TyG指数、嗅觉功能与2型糖尿病并发认知障碍的关系-现代医学

TyG指数、嗅觉功能与2型糖尿病并发认知障碍的关系

单位：1. 中国人民解放军总医院内分泌科, 北京 100853;
2. 徐州医科大学附属医院肝胆胰外科, 江苏徐州 221006;
3. 扬州市妇幼保健院新生儿科, 江苏扬州 225006;
4. 南京中医药大学护理系, 江苏南京 210023

关键词：2型糖尿病认知障碍嗅觉功能甘油三酯-葡萄糖指数

分类号：R587.1

出版年·卷·期（页码）：2026·54·第五期（817-823）

摘要：

Objective: To explore the relationship of triglyceride-glucose(TyG) index and olfactory function with cognitive impairment in patients with type 2 diabetes mellitus(T2DM). Methods: A total of 206 T2DM patients at Chinese PLA General Hospital from June 2020 to July 2025 were enrolled in this study. According to the Montreal Cognitive Assessment(MoCA) evaluation results, they were divided into the cognitive impairment group and the normal cognition group. Clinical data including olfactory function score and TyG index were collected. Binary Logistic regression was used to analyze the independent correlating factors for cognitive impairment in T2DM patients. The dose-response relationship between TyG index, olfactory function score and the risk of cognitive impairment in T2DM patients was explored. Results: This study included 206 T2DM patients, of whom 67 cases developed cognitive impairment, with an incidence rate of 32.52%. Age, duration of diabetes, glycosylated hemoglobin(HbA1c), TyG index, and the proportion of comorbid diabetic retinopathy in the cognitive impairment group were higher than those in the normal cognition group, while years of education, frequency of physical exercise, and olfactory function score were lower than those in the normal cognition group(P<0.05). After variable screening by least absolute shrinkage and selection operator(LASSO) regression, binary Logistic regression analysis showed that age(OR=1.094), years of education(OR=0.844), duration of diabetes(OR=1.596), olfactory function score(OR=0.591) and TyG index(OR=2.981) were all independently correlated with cognitive impairment in T2DM patients(P<0.05). Restricted cubic spline(RCS) curve showed that TyG index had a significant linear positive correlation with the risk of cognitive impairment in T2DM patients, while olfactory function score had a significant linear negative correlation with it(P<0.05).Conclusion:The incidence rate of cognitive impairment in T2DM patients is relatively high. TyG index and olfactory function are significantly correlated with its risk of occurrence, which can provide a basis for clinical formulation of intervention strategies.

参考文献：

[1] 中华医学会糖尿病学分会.中国2型糖尿病防治指南(2020年版)[J].中华糖尿病杂志, 2021, 13(4):315-409.
[2] 王猛猛, 蒋萌, 时巧梅, 等.老年2型糖尿病患者夜间睡眠时长对认知障碍的影响[J].东南大学学报(医学版), 2025, 44(3):412-419.
[3] 中华医学会内分泌学分会.糖尿病患者认知功能障碍专家共识[J].中华糖尿病杂志，2021, 13(7):678-694.
[4] 解馨瑜, 何阳, 沈伟, 等.城市社区老年人胰岛素抵抗与认知障碍的相关性研究[J].中国临床保健杂志, 2024, 27(1):60-64.
[5] 施琪, 杨静, 李洋, 等.甘油三酯葡萄糖指数对社区老年人轻度认知功能障碍的预测价值[J].山东医药, 2025, 65(11):26-30.
[6] 朱雅静, 陆加明, 张鑫, 等.阿尔茨海默病患者嗅觉相关磁共振研究进展[J].中国CT和MRI杂志, 2024, 22(1):170-172.
[7] 马永信, 李梅, 陈敏, 等.高压氧综合治疗2型糖尿病神经病变嗅觉功能障碍的疗效观察[J].中华航海医学与高气压医学杂志, 2021, 28(6):802-804.
[8] 米颜.嗅觉识别功能评估在轻度认知障碍筛查中的应用[D].延安:延安大学, 2022.
[9] 冯琳, 高凌.中年2型糖尿病周围神经病变患者认知功能特点及影响因素的研究[J].临床内科杂志, 2025, 42(2):136-139.
[10] 杨恕宁, 刘鑫, 徐运.脑小血管病患者神经心理及认知障碍的危险因素分析[J].现代医学, 2025, 53(10):1549-1556.
[11] 张宁, 陈雁, 张红梅, 等.2型糖尿病患者轻度认知功能障碍发生风险的Logistic回归和决策树预测模型的构建[J].中国实用护理杂志, 2023, 39(32):2514-2520.
[12] YOU Y, LIU Z Z, CHEN Y N, et al.The prevalence of mild cognitive impairment in type 2 diabetes mellitus patients:a systematic review and meta-analysis[J].Acta Diabetol, 2021, 58(6):671-685.
[13] 于书卷, 王美娟, 陈丽, 等.老年2型糖尿病患者轻度认知功能障碍的影响因素[J].山东大学学报(医学版), 2022, 60(11):108-112.
[14] ZEIDAN O, JARAGH N, TAMA M, et al.The influence of insulin resistance and type 2 diabetes on cognitive decline and dementia in parkinson's disease:a systematic review[J].Int J Mol Sci, 2025, 26(16):8078.
[15] YANG C, ZHANG H, MA Z, et al.Structural and functional alterations of the hippocampal subfields in T2DM with mild cognitive impairment and insulin resistance:a prospective study[J].J Diabetes, 2024, 16(11):e70029.
[16] HAN Y, MENG X, WANG D.Association between triglyceride glucose index with cognitive impairment and dementia in adult population:a meta-analysis[J].Horm Metab Res, 2024, 56(10):737-748.
[17] TIAN N, SONG L, HOU T T, et al.Association of triglyceride-glucose index with cognitive function and brain atrophy:a population-based study[J].Am J Geriatr Psychiatry, 2024, 32(2):151-162.
[18] WEYMAN-VELA Y, SIMENTAL-MENDÍA LE, CAMACHO-LUIS A, et al.The triglycerides and glucose index is associated with mild cognitive impairment in older adults[J].Endocr Res, 2022, 47(2):89-93.
[19] MA Y M, WEI S, DANG L J, et al.Association between the triglyceride-glucose index and cognitive impairment in China:a community population-based cross-sectional study[J].Nutr Neurosci, 2024, 27(4):342-352.
[20] VURAL A, ALTUNIŞIK E, SUT S K, et al.Case-controlled clinical assessment of the olfactory system via cranial magnetic resonance imaging in patients with type 2 diabetes mellitus[J].Brain Behav, 2026, 16(1):e71210.
[21] 吴倩, 李华婷.代谢性疾病与嗅觉改变及其机制进展[J].上海交通大学学报(医学版), 2024, 44(1):131-136.
[22] LI Q, LI X, BI Y，et al.Sensory network dysregulation in type 2 diabetes:linking olfactory，visual，and cognitive function[J].Diabetes Obes Metab, 2026, 28(2):1234-1246.
[23] 龚丽娜, 谢建飞, 刘佳, 等.嗅觉障碍是2型糖尿病合并轻度认知功能障碍的危险因素[J].中南大学学报(医学版), 2021, 46(8):831-837.
[24] DONG Y, LI Y, LIU K, et al.Anosmia, mild cognitive impairment, and biomarkers of brain aging in older adults[J].Alzheimers Dement, 2023, 19(2):589-601.
[25] SHAHSAVAR P, GHAZVINEH S, RAOUFY M R.From nasal respiration to brain dynamic[J].Rev Neurosci, 2024, 35(6):639-650.
[26] 朱为, 吴昊伟, 徐东刚.嗅觉刺激在改善认知功能障碍中的研究进展[J].军事医学, 2024, 48(9):701-707.
[27] 文凡, 向阳, 朱欢, 等.运动干预改善2型糖尿病患者的微血管功能[J].中国组织工程研究, 2026, 30(5):1225-1235.

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