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NTIS 바로가기精神身體醫學 = Korean journal of psychosomatic medicine, v.26 no.1, 2018년, pp.59 - 67
고동환 (고신대학교 의과대학 정신건강의학교실) , 전진숙 (고신대학교 의과대학 정신건강의학교실) , 최영식 (고신대학교 의과대학 내과학교실) , 김호찬 (고신대학교 의과대학 정신건강의학교실) , 오병훈 (연세대학교 의과대학 정신건강의학교실)
Objectives : The aims of this study were to know the frequency and the nature of cognitive dysfunction in type 2 diabetics, and to reveal influencing variables on it. Methods : From eighty type 2 diabetics (42 males and 38 females), demographic and clinical data were obtained by structured interview...
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핵심어 | 질문 | 논문에서 추출한 답변 |
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당뇨병 발생과 연관되는 분자 생물학적 기전으로 무엇이 있는가? | 2형 당뇨병 환자에서 나타나는 인지 장애의 기전은 아직까지 확실히 밝혀지지는 않았으나, 여러 동물 모형을 사용한 실험이나 역학적 연구에서 당뇨병 발생과 연관되는 분자 생물학적 기전이 모든 유형의 치매(알츠하이머병, 혈관성 치매, 픽병)의 위험을 증가시킨다고 보고되었다. 5) 그 기전으로는 2형 당뇨병과 알츠하이머병이 공유하는 공통된 이상인 포도당 대사의 장애, 산화 스트레스의 증가. 비정상적인 인슐린 수용체 신호와 인슐린저항성, 단백질의 구조적 이상과 amyloidogenesis가 있다. 24,25,27) 최근의 근거들은 형태학적, 전기 생리학적 및 인지적 변화가 해마(hippocampus)에 보여서, 당뇨병 환자에서 뇌의 노화가 촉진된다는 ‘조기 뇌 노화설(theory of advanced brain aging)’이 주장되기도 하였다. | |
2형 당뇨병 환자에서 나타나는 인지 장애의 특징은 무엇인가? | 75%, MoCA-K로는 38.8%였고, 특히 시공간/실행력과 주의집중력, 언어, 지연 회상력, 지남력이 저하되었다. 본 연구에서 2형 당뇨병 환자의 인지 장애는 남성, 낮은 교육 수준, 높은 공복 시 혈당, 우울증의 심한 정 는 인지 장애의 위험도에 유의한 영향을 미쳤다. | |
2형 당뇨병이 뇌에 영향 미치는 병태 생리적 기전으로 무엇이 있는가? | 2형 당뇨병 환자에서 뇌혈관 병리는 흔한데, 29) 2형 당뇨병이 뇌에 영향 미치는 병태 생리적 기전으로서 Biessels와 Kappelle 30) 은 첫째로 대사성 및 혈관성 위험 인자에 관계되는 인자, 둘째로 고혈당증으로 뇌와 혈관에 독성 지닌 포도당 대사물에 의한 나쁜 영향, 셋째로 인슐린에 의해서 직접적으로 연접부 가소성(synaptic plasticity), 학습 및 기억을 조정하거나 인슐린 신호 전달 경로에 장해를 초래해서 AD와 뇌 노화에 내포될 가능성을 제시하였으며, 그 중에서도 특히 인슐린 그 자체의 역할을 강조하였다. 뇌 인슐린 작용의 장애는 비만, 2형 당뇨병뿐만 아니라 노화와 치매에서도 관찰된다. |
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