNA L,BATTEN I,et al.Peripheral inflammation and cognitive performance in middle-aged adults with and without type 2 diabetes:results from the ENBIND study[J/OL].Front Aging Neurosci,2020,12[2023-06-28].https://doi.org/10.3389/fnagi.2020.605878. [24] BERTRAM S,BRIXIUS K,BRINKMANN C.Exercise for the diabetic brain:how physical training may help prevent dementia and Alzheimer's disease in T2DM patients[J].Endocrine,2016,53(2):350-363. [25] SHEN D,TIAN X,SANG W,et al.Effect of melatonin and resveratrol against memory impairment and hippocampal damage in a rat model of vascular dementia[J].Neuroimmunomodulation,2016,23(5/6):318-331. [26] HAMED S A.Brain injury with diabetes mellitus:evidence,mechanisms and treatment implications[J].Expert Rev Clin Pharmacol,2017,10(4):409-428. [27] ESMAEILI M H,ENAYATI M,KHABBAZ-ABKENAR F,et al.Glibenclamide mitigates cognitive impairment and hippocampal neuroinflammation in rats with type 2 diabetes and sporadic Alzheimer-like disease[J/OL].Behav Brain Res,2020,379[2023-06-28].https://doi.org/10.1016/j.bbr.2019.112359. [28] GROENEVELD O N,KAPPELLE L J,BIESSELS G J.Potentials of incretin-based therapies in dementia and stroke in type 2 diabetes mellitus[J].J Diabetes Investig,2016,7(1):5-16. [29] HARDIGAN T,YASIR A,ABDELSAI M,et al.Linagliptin treatment improves cerebrovascular function and remodeling and restores reduced cerebral perfusion in type 2 diabetes[J].Am J Physiol Regul Integr Comp Physiol,2016,311(3):466-477. [30] PINTANA H,APAIJAI N,CHATTIPAKORN N,et al.DPP-4 inhibitors improve cognition and brain mitochondrial function of insulin-resistant rats[J].J Endocrinol,2013,218(1):1-11. [31] GRIECO M,GIORGI A,GENTILE M C,et al.Glucagon-like peptide-1:a focus on neurodegenerative diseases[J/OL].Front Neurosci,2019,13[2023-06-28].https://doi.org/10.3389/fnins.2019.01112. [32] PORTER K M,WARD M,HUGHES C F,et al.Hyperglycemia and metformin use are associated with B vitamin deficiency and cognitive dysfunction in older adults[J].J Clin Endocrinol Metab,2019,104(10):4837-4847. [33] MILLER J W.Proton pump inhibitors,H2-receptor antagonists,metformin,and vitamin B-12 deficiency:clinical implications[J].Adv Nutr,2018,9(4):511-518. [34] SONG J,WHITCOMB D J,KIM B C.The role of melatonin in the onset and progression of type 3 diabetes[J/OL].Mol Brain,2017,10(1)[2023-06-28].https://doi.org/10.1186/s13041-017-0315-x. [35] BROOK E,MAMO J,WONG R,et al.Blood-brain barrier disturbances in diabetes-associated dementia:therapeutic potential for cannabinoids[J].Pharmacol Res,2019,141:291-297. [36] SHANNON O M,RANSON J M,GREGORY S,et al.Mediterranean diet adherence is associated with lower dementia risk,independent of genetic predisposition:findings from the UK Biobank prospective cohort study[J].BMC Med,2023,21(1):1-13. [37] ZUO X,ZHAO R,WU M,et al.Soy consumption and the risk of type 2 diabetes and cardiovascular diseases:a systematic review and meta-analysis[J/OL].Nutrients,2023,15[2023-06-28].https://doi.org/10.3390/nu15061358. [38] OCHOA-ROSALES C,VAN-DER S N,BRAUN K V E,et al.C-reactive protein partially mediates the inverse association between coffee consumption and risk of type 2 diabetes:the UK Biobank and the Rotterdam study cohorts[J].Clin Nutr,2023,42(5):661-669. [39] DEL-POZO C B,AHMADI M,NAISMITH S L,et al.Association of daily step count and intensity with incident dementia in 78 430 adults living in the UK[J].JAMA Neurol,2022,79(10):1059-1063.