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Yu JX, Hussein A, Mah L, Jean Chen J. The associations among glycemic control, heart variability, and autonomic brain function in healthy individuals: Age- and sex-related differences. Neurobiol Aging 2024; 142:41-51. [PMID: 39128180 DOI: 10.1016/j.neurobiolaging.2024.05.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2023] [Revised: 05/08/2024] [Accepted: 05/11/2024] [Indexed: 08/13/2024]
Abstract
INTRODUCTION The purpose of this study was to clarify the relationships between glycemia and function of the autonomic nervous system (ANS), assessed via resting-state functional connectivity (FC) and heart-rate variability (HRV). METHODS Data for this study were extracted from the Leipzig Study for Mind-Body-Emotion Interactions, including 146 healthy adults (114 young, 32 older). Variables of interest were glycated hemoglobin (HbA1c), resting-state FC in the salience aspect of the central-autonomic (S-CAN) and salience network (SN) and HRV (RMSSD and high-frequency HRV (HF-HRV)). RESULTS HbA1c was inversely correlated with FC in the S-CAN but not SN. HbA1c was inversely correlated with HRV. Both RMSSD and log(HF-HRV) were correlated with FC in the S-CAN and SN. Age- (not sex-related) differences were observed in the Hb1Ac-FC associations (stronger in older adults) while sex- (not age-related) differences were observed in the HRV-FC (stronger in females). CONCLUSIONS These findings extend the diabetes literature to healthy adults in relating glycemia and brain function. The age- and sex-related differences in these relationships highlight the need to account for the potential effects of age and sex in future investigations.
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Affiliation(s)
- Jeffrey X Yu
- Rotman Research Institute, Baycrest Health Sciences, Toronto, ON, Canada; Institute of Medical Science, University of Toronto, Toronto, ON, Canada
| | - Ahmad Hussein
- Rotman Research Institute, Baycrest Health Sciences, Toronto, ON, Canada
| | - Linda Mah
- Rotman Research Institute, Baycrest Health Sciences, Toronto, ON, Canada; Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| | - J Jean Chen
- Rotman Research Institute, Baycrest Health Sciences, Toronto, ON, Canada; Institute of Medical Science, University of Toronto, Toronto, ON, Canada; Department of Biomedical Engineering, University of Toronto, Toronto, ON, Canada.
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Yatagan Sevim G, Alkan E, Taporoski TP, Krieger JE, Pereira AC, Evans SL. Effects of glycaemic control on memory performance, hippocampal volumes and depressive symptomology. Diabetol Metab Syndr 2024; 16:219. [PMID: 39261923 PMCID: PMC11389280 DOI: 10.1186/s13098-024-01429-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/05/2024] [Accepted: 07/24/2024] [Indexed: 09/13/2024] Open
Abstract
BACKGROUND Diabetes and poor glycaemic control have been shown to negatively impact cognitive abilities, while also raising risk of both mood disorders and brain structural atrophy. Sites of atrophy include the hippocampus, which has been implicated in both memory performance and depression. The current study set out to better characterise the associations between poor glycaemic control, memory performance, and depression symptoms, and investigate whether loss of hippocampal volume could represent a neuropathological mechanism underlying these. METHODS 1331 participants (60.9% female, age range 18-88 (Mean = 44.02), 6.5% with likely diabetes) provided HbA1c data (as an index of glycaemic control), completed a word list learning task, and a validated depression scale. A subsample of 392 participants underwent structural MRI; hippocampal volumes were extracted using FreeSurfer. RESULTS Partial correlation analyses (controlling for age, gender, and education) showed that, in the full sample, poorer glycaemic control was related to lower word list memory performance. In the MRI sub-sample, poorer glycaemic control was related to higher depressive symptoms, and lower hippocampal volumes. Total hippocampus volume partially mediated the association between HbA1c levels and depressive symptoms. CONCLUSIONS Results emphasise the impact of glycaemic control on memory, depression and hippocampal volume and suggest hippocampal volume loss could be a pathophysiological mechanism underlying the link between HbA1c and depression risk; inflammatory and stress-hormone related processes might have a role in this.
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Affiliation(s)
- Gulin Yatagan Sevim
- Faculty of Health and Medical Sciences, School of Psychology, University of Surrey, Guildford, Surrey, GU2 7XH, UK
| | - Erkan Alkan
- Faculty of Health, Science, Social Care and Education, Kingston University, London, UK
| | - Tamara P Taporoski
- Harvard Center for Population and Development Studies, Harvard University, Cambridge, Massachusetts, USA
| | - Jose E Krieger
- University of São Paulo School of Medicine, São Paulo, Brazil
| | - Alex C Pereira
- University of São Paulo School of Medicine, São Paulo, Brazil
| | - Simon L Evans
- Faculty of Health and Medical Sciences, School of Psychology, University of Surrey, Guildford, Surrey, GU2 7XH, UK.
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Liu Q, Celis-Morales C, Sattar N, Welsh P. Association of glycaemic control with intraocular pressure in a large general population: Results from the UK Biobank. Diabetes Obes Metab 2024. [PMID: 39157858 DOI: 10.1111/dom.15865] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/04/2024] [Revised: 07/18/2024] [Accepted: 07/25/2024] [Indexed: 08/20/2024]
Abstract
AIM To evaluate the association of glycated haemoglobin (HbA1c) and serum glucose with intraocular pressure (IOP) in a large UK general population. MATERIALS AND METHODS Participants were selected from the UK Biobank, excluding those with eye conditions that may affect IOP. IOP was measured using an ocular response analyser. Goldmann-correlated IOP (IOPg) and corneal-compensated IOP (IOPcc) were outcomes of interest, and ocular hypertension was defined as left-eye IOPg or IOPcc > 21 mmHg. HbA1c and random (non-fasting) serum glucose were the exposures of interest. Multivariate restricted cubic spline models, as well as linear regression, were applied to explore the associations of interest. RESULTS Among 68 806 participants (46.5% male), the mean age was 56.7 years. The mean (standard deviation) for IOPg was 15.7 (3.6) mmHg and 15.9 (3.6) mmHg for IOPcc. Occular hypertension was prevalent in 8055 participants (11.7%) and 4178 participants (6.1%) had diabetes. Those with diabetes had higher IOP and a higher prevalence of ocular hypertension. After adjustment for demographic and clinical variables, HbA1c was positively associated with IOP in participants with diabetes, but not in those without diabetes. For every 10-mmol/mol increase in HbA1c, IOPg increased by 0.20 mmHg (95% confidence interval [CI] 0.12, 0.28) and IOPcc by 0.15 mmHg (95% CI 0.07, 0.23); the odds of ocular hypertension was increased by 6% (95% CI 1.00, 1.13) in participants with diabetes. A borderline positive association between serum glucose and IOP was found only in participants without diabetes. CONCLUSIONS Impaired glycaemic control was associated with elevated IOP and a possible risk of ocular hypertension among participants with diabetes but of normal ocular health.
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Affiliation(s)
- Qiaoling Liu
- School of Cardiovascular and Metabolic Health, University of Glasgow, Glasgow, UK
| | - Carlos Celis-Morales
- School of Cardiovascular and Metabolic Health, University of Glasgow, Glasgow, UK
- Human Performance Lab, Education, Physical Activity and Health Research Unit, University Católica del Maule, Talca, Chile
| | - Naveed Sattar
- School of Cardiovascular and Metabolic Health, University of Glasgow, Glasgow, UK
| | - Paul Welsh
- School of Cardiovascular and Metabolic Health, University of Glasgow, Glasgow, UK
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Yu D, Wang Z, Osuagwu UL, Pickering K, Baker J, Cutfield R, Cai Y, Orr-Walker BJ, Sundborn G, Qu B, Zhao Z, Simmons D. Long-term impact of type 2 diabetes onset on dementia incidence rate among New Zealanders with impaired glucose tolerance: A tapered-matched landmark analysis over 25 years. Alzheimers Dement 2024; 20:4423-4433. [PMID: 38874317 PMCID: PMC11247710 DOI: 10.1002/alz.13855] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2023] [Revised: 03/25/2024] [Accepted: 03/29/2024] [Indexed: 06/15/2024]
Abstract
INTRODUCTION We aimed to investigate the association between the onset of type 2 diabetes (T2D) and dementia incidence rates (IR) in the population with impaired glucose tolerance (IGT) identified in primary care in New Zealand (NZ) over 25 years. METHODS Tapered matching and landmark analysis (accounting for immortal bias) were used to control for potential effects of known confounders. The association between T2D onset and 5- and 10-year IR of dementia was estimated by weighted Cox models. RESULTS The onset of T2D was significantly associated with the 10-year IR of dementia, especially in the socioeconomically deprived, those of non-NZ European ethnicity, those currently smoking, and patients with higher metabolic measures. DISCUSSION Our findings suggest that the onset of T2D is a significant risk factor for dementia in individuals with IGT. Dementia screening and structured diabetes prevention are vital in the population with IGT, particularly those from deprived or ethnic minority backgrounds. HIGHLIGHTS Increased dementia incidence rate links with T2D onset in people with IGT. Significant incidence varied by ethnicity, socioeconomic status, and health factors. Results emphasize the diabetes manage and socioeconomic factors on dementia risk. Secondary analysis highlights the key role of vascular health in dementia prevention.
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Affiliation(s)
- Dahai Yu
- Department of Nephrology, the First Affiliated Hospital, Zhengzhou University, Zhengzhou, China
- Primary Care Centre Versus Arthritis, School of Medicine, Keele University, Keele, UK
| | - Zheng Wang
- Department of Nephrology, the First Affiliated Hospital, Zhengzhou University, Zhengzhou, China
| | - Uchechukwu Levi Osuagwu
- Translational Health Research Institute (THRI), Western Sydney University, Sydney, New South Wales, Australia
- School of Medicine, Western Sydney University, Sydney, New South Wales, Australia
| | | | - John Baker
- Diabetes Foundation Aotearoa, Otara, Auckland, New Zealand
- Department of Diabetes and Endocrinology, Counties Manukau Health, Otahuhu, Auckland, New Zealand
| | - Richard Cutfield
- Diabetes Foundation Aotearoa, Otara, Auckland, New Zealand
- Department of Diabetes and Endocrinology, Waitemata District Health Board, Takapuna, Auckland, New Zealand
| | - Yamei Cai
- Department of Nephrology, the First Affiliated Hospital, Zhengzhou University, Zhengzhou, China
| | - Brandon J Orr-Walker
- Diabetes Foundation Aotearoa, Otara, Auckland, New Zealand
- Department of Diabetes and Endocrinology, Counties Manukau Health, Otahuhu, Auckland, New Zealand
| | - Gerhard Sundborn
- Section of Pacific Health, the University of Auckland, Auckland, New Zealand
| | - Bingjie Qu
- Department of Nephrology, the First Affiliated Hospital, Zhengzhou University, Zhengzhou, China
| | - Zhanzheng Zhao
- Department of Nephrology, the First Affiliated Hospital, Zhengzhou University, Zhengzhou, China
| | - David Simmons
- Department of Nephrology, the First Affiliated Hospital, Zhengzhou University, Zhengzhou, China
- Translational Health Research Institute (THRI), Western Sydney University, Sydney, New South Wales, Australia
- School of Medicine, Western Sydney University, Sydney, New South Wales, Australia
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Topriceanu CC, Chaturvedi N, Mathur R, Garfield V. Validity of European-centric cardiometabolic polygenic scores in multi-ancestry populations. Eur J Hum Genet 2024; 32:697-707. [PMID: 38182743 PMCID: PMC11153583 DOI: 10.1038/s41431-023-01517-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2023] [Revised: 10/29/2023] [Accepted: 11/28/2023] [Indexed: 01/07/2024] Open
Abstract
Polygenic scores (PGSs) provide an individual level estimate of genetic risk for any given disease. Since most PGSs have been derived from genome wide association studies (GWASs) conducted in populations of White European ancestry, their validity in other ancestry groups remains unconfirmed. This is especially relevant for cardiometabolic diseases which are known to disproportionately affect people of non-European ancestry. Thus, we aimed to evaluate the performance of PGSs for glycaemic traits (glycated haemoglobin, and type 1 and type 2 diabetes mellitus), cardiometabolic risk factors (body mass index, hypertension, high- and low-density lipoproteins, and total cholesterol and triglycerides) and cardiovascular diseases (including stroke and coronary artery disease) in people of White European, South Asian, and African Caribbean ethnicity in the UK Biobank. Whilst PGSs incorporated some GWAS data from multi-ethnic populations, the vast majority originated from White Europeans. For most outcomes, PGSs derived mostly from European populations had an overall better performance in White Europeans compared to South Asians and African Caribbeans. Thus, multi-ancestry GWAS data are needed to derive ancestry stratified PGSs to tackle health inequalities.
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Affiliation(s)
- Constantin-Cristian Topriceanu
- Department of Population Science and Experimental Medicine, Institute of Cardiovascular Science, University College London, Gower Street, London, WC1E 6BT, UK.
- MRC Unit for Lifelong Health and Ageing, University College London, 1-19 Torrington Place, London, WC1E 7HB, UK.
| | - Nish Chaturvedi
- Department of Population Science and Experimental Medicine, Institute of Cardiovascular Science, University College London, Gower Street, London, WC1E 6BT, UK
- MRC Unit for Lifelong Health and Ageing, University College London, 1-19 Torrington Place, London, WC1E 7HB, UK
| | - Rohini Mathur
- Centre for Primary Care, Wolfson Institute of Population Health, Queen Mary University of London, London, UK
| | - Victoria Garfield
- Department of Population Science and Experimental Medicine, Institute of Cardiovascular Science, University College London, Gower Street, London, WC1E 6BT, UK
- MRC Unit for Lifelong Health and Ageing, University College London, 1-19 Torrington Place, London, WC1E 7HB, UK
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Otsuka S, Kikuchi K, Takeshita Y, Takada S, Tani A, Sakakima H, Maruyama I, Makizako H. Relationship between physical activity and cerebral white matter hyperintensity volumes in older adults with depressive symptoms and mild memory impairment: a cross-sectional study. Front Aging Neurosci 2024; 16:1337397. [PMID: 38414630 PMCID: PMC10896982 DOI: 10.3389/fnagi.2024.1337397] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2023] [Accepted: 01/24/2024] [Indexed: 02/29/2024] Open
Abstract
Introduction Cerebral white matter hyperintensities (WMHs) are commonly found in the aging brain and have been implicated in the initiation and severity of many central nervous system diseases. Furthermore, an increased WMH volume indicates reduced brain health in older adults. This study investigated the association between WMH volume and physical activity in older adults with depressive symptoms (DS) and mild memory impairment (MMI). Factors associated with the WMH volume were also investigated. Methods A total of 57 individuals aged over 65 years with DS and MMI were included in this study. The participants underwent magnetic resonance imaging to quantify WMH volumes. After WMH volume was accumulated, normalized to the total intracranial volume (TIV), the percentage of WMH volume was calculated. In addition, all participants wore a triaxial accelerometer for 2 weeks, and the average daily physical activity and number of steps were measured. The levels of blood biomarkers including cortisol, interleukin-6 (IL-6), brain-derived insulin-like growth factor-1, and brain-derived neurotrophic factor were measured. Motor and cognitive functions were also assessed. Results Faster maximum walking speed and longer time spent engaged in moderate physical activity were associated with a smaller percent of WMH volume, whereas higher serum IL-6 levels were associated with a larger percent of WMH volume. The number of steps per day, time spent engaged in low levels of physical activity, cognitive function, and all other measured biomarkers were not significantly associated with percent of WMH volume. Discussion Higher blood inflammatory cytokine levels, shorter duration of moderate physical activity, and lower maximum walking speed were associated with a higher percent of WMH volume. Our results provide useful information for maintaining brain health in older adults at a high risk of developing dementia and may contribute to the development of preventive medicine for brain health.
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Affiliation(s)
- Shotaro Otsuka
- Department of Laboratory and Vascular Medicine, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima, Japan
| | - Kiyoshi Kikuchi
- Division of Brain Science, Department of Physiology, Kurume University School of Medicine, Kurume, Japan
- Department of Neurosurgery, Kurume University School of Medicine, Kurume, Japan
| | - Yasufumi Takeshita
- Department of Physical Therapy, School of Health Sciences, Faculty of Medicine, Kagoshima University, Kagoshima, Japan
| | - Seiya Takada
- Department of Laboratory and Vascular Medicine, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima, Japan
| | - Akira Tani
- Department of Physical Therapy, School of Health Sciences, Faculty of Medicine, Kagoshima University, Kagoshima, Japan
| | - Harutoshi Sakakima
- Department of Physical Therapy, School of Health Sciences, Faculty of Medicine, Kagoshima University, Kagoshima, Japan
| | - Ikuro Maruyama
- Department of Laboratory and Vascular Medicine, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima, Japan
| | - Hyuma Makizako
- Department of Physical Therapy, School of Health Sciences, Faculty of Medicine, Kagoshima University, Kagoshima, Japan
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Laksmi PW, Purnamasari D, Sofian N, Sari NK, Kurniawan M, Sukrisman L, Tahapary DL, Dwimartutie N, Rinaldi I. Physio-cognitive decline syndrome among middle-aged diabetes patients: Handgrip strength significantly correlates with glycaemic control and cognitive score. Heliyon 2024; 10:e24018. [PMID: 38293379 PMCID: PMC10827469 DOI: 10.1016/j.heliyon.2024.e24018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2023] [Revised: 12/21/2023] [Accepted: 01/02/2024] [Indexed: 02/01/2024] Open
Abstract
Aims To investigate the correlation between glycaemic control with component of Physio-Cognitive Decline Syndrome (PCDS) and among each component of PCDS itself. Methods A cross sectional study was conducted (January 2021-November 2022) at Dr. Cipto Mangunkusumo Hospital, Jakarta, Indonesia on consecutively recruited T2DM outpatients aged 40-59 years old. Data on the latest three months HbA1c, hand grip strength (HGS), usual gait speed (GS), and Indonesian Montreal Cognitive Assessment (MoCA-Ina) were evaluated. Pearson or Spearman's test was used to analyse the correlations. Results There were 133 subjects with median age 53 (40-59) years. The PCDS was found in 48.1 % subjects, of which 64.1 % with uncontrolled glycaemia. Significant correlations were found between HGS and HbA1c (r = -0.24, R2 = 0.06, p < 0.01) and MoCA-Ina score (r = 0.21, R2 = 0.04, p < 0.05). Conclusion The higher HbA1c and the lower MoCA-Ina score, the weaker handgrip strength was.
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Affiliation(s)
- Purwita Wijaya Laksmi
- Geriatric Division, Department of Internal Medicine, Dr. Cipto Mangunkusumo National Referral Hospital, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia
| | - Dyah Purnamasari
- Endocrinology, Metabolism, and Diabetes Division, Department of Internal Medicine, Dr. Cipto Mangunkusumo National Referral Hospital, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia
- Metabolic Disorder, Cardiovascular, and Aging Research Center, The Indonesian Medical Education and Research Institute, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia
| | - Naldo Sofian
- Department of Internal Medicine, Dr. Cipto Mangunkusumo National Referral Hospital, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia
| | - Nina Kemala Sari
- Geriatric Division, Department of Internal Medicine, Dr. Cipto Mangunkusumo National Referral Hospital, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia
| | - Mohammad Kurniawan
- Department of Neurology, Dr. Cipto Mangunkusumo National Referral Hospital, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia
| | - Lugyanti Sukrisman
- Medical Hematology and Oncology Division, Department of Internal Medicine, Dr. Cipto Mangunkusumo National Referral Hospital, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia
| | - Dicky Levenus Tahapary
- Endocrinology, Metabolism, and Diabetes Division, Department of Internal Medicine, Dr. Cipto Mangunkusumo National Referral Hospital, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia
- Metabolic Disorder, Cardiovascular, and Aging Research Center, The Indonesian Medical Education and Research Institute, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia
| | - Noto Dwimartutie
- Geriatric Division, Department of Internal Medicine, Dr. Cipto Mangunkusumo National Referral Hospital, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia
| | - Ikhwan Rinaldi
- Medical Hematology and Oncology Division, Department of Internal Medicine, Dr. Cipto Mangunkusumo National Referral Hospital, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia
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Yu J, Lee KN, Kim HS, Han K, Lee SH. Cumulative effect of impaired fasting glucose on the risk of dementia in middle-aged and elderly people: a nationwide cohort study. Sci Rep 2023; 13:20600. [PMID: 37996487 PMCID: PMC10667225 DOI: 10.1038/s41598-023-47566-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Accepted: 11/15/2023] [Indexed: 11/25/2023] Open
Abstract
The relationship between prediabetes and dementia remains controversial. We aimed to examine the association between cumulative exposure to impaired fasting glucose (IFG) and the risk of dementia in the general population. 1,463,066 middle-aged and elderly subjects who had had health examinations for four consecutive years were identified from a Korean nationwide population-based cohort database. IFG was defined as fasting blood glucose 100-125 mg/dL, and the risk of dementia-according to the number of IFG exposure (range 0-4)-was analyzed using the multivariable Cox proportional-hazards model. During the median 6.4 years of follow-up, 7614 cases of all-cause dementia, 5603 cases of Alzheimer's disease, and 1257 cases of vascular dementia occurred. There was a significant trend towards a higher risk of all-cause dementia (P for trend = 0.014) and Alzheimer's disease ( Pfor trend = 0.005) according to the cumulative exposure to IFG, but with a modest (approximately 7-14%) increase in the hazards. A significant stepwise increase in the risk of all-cause dementia and Alzheimer's disease was seen in non-obese subjects, whereas no significant association was observed in obese subjects. This study supports the association between prediabetes and incident dementia and emphasizes that even mild hyperglycemia should not be overlooked.
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Affiliation(s)
- Jin Yu
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, 222, Banpo-daero, Seocho-gu, Seoul, 06591, Republic of Korea
| | - Kyu-Na Lee
- Department of Biomedicine and Health Science, The Catholic University of Korea, Seoul, Republic of Korea
| | - Hun-Sung Kim
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, 222, Banpo-daero, Seocho-gu, Seoul, 06591, Republic of Korea
- Department of Medical Informatics, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Kyungdo Han
- Department of Statistics and Actuarial Science, Soongsil University, #369 Sangdo-ro, Dongjak-gu, Seoul, 06978, Republic of Korea.
| | - Seung-Hwan Lee
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, 222, Banpo-daero, Seocho-gu, Seoul, 06591, Republic of Korea.
- Department of Medical Informatics, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.
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Al-Sofiani ME, Asiri A, Alajmi S, Alkeridy W. Perspectives on Prediabetes and Aging. Endocrinol Metab Clin North Am 2023; 52:377-388. [PMID: 36948785 DOI: 10.1016/j.ecl.2022.10.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/18/2023]
Abstract
Diabetes prevention programs (DPPs) have been shown to effectively delay, and sometimes prevent, the progression from prediabetes to diabetes; however, labeling someone with prediabetes comes with potential negative psychological, financial, and self-perception consequences. Many older adults with prediabetes nowadays have a relatively "low-risk" form of prediabetes that rarely progresses to diabetes and may regress to normoglycemia. In this article, we review the impact of aging on glucose metabolism and provide a holistic approach to cases of prediabetes in older adults that maximizes the benefit-risk balance of interventions aimed at addressing prediabetes.
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Affiliation(s)
- Mohammed E Al-Sofiani
- Division of Endocrinology, Department of Internal Medicine, College of Medicine, King Saud University, Riyadh, Central Region, 12372, Saudi Arabia; Division of Endocrinology, Diabetes & Metabolism, The Johns Hopkins University, 1830 East Monument Street, Baltimore, MD 21287, USA.
| | - Alanood Asiri
- Division of Endocrinology, Department of Internal Medicine, College of Medicine, King Saud University, Riyadh, Central Region, 12372, Saudi Arabia
| | - Sarah Alajmi
- Division of Endocrinology, Department of Internal Medicine, College of Medicine, King Saud University, Riyadh, Central Region, 12372, Saudi Arabia
| | - Walid Alkeridy
- Department of Medicine, King Saud University, College of Medicine, Riyadh, Central Region, 12372, Saudi Arabia
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Gao Y, Sui C, Chen B, Xin H, Che Y, Zhang X, Wang N, Wang Y, Liang C. Voxel-based morphometry reveals the correlation between gray matter volume and serum P-tau-181 in type 2 diabetes mellitus patients with different HbA1c levels. Front Neurosci 2023; 17:1202374. [PMID: 37255749 PMCID: PMC10225590 DOI: 10.3389/fnins.2023.1202374] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2023] [Accepted: 04/27/2023] [Indexed: 06/01/2023] Open
Abstract
Introduction Emerging evidence suggested widespread decreased gray matter volume (GMV) and tau hyperphosphorylation were associated with type 2 diabetes mellitus (T2DM). Insulin resistance is one of the mechanisms of neuron degeneration in T2DM; it can decrease the activity of protein kinase B and increase the activity of glycogen synthesis kinase-3β, thus promoting the hyperphosphorylation of tau protein and finally leading to neuronal degeneration. However, the association between GMV and serum tau protein phosphorylated at threonine 181 (P-tau-181) in T2DM patients lacks neuroimaging evidence. We aimed to investigate the difference in brain GMV between T2DM patients with different glycated hemoglobin A1c (HbA1c) levels and healthy control (HC) subjects and the correlation between serum P-tau-181 and GMV in T2DM patients. Methods Clinical parameters, biochemical indicators, and MRI data were collected for 41 T2DM patients with high glycosylated hemoglobin level (HGL), 17 T2DM patients with normal glycosylated hemoglobin level (NGL), and 42 HC subjects. Voxel-based morphometry (VBM) method was applied to investigate GMV differences among groups, and multiple regression analysis was used to examine the correlation between serum P-tau-181 and GMV. Results Compared with HC subjects, the T2DM patients with HGL or NGL all showed significantly decreased GMV. Briefly, the GMV decreased in T2DM patients with HGL was mainly in the bilateral parahippocampal gyrus (PHG), right middle temporal gyrus (MTG), temporal pole (TPOmid), hippocampus (HIP), and left lingual gyrus. The GMV reduction in T2DM patients with NGL was in the right superior temporal gyrus (STG), and there was no significant difference in GMV between the two diabetic groups. The GMV values of bilateral PHG, right MTG, TPOmid, HIP, and STG can significantly (p < 0.0001) distinguish T2DM patients from HC subjects in ROC curve analysis. In addition, we found that serum P-tau-181 levels were positively correlated with GMV in the right superior and middle occipital gyrus and cuneus, and negatively correlated with GMV in the right inferior temporal gyrus in T2DM patients. Conclusion Our study shows that GMV atrophy can be used as a potential biological indicator of T2DM and also emphasizes the important role of P-tau-181 in diabetic brain injury, providing new insights into the neuropathological mechanism of diabetic encephalopathy.
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Affiliation(s)
- Yian Gao
- Department of Radiology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, China
| | - Chaofan Sui
- Department of Radiology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, China
| | - Boyao Chen
- College of Radiology, Shandong First Medical University (Shandong Academy of Medical Sciences), Tai’an, Shandong, China
| | - Haotian Xin
- Department of Radiology, Shandong Provincial Hospital, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China
| | - Yena Che
- Department of Radiology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, China
| | - Xinyue Zhang
- Department of Radiology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, China
| | - Na Wang
- Department of Radiology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, China
| | - Yuanyuan Wang
- Department of Medical Imaging, Binzhou Medical University, Yantai, Shandong, China
| | - Changhu Liang
- Department of Radiology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, China
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11
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Yu JH, Kim REY, Park SY, Lee DY, Cho HJ, Kim NH, Yoo HJ, Seo JA, Kim SG, Choi KM, Baik SH, Shin C, Kim NH. Association of long-term hyperglycaemia and insulin resistance with brain atrophy and cognitive decline: A longitudinal cohort study. Diabetes Obes Metab 2023; 25:1091-1100. [PMID: 36564910 DOI: 10.1111/dom.14958] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2022] [Revised: 12/15/2022] [Accepted: 12/19/2022] [Indexed: 12/25/2022]
Abstract
AIM To investigate the longitudinal changes in brain volume and cognitive function associated with diabetes at midlife, and to examine whether long-term hyperglycaemia, insulin resistance or secretory function is associated with brain atrophy and cognitive decline. MATERIALS AND METHODS We used data from 2377 participants with both baseline and 4-year follow-up brain magnetic resonance images and neuropsychological measures from the Ansan cohort of the Korean Genome Epidemiology Study. Time-weighted mean glycaemic values were calculated using all measurements over an average duration of 10.6 years from cohort initiation to baseline visits. RESULTS Type 2 diabetes was associated with greater white matter volume reduction (adjusted volume difference = -1.96 ml, 95% CI: -3.73, -0.18) and executive function decline (adjusted Z score difference = -0.14, 95% CI: -0.23, -0.05) during the follow-up period of 4.2 years. Decline of verbal and visual memory or verbal fluency was not associated with diabetes. Greater executive function decline was associated with higher time-weighted mean HbA1c level over the preceding 10.6 years (P < .001), but not with insulin resistance markers in the diabetes group. Participants with diabetes, whose time-weighted average HbA1c level was maintained above 6.5% over the previous decade, showed greater decline in executive function and global cognition than the normal glucose group. CONCLUSIONS Long-term hyperglycaemia was a major independent factor associated with rapid cognitive decline in middle-aged adults with diabetes. Maintaining ideal glucose levels in diabetes at midlife might prevent later rapid cognitive decline.
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Affiliation(s)
- Ji Hee Yu
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Korea University College of Medicine, Seoul, Republic of Korea
| | - Regina E Y Kim
- Institute of Human Genomic Study, Korea University Ansan Hospital, Korea University College of Medicine, Ansan, Republic of Korea
- Psychiatry, University of Iowa, Iowa City, Iowa, USA
| | - So Young Park
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Korea University College of Medicine, Seoul, Republic of Korea
| | - Da Young Lee
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Korea University College of Medicine, Seoul, Republic of Korea
| | - Hyun Joo Cho
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Korea University College of Medicine, Seoul, Republic of Korea
| | - Nam Hoon Kim
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Korea University College of Medicine, Seoul, Republic of Korea
| | - Hye Jin Yoo
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Korea University College of Medicine, Seoul, Republic of Korea
| | - Ji A Seo
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Korea University College of Medicine, Seoul, Republic of Korea
| | - Sin Gon Kim
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Korea University College of Medicine, Seoul, Republic of Korea
| | - Kyung Mook Choi
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Korea University College of Medicine, Seoul, Republic of Korea
| | - Sei Hyun Baik
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Korea University College of Medicine, Seoul, Republic of Korea
| | - Chol Shin
- Institute of Human Genomic Study, Korea University Ansan Hospital, Korea University College of Medicine, Ansan, Republic of Korea
| | - Nan Hee Kim
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Korea University College of Medicine, Seoul, Republic of Korea
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12
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Botoseneanu A, Markwardt S, Quiñones AR. Multimorbidity and Functional Disability among Older Adults: The Role of Inflammation and Glycemic Status - An Observational Longitudinal Study. Gerontology 2023; 69:826-838. [PMID: 36858034 PMCID: PMC10442862 DOI: 10.1159/000528648] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2022] [Accepted: 12/07/2022] [Indexed: 03/03/2023] Open
Abstract
INTRODUCTION Specific multimorbidity combinations, in particular those including arthritis, stroke, and cognitive impairment, have been associated with high burden of activities of daily living (ADL)-instrumental activities of daily living (IADL) disability in older adults. The biologic underpinnings of these associations are still unclear. METHODS Observational longitudinal study using data from the Health and Retirement Study (N = 8,618, mean age = 74 years, 58% female, 25% non-white) and negative binomial regression models stratified by sex to evaluate the role of inflammatory and glycemic biomarkers (high-sensitivity C-reactive protein (hs-CRP) and HbA1c) in the association between specific multimorbidity combinations (grouped around one of eight index diseases: arthritis, cancer, cognitive impairment, diabetes, heart disease, hypertension, lung disease, and stroke; assessed between 2006 and 2014) and prospective ADL-IADL disability (2 years later, 2008-2016). Results were adjusted for sociodemographic characteristics, body mass index, number of coexisting diseases, and baseline ADL-IADL score. RESULTS Multimorbidity combinations indexed by arthritis (IRR = 1.1, 95% CI = 1.01-1.20), diabetes (IRR = 1.19, 95% CI = 1.09-1.30), and cognitive impairment (IRR = 1.11, 95% CI = 1.01-1.23) among men and diabetes-indexed multimorbidity combinations (IRR = 1.07, 95% CI = 1.01-1.14) among women were associated with higher ADL-IADL scores at increasing levels of HbA1c. Across higher levels of hs-CRP, multimorbidity combinations indexed by arthritis (IRR = 1.06, 95% CI = 1.02-1.11), hypertension (IRR = 1.06, 95% CI = 1.02-1.11), heart disease (IRR = 1.06, 95% CI = 1.01-1.12), and lung disease (IRR = 1.14, 95% CI = 1.07-1.23) were associated with higher ADL-IADL scores among women, while there were no significant associations among men. CONCLUSION The findings suggest potential for anti-inflammatory management among older women and optimal glycemic control among older men with these particular multimorbidity combinations as focus for therapeutic/preventive options for maintaining functional health.
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Affiliation(s)
- Anda Botoseneanu
- Department of Health & Human Services, University of Michigan, Dearborn, MI, USA
- Institute of Gerontology, University of Michigan, Ann Arbor, MI, USA
| | - Sheila Markwardt
- School of Public Health, Oregon Health & Science University, Portland, OR, USA
| | - Ana R. Quiñones
- School of Public Health, Oregon Health & Science University, Portland, OR, USA
- Department of Family Medicine, Oregon Health & Science University, Portland, OR, USA
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13
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Cerin E, Barnett A, Wu YT, Martino E, Shaw JE, Knibbs LD, Poudel G, Jalaludin B, Anstey KJ. Do neighbourhood traffic-related air pollution and socio-economic status moderate the associations of the neighbourhood physical environment with cognitive function? Findings from the AusDiab study. THE SCIENCE OF THE TOTAL ENVIRONMENT 2023; 858:160028. [PMID: 36368384 DOI: 10.1016/j.scitotenv.2022.160028] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/17/2022] [Revised: 11/02/2022] [Accepted: 11/03/2022] [Indexed: 06/16/2023]
Abstract
Characteristics of the neighbourhood environment, including the built and natural environment, area-level socio-economic status (SES) and air pollution, have been linked to cognitive health. However, most studies have focused on single neighbourhood characteristics and have not considered the extent to which the effects of environmental factors may interact. We examined the associations of measures of the neighbourhood built and natural environment, area-level SES and traffic-related air pollution (TRAP) with two cognitive function domains (memory and processing speed), and the extent to which area-level SES and TRAP moderated the associations. We used cross-sectional data from the AusDiab3 study, an Australian cohort study of adults (mean age: 61 years) in 2011-12 (N = 4141) for which geocoded residential addresses were available. Spatial data were used to create composite indices of built environment complexity (population density, intersection density, non-commercial land use mix, commercial land use) and natural environment (parkland and blue spaces). Area-level SES was obtained from national census indices and TRAP was based on estimates of annual average levels of nitrogen dioxide (NO2). Confounder-adjusted generalised additive mixed models were used to estimate the independent associations of the environmental measures with cognitive function and the moderating effects of area-level SES and TRAP. The positive associations between built environment complexity and memory were stronger in those living in areas with higher SES and lower NO2 concentrations. A positive association between the natural environment and memory was found only in those living in areas with lower NO2 concentrations and average or below-average SES. Built environment complexity and the natural environment were positively related to processing speed. Complex urban environments and access to nature may benefit cognitive health in ageing populations. For higher-order cognitive abilities, such as memory, these positive effects may be stronger in areas with lower levels of TRAP.
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Affiliation(s)
- Ester Cerin
- Mary MacKillop Institute for Health Research, Australian Catholic University, 215 Spring St., Melbourne, VIC, Australia; School of Public Health, The University of Hong Kong, 7 Sassoon Rd., Sandy Bay, Hong Kong; Baker Heart and Diabetes Institute, Melbourne, VIC, Australia; Department of Community Medicine, UiT The Artic University of Norway, Tromsø, Norway.
| | - Anthony Barnett
- Mary MacKillop Institute for Health Research, Australian Catholic University, 215 Spring St., Melbourne, VIC, Australia
| | - Yu-Tzu Wu
- Population Health Sciences Institute, Newcastle University, Newcastle NE4 5PL, United Kingdom
| | - Erika Martino
- School of Population and Global Health, University of Melbourne, Melbourne, VIC, Australia
| | - Jonathan E Shaw
- Baker Heart and Diabetes Institute, Melbourne, VIC, Australia; School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia; School of Life Sciences, La Trobe University, Melbourne, VIC, Australia
| | - Luke D Knibbs
- Sydney School of Public Health, The University of Sydney, Camperdown, NSW, Australia; Public Health Unit, Sydney Local Health District, Camperdown, NSW, Australia
| | - Govinda Poudel
- Mary MacKillop Institute for Health Research, Australian Catholic University, 215 Spring St., Melbourne, VIC, Australia
| | - Bin Jalaludin
- School of Population Health, University of New South Wales, Randwick, NSW, Australia
| | - Kaarin J Anstey
- School of Psychology, University of New South Wales, Randwick, NSW, Australia; Neuroscience Research Australia (NeuRA), Sydney, Australia; UNSW Ageing Futures Institute, Sydney, Australia
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14
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Fanelli G, Mota NR, Salas-Salvadó J, Bulló M, Fernandez-Aranda F, Camacho-Barcia L, Testa G, Jiménez-Murcia S, Bertaina-Anglade V, Franke B, Poelmans G, van Gils V, Jansen WJ, Vos SJB, Wimberley T, Dalsgaard S, Barta C, Serretti A, Fabbri C, Bralten J. The link between cognition and somatic conditions related to insulin resistance in the UK Biobank study cohort: a systematic review. Neurosci Biobehav Rev 2022; 143:104927. [PMID: 36367493 DOI: 10.1016/j.neubiorev.2022.104927] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2022] [Revised: 10/14/2022] [Accepted: 10/23/2022] [Indexed: 11/09/2022]
Abstract
Clinical and genomic studies have shown an overlap between neuropsychiatric disorders and insulin resistance (IR)-related somatic conditions, including obesity, type 2 diabetes, and cardiovascular diseases. Impaired cognition is often observed among neuropsychiatric disorders, where multiple cognitive domains may be affected. In this review, we aimed to summarise previous evidence on the relationship between IR-related diseases/traits and cognitive performance in the large UK Biobank study cohort. Electronic searches were conducted on PubMed, Scopus, and Web of Science until April 2022. Eighteen articles met the inclusion criteria and were qualitatively reviewed. Overall, there is substantial evidence for an association between IR-related cardio-metabolic diseases/traits and worse performance on various cognitive domains, which is largely independent of possible confoundings. The most consistent findings referred to IR-related associations with poorer verbal and numerical reasoning ability, as well as slower processing speed. The observed associations might be mediated by alterations in immune-inflammation, brain integrity/connectivity, and/or comorbid somatic or psychiatric diseases/traits. Our findings provide impetus for further research into the underlying neurobiology and possible new therapeutic targets.
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Affiliation(s)
- Giuseppe Fanelli
- Department of Human Genetics, Radboud university medical center, Nijmegen, The Netherlands; Donders Institute for Brain, Cognition and Behaviour, Radboud University, Nijmegen, The Netherlands; Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy
| | - Nina Roth Mota
- Department of Human Genetics, Radboud university medical center, Nijmegen, The Netherlands; Donders Institute for Brain, Cognition and Behaviour, Radboud University, Nijmegen, The Netherlands
| | - Jordi Salas-Salvadó
- Universitat Rovira i Virgili, Departament de Bioquímica i Biotecnologia, Reus, Spain; Institut d'Investigació Sanitària Pere Virgili (IISPV), Reus, Spain; CIBER Fisiopatología Obesidad y Nutrición (CIBERObn), Carlos III Health Institute (ISCIII), Madrid, Spain
| | - Mònica Bulló
- Universitat Rovira i Virgili, Departament de Bioquímica i Biotecnologia, Reus, Spain; Institut d'Investigació Sanitària Pere Virgili (IISPV), Reus, Spain; CIBER Fisiopatología Obesidad y Nutrición (CIBERObn), Carlos III Health Institute (ISCIII), Madrid, Spain
| | - Fernando Fernandez-Aranda
- CIBER Fisiopatología Obesidad y Nutrición (CIBERObn), Carlos III Health Institute (ISCIII), Madrid, Spain; Psychoneurobiology of Eating and Addictive Behaviours Group, Bellvitge Biomedical Research Institute (IDIBELL), Barcelona, Spain; Department of Psychiatry, Bellvitge University Hospital, Barcelona, Spain; Department of Clinical Sciences, School of Medicine and Health Sciences, University of Barcelona, Barcelona, Spain
| | - Lucía Camacho-Barcia
- CIBER Fisiopatología Obesidad y Nutrición (CIBERObn), Carlos III Health Institute (ISCIII), Madrid, Spain; Psychoneurobiology of Eating and Addictive Behaviours Group, Bellvitge Biomedical Research Institute (IDIBELL), Barcelona, Spain; Department of Psychiatry, Bellvitge University Hospital, Barcelona, Spain
| | - Giulia Testa
- CIBER Fisiopatología Obesidad y Nutrición (CIBERObn), Carlos III Health Institute (ISCIII), Madrid, Spain; Psychoneurobiology of Eating and Addictive Behaviours Group, Bellvitge Biomedical Research Institute (IDIBELL), Barcelona, Spain; Department of Psychiatry, Bellvitge University Hospital, Barcelona, Spain
| | - Susana Jiménez-Murcia
- CIBER Fisiopatología Obesidad y Nutrición (CIBERObn), Carlos III Health Institute (ISCIII), Madrid, Spain; Psychoneurobiology of Eating and Addictive Behaviours Group, Bellvitge Biomedical Research Institute (IDIBELL), Barcelona, Spain; Department of Psychiatry, Bellvitge University Hospital, Barcelona, Spain; Department of Clinical Sciences, School of Medicine and Health Sciences, University of Barcelona, Barcelona, Spain
| | | | - Barbara Franke
- Department of Human Genetics, Radboud university medical center, Nijmegen, The Netherlands; Donders Institute for Brain, Cognition and Behaviour, Radboud University, Nijmegen, The Netherlands; Department of Psychiatry, Radboud university medical center, Nijmegen, The Netherlands
| | - Geert Poelmans
- Department of Human Genetics, Radboud university medical center, Nijmegen, The Netherlands
| | - Veerle van Gils
- Alzheimer Center Limburg, Department of Psychiatry and Neuropsychology, School for Mental Health and NeuroScience, Maastricht University, Maastricht, The Netherlands
| | - Willemijn J Jansen
- Alzheimer Center Limburg, Department of Psychiatry and Neuropsychology, School for Mental Health and NeuroScience, Maastricht University, Maastricht, The Netherlands
| | - Stephanie J B Vos
- Alzheimer Center Limburg, Department of Psychiatry and Neuropsychology, School for Mental Health and NeuroScience, Maastricht University, Maastricht, The Netherlands
| | - Theresa Wimberley
- National Centre for Register-based Research, School of Business and Social Sciences, Aarhus University, Aarhus, Denmark
| | - Søren Dalsgaard
- National Centre for Register-based Research, School of Business and Social Sciences, Aarhus University, Aarhus, Denmark; Institute of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark; Department of Child and Adolescent Psychiatry, Mental Health Services of the Capital Region, Glostrup, Denmark
| | - Csaba Barta
- Department of Molecular Biology, Institute of Biochemistry and Molecular Biology, Semmelweis University, Budapest, Hungary
| | - Alessandro Serretti
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy
| | - Chiara Fabbri
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy; Social, Genetic & Developmental Psychiatry Centre, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Janita Bralten
- Department of Human Genetics, Radboud university medical center, Nijmegen, The Netherlands; Donders Institute for Brain, Cognition and Behaviour, Radboud University, Nijmegen, The Netherlands.
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15
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Lopez-Vilaret KM, Fernandez-Alvarez M, Shokri-Kojori E, Tomasi D, Cantero JL, Atienza M. Pre-diabetes is associated with altered functional connectivity density in cortical regions of the default-mode network. Front Aging Neurosci 2022; 14:1034355. [PMID: 36438011 PMCID: PMC9686287 DOI: 10.3389/fnagi.2022.1034355] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2022] [Accepted: 10/25/2022] [Indexed: 09/29/2023] Open
Abstract
Insulin resistance and glucose dysregulation are associated with patterns of regional brain hypometabolism characteristic of Alzheimer's disease (AD). As predicted by evidence linking brain glucose metabolism to brain functional connectivity, type 2 diabetes is accompanied by altered functional connectivity density (FCD) in regions highly vulnerable to AD, but whether these alterations start at earlier stages such as pre-diabetes remain to be elucidated. Here, in addition to assessing whether pre-diabetes leads to a functional reorganization of densely connected cortical areas (hubs), we will assess whether such reorganization is conditioned by sex and/or insulin resistance, and contributes to improved cognition. One hundred and forty-four cognitively unimpaired middle-aged and older adults (55-78 years, 79 females), 73 with normoglycemia and 71 with pre-diabetes, underwent resting-state fMRI scanning. We first computed FCD mapping on cortical surfaces to determine the number of short- and long-range functional connections of every vertex in the cortex, and next used hubs showing aberrant FCD as seeds for the resting-state functional connectivity (rs-FC) calculation. ANCOVAs and linear multiple regression analyses adjusted by demographic and cardiometabolic confounders using frequentist and Bayesian approaches were applied. Analyses revealed higher long-range FCD in the right precuneus of pre-diabetic females and lower short-range FCD in the left medial orbitofrontal cortex (mOFC) of pre-diabetic individuals with higher insulin resistance. Although the mOFC also showed altered rs-FC patterns with other regions of the default mode network in pre-diabetic individuals, it was FCD of the precuneus and mOFC, and not the magnitude of their rs-FC, that was associated with better planning abilities and Mini-Mental State Examination (MMSE) scores. Results suggest that being female and/or having high insulin resistance exacerbate pre-diabetes-induced alterations in the FCD of hubs of the default-mode network that are particularly vulnerable to AD pathology. These changes in brain network organization appear to be compensatory for pre-diabetic females, likely assisting them to maintain cognitive functioning at early stages of glucose dysregulation.
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Affiliation(s)
| | - Marina Fernandez-Alvarez
- Laboratory of Functional Neuroscience, Pablo de Olavide University, Seville, Spain
- CIBERNED, Network Center for Biomedical Research in Neurodegenerative Diseases, Madrid, Spain
| | - Ehsan Shokri-Kojori
- National Institute on Alcohol Abuse and Alcoholism, Bethesda, MD, United States
| | - Dardo Tomasi
- National Institute on Alcohol Abuse and Alcoholism, Bethesda, MD, United States
| | - Jose L Cantero
- Laboratory of Functional Neuroscience, Pablo de Olavide University, Seville, Spain
- CIBERNED, Network Center for Biomedical Research in Neurodegenerative Diseases, Madrid, Spain
| | - Mercedes Atienza
- Laboratory of Functional Neuroscience, Pablo de Olavide University, Seville, Spain
- CIBERNED, Network Center for Biomedical Research in Neurodegenerative Diseases, Madrid, Spain
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16
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Wang Q, Li X, Teng N, Li X. Prediabetes and the incidence of dementia in general population: a systematic review and meta-analysis of prospective studies. Psychogeriatrics 2022; 22:666-678. [PMID: 35777977 DOI: 10.1111/psyg.12869] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2022] [Revised: 05/23/2022] [Accepted: 06/01/2022] [Indexed: 11/29/2022]
Abstract
BACKGROUND Continuous hyperglycaemia has been related with dementia. However, it remains unclear whether prediabetes poses a higher risk of dementia. A meta-analysis was therefore conducted to comprehensively investigate the possible role of prediabetes as a risk factor of dementia. METHODS Prospective cohort studies reporting the association of prediabetes and dementia were identified from PubMed, Web of Science, and Embase databases. A random-effects model was applied to combine the results by incorporating the influence of heterogeneity. Subgroup analyses were also conducted to explore the influences of study features on the relationship. Sensitivity analysis re-estimated the combined effect size after excluding single studies separately to explore the robustness of the results. RESULTS Nine studies involving 29 986 adults from the general population, 6265 (20.9%) of whom had prediabetes, were included. It was shown that prediabetes was not independently associated with a higher incidence of dementia compared with normoglycaemia (adjusted risk ratio (RR): 1.01, 95% confidence interval (CI): 0.85-1.21, P = 0.89, I2 = 39%). Subgroup analyses according to the definitions of prediabetes, follow-up duration, method for diagnosis of dementia, and quality score produced similar findings (P for all subgroup differences >0.05). In addition, prediabetes was not independently associated with the incidence of Alzheimer's disease (RR: 1.24, 95% CI: 0.98-1.56, P = 0.07, I2 = 0%) or vascular dementia (RR: 1.16, 95% CI: 0.70-1.92, P = 0.56, I2 = 0%). Different definitions of prediabetes have the potential to influence the results, as reflected in the subgroup analysis for Alzheimer's disease (RR: 1.30, 95% CI: 1.06-1.60, P = 0.01, I2 = 0%). CONCLUSIONS Prediabetes may not be an independent risk factor of all-cause dementia or vascular dementia in the general adult population. However, changing the definition of prediabetes may have an impact on the outcome for Alzheimer's disease.
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Affiliation(s)
- Qihao Wang
- The Second Affiliated Hospital, Dalian Medical University, Dalian, China
| | - Xinying Li
- The Second Affiliated Hospital, Dalian Medical University, Dalian, China
| | - Nan Teng
- School of Public Health, Dalian Medical University, Dalian, China
| | - Xiaofeng Li
- School of Public Health, Dalian Medical University, Dalian, China
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17
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Zhang T, Shaw M, Cherbuin N. Association between Type 2 Diabetes Mellitus and Brain Atrophy: A Meta-Analysis. Diabetes Metab J 2022; 46:781-802. [PMID: 35255549 PMCID: PMC9532183 DOI: 10.4093/dmj.2021.0189] [Citation(s) in RCA: 22] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/06/2021] [Accepted: 12/11/2021] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Type 2 diabetes mellitus (T2DM) is known to be associated with cognitive decline and brain structural changes. This study systematically reviews and estimates human brain volumetric differences and atrophy associated with T2DM. METHODS PubMed, PsycInfo and Cochrane Library were searched for brain imaging studies reporting on brain volume differences between individuals with T2DM and healthy controls. Data were examined using meta-analysis, and association between age, sex, diabetes characteristics and brain volumes were tested using meta-regression. RESULTS A total of 14,605 entries were identified; after title, abstract and full-text screening applying inclusion and exclusion criteria, 64 studies were included and 42 studies with compatible data contributed to the meta-analysis (n=31,630; mean age 71.0 years; 44.4% male; 26,942 control; 4,688 diabetes). Individuals with T2DM had significantly smaller total brain volume, total grey matter volume, total white matter volume and hippocampal volume (approximately 1% to 4%); meta-analyses of smaller samples focusing on other brain regions and brain atrophy rate in longitudinal investigations also indicated smaller brain volumes and greater brain atrophy associated with T2DM. Meta-regression suggests that diabetes-related brain volume differences start occurring in early adulthood, decreases with age and increases with diabetes duration. CONCLUSION T2DM is associated with smaller total and regional brain volume and greater atrophy over time. These effects are substantial and highlight an urgent need to develop interventions to reduce the risk of T2DM for brain health.
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Affiliation(s)
- Tianqi Zhang
- Centre for Research on Ageing, Health and Wellbeing, The Australian National University, Canberra, Australia
| | - Marnie Shaw
- Centre for Research on Ageing, Health and Wellbeing, The Australian National University, Canberra, Australia
| | - Nicolas Cherbuin
- Centre for Research on Ageing, Health and Wellbeing, The Australian National University, Canberra, Australia
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18
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Hirabayashi N, Hata J, Furuta Y, Ohara T, Shibata M, Hirakawa Y, Yamashita F, Yoshihara K, Kitazono T, Sudo N, Ninomiya T. Association Between Diabetes and Gray Matter Atrophy Patterns in a General Older Japanese Population: The Hisayama Study. Diabetes Care 2022; 45:1364-1371. [PMID: 35500069 DOI: 10.2337/dc21-1911] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2021] [Accepted: 03/25/2022] [Indexed: 02/03/2023]
Abstract
OBJECTIVE To examine the association between diabetes and gray matter atrophy patterns in a general older Japanese population. RESEARCH DESIGN AND METHODS In 2012, a total of 1,189 community-dwelling Japanese aged ≥65 years underwent brain MRI scans. Regional gray matter volumes (GMV) and intracranial volume (ICV) were measured by applying voxel-based morphometry (VBM) methods. The associations of diabetes and related parameters with the regional GMV/ICV were examined using an ANCOVA. The regional gray matter atrophy patterns in the subjects with diabetes or elevated fasting plasma glucose (FPG) or 2-h postload glucose (2hPG) levels were investigated using VBM. RESULTS Subjects with diabetes had significantly lower mean values of GMV/ICV in the frontal lobe, temporal lobe, insula, deep gray matter structures, and cerebellum than subjects without diabetes after adjusting for potential confounders. A longer duration of diabetes was also significantly associated with lower mean values of GMV/ICV in these brain regions. The multivariable-adjusted mean values of the temporal, insular, and deep GMV/ICV decreased significantly with elevating 2hPG levels, whereas higher FPG levels were not significantly associated with GMV/ICV of any brain regions. In the VBM analysis, diabetes was associated with gray matter atrophy in the bilateral superior temporal gyri, right middle temporal gyrus, left inferior temporal gyrus, right middle frontal gyrus, bilateral thalami, right caudate, and right cerebellum. CONCLUSIONS The current study suggests that a longer duration of diabetes and elevated 2hPG levels are significant risk factors for gray matter atrophy in various brain regions.
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Affiliation(s)
- Naoki Hirabayashi
- Department of Epidemiology and Public Health, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.,Ito Clinic, Kyushu University, Fukuoka, Japan.,Department of Psychosomatic Medicine, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Jun Hata
- Department of Epidemiology and Public Health, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.,Center for Cohort Studies, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.,Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Yoshihiko Furuta
- Department of Epidemiology and Public Health, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.,Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.,Department of Medical-Engineering Collaboration for Healthy Longevity, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Tomoyuki Ohara
- Department of Epidemiology and Public Health, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.,Department of Neuropsychiatry, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Mao Shibata
- Department of Epidemiology and Public Health, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.,Department of Psychosomatic Medicine, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.,Center for Cohort Studies, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Yoichiro Hirakawa
- Department of Epidemiology and Public Health, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.,Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Fumio Yamashita
- Division of Ultrahigh Field MRI, Institute for Biomedical Sciences, Iwate Medical University, Iwate, Japan
| | - Kazufumi Yoshihara
- Department of Psychosomatic Medicine, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Takanari Kitazono
- Center for Cohort Studies, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.,Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Nobuyuki Sudo
- Department of Psychosomatic Medicine, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Toshiharu Ninomiya
- Department of Epidemiology and Public Health, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.,Center for Cohort Studies, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
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19
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Newby D, Garfield V. Understanding the inter-relationships of type 2 diabetes and hypertension with brain and cognitive health: A UK Biobank study. Diabetes Obes Metab 2022; 24:938-947. [PMID: 35112465 PMCID: PMC9415107 DOI: 10.1111/dom.14658] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/23/2021] [Revised: 01/13/2022] [Accepted: 01/30/2022] [Indexed: 01/28/2023]
Abstract
AIM To understand the impact of diabetes and co-morbid hypertension on cognitive and brain health. MATERIALS AND METHODS We used data from the UK Biobank cohort consisting of ~500 000 individuals aged 40 to 69 years. Our outcomes included brain structural magnetic resonance imaging variables and cognitive function tests in a maximum of 38 918 individuals. We firstly tested associations with all outcomes between those with diabetes (n = 2043) and without (n = 36 875) and, secondly, compared those with co-morbid diabetes/hypertension (n = 1283) with those with only diabetes (n = 760), hypertension (n = 9649) and neither disease (n = 27 226). Our analytical approach comprised linear regression models, with adjustment for a range of demographic and health factors. Standardized betas are reported. RESULTS Those with diabetes had worse brain and cognitive health for the majority of neuroimaging and cognitive measures, with the exception of g fractional anisotropy (white matter integrity), amygdala, pairs matching and tower rearranging. Compared with individuals with co-morbid diabetes and hypertension, those with only hypertension had better brain health overall, with the largest difference observed in the pallidum (β = .189, 95% CI = 0.241; 0.137), while those with only diabetes differed in total grey volume (β = .150, 95% CI = 0.122; 0.179). Individuals with only diabetes had better verbal and numeric reasoning (β = .129, 95% CI = 0.077; 0.261), whereas those with only hypertension performed better on the symbol-digit substitution task (β = .117, 95% CI = 0.048; 0.186). CONCLUSIONS Individuals with co-morbid diabetes and hypertension have worse brain and cognitive health compared with those with only one of these diseases. These findings potentially suggest that prevention of both diabetes and hypertension may delay changes in brain structure, as well as cognitive decline and dementia diagnosis.
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Affiliation(s)
- Danielle Newby
- Department of PsychiatryUniversity of Oxford, Warneford HospitalOxfordUK
| | - Victoria Garfield
- MRC Unit for Lifelong Health and Ageing at UCL, Department of Population Science and Experimental Medicine, Institute of Cardiovascular ScienceUniversity College LondonLondonUK
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20
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Newby D, Winchester L, Sproviero W, Fernandes M, Ghose U, Lyall D, Launer LJ, Nevado‐Holgado AJ. The relationship between isolated hypertension with brain volumes in UK Biobank. Brain Behav 2022; 12:e2525. [PMID: 35362209 PMCID: PMC9120723 DOI: 10.1002/brb3.2525] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/10/2021] [Revised: 01/17/2022] [Accepted: 01/24/2022] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Hypertension is a well-established risk factor for cognitive impairment, brain atrophy, and dementia. However, the relationship of other types of hypertensions, such as isolated hypertension on brain health and its comparison to systolic-diastolic hypertension (where systolic and diastolic measures are high), is still relatively unknown. Due to its increased prevalence, it is important to investigate the impact of isolated hypertension to help understand its potential impact on cognitive decline and future dementia risk. In this study, we compared a variety of global brain measures between participants with isolated hypertension to those with normal blood pressure (BP) or systolic-diastolic hypertension using the largest cohort of healthy individuals. METHODS Using the UK Biobank cohort, we carried out a cross-sectional study using 29,775 participants (mean age 63 years, 53% female) with BP measurements and brain magnetic resonance imaging (MRI) data. We used linear regression models adjusted for multiple confounders to compare a variety of global, subcortical, and white matter brain measures. We compared participants with either isolated systolic or diastolic hypertension with normotensives and then with participants with systolic-diastolic hypertension. RESULTS The results showed that participants with isolated systolic or diastolic hypertension taking BP medications had smaller gray matter but larger white matter microstructures and macrostructures compared to normotensives. Isolated systolic hypertensives had larger total gray matter and smaller white matter traits when comparing these regions with participants with systolic-diastolic hypertension. CONCLUSIONS These results provide support to investigate possible preventative strategies that target isolated hypertension as well as systolic-diastolic hypertension to maintain brain health and/or reduce dementia risk earlier in life particularly in white matter regions.
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Affiliation(s)
- Danielle Newby
- Department of PsychiatryWarneford Hospital, University of OxfordOxfordUK
| | - Laura Winchester
- Department of PsychiatryWarneford Hospital, University of OxfordOxfordUK
| | - William Sproviero
- Department of PsychiatryWarneford Hospital, University of OxfordOxfordUK
| | - Marco Fernandes
- Department of PsychiatryWarneford Hospital, University of OxfordOxfordUK
| | - Upamanyu Ghose
- Department of PsychiatryWarneford Hospital, University of OxfordOxfordUK
| | - Donald Lyall
- Institute of Health and WellbeingUniversity of GlasgowScotlandUK
| | | | - Alejo J. Nevado‐Holgado
- Department of PsychiatryWarneford Hospital, University of OxfordOxfordUK
- Big Data InstituteUniversity of OxfordOxfordUK
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21
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Wirth M, Gaubert M, Köbe T, Garnier-Crussard A, Lange C, Gonneaud J, de Flores R, Landeau B, de la Sayette V, Chételat G. Vascular Health Is Associated With Functional Connectivity Decline in Higher-Order Networks of Older Adults. Front Integr Neurosci 2022; 16:847824. [PMID: 35558154 PMCID: PMC9088922 DOI: 10.3389/fnint.2022.847824] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2022] [Accepted: 03/14/2022] [Indexed: 12/03/2022] Open
Abstract
Background Poor vascular health may impede brain functioning in older adults, thus possibly increasing the risk of cognitive decline and Alzheimer’s disease (AD). The emerging link between vascular risk factors (VRF) and longitudinal decline in resting-state functional connectivity (RSFC) within functional brain networks needs replication and further research in independent cohorts. Method We examined 95 non-demented older adults using the IMAP+ cohort (Caen, France). VRF were assessed at baseline through systolic and diastolic blood pressure, body-mass-index, and glycated hemoglobin (HbA1c) levels. Brain pathological burden was measured using white matter hyperintensity (WMH) volumes, derived from FLAIR images, and cortical β-Amyloid (Aβ) deposition, derived from florbetapir-PET imaging. RSFC was estimated from functional MRI scans within canonical brain networks at baseline and up to 3 years of follow-up. Linear mixed-effects models evaluated the independent predictive value of VRF on longitudinal changes in network-specific and global RSFC as well as a potential association between these RSFC changes and cognitive decline. Results We replicate that RSFC increased over time in global RSFC and in the default-mode, salience/ventral-attention and fronto-parietal networks. In contrast, higher diastolic blood pressure levels were independently associated with a decrease of RSFC over time in the default-mode, salience/ventral-attention, and fronto-parietal networks. Moreover, higher HbA1c levels were independently associated with a reduction of the observed RSFC increase over time in the salience/ventral-attention network. Both of these associations were independent of brain pathology related to Aβ load and WMH volumes. The VRF-related changes in RSFC over time were not significantly associated with longitudinal changes in cognitive performance. Conclusion Our longitudinal findings corroborate that VRF promote RSFC alterations over time within higher-order brain networks, irrespective of pathological brain burden. Altered RSFC in large-scale cognitive networks may eventually increase the vulnerability to aging and AD.
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Affiliation(s)
- Miranka Wirth
- German Center for Neurodegenerative Diseases (DZNE), Dresden, Germany
- *Correspondence: Miranka Wirth,
| | - Malo Gaubert
- German Center for Neurodegenerative Diseases (DZNE), Dresden, Germany
| | - Theresa Köbe
- German Center for Neurodegenerative Diseases (DZNE), Dresden, Germany
| | - Antoine Garnier-Crussard
- Clinical and Research Memory Center of Lyon, Lyon Institute for Aging, Hospices Civils de Lyon, Lyon, France
- INSERM 1048, CNRS 5292, Neuroscience Research Centre, Lyon, France
- UNICAEN, INSERM, U1237, PhIND “Physiopathology and Imaging of Neurological Disorders,” Institut Blood and Brain @ Caen-Normandie, Cyceron, Normandy University, Caen, France
| | - Catharina Lange
- German Center for Neurodegenerative Diseases (DZNE), Dresden, Germany
- Department of Nuclear Medicine, Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Julie Gonneaud
- UNICAEN, INSERM, U1237, PhIND “Physiopathology and Imaging of Neurological Disorders,” Institut Blood and Brain @ Caen-Normandie, Cyceron, Normandy University, Caen, France
| | - Robin de Flores
- UNICAEN, INSERM, U1237, PhIND “Physiopathology and Imaging of Neurological Disorders,” Institut Blood and Brain @ Caen-Normandie, Cyceron, Normandy University, Caen, France
| | - Brigitte Landeau
- UNICAEN, INSERM, U1237, PhIND “Physiopathology and Imaging of Neurological Disorders,” Institut Blood and Brain @ Caen-Normandie, Cyceron, Normandy University, Caen, France
| | - Vincent de la Sayette
- UNICAEN, INSERM, U1237, PhIND “Physiopathology and Imaging of Neurological Disorders,” Institut Blood and Brain @ Caen-Normandie, Cyceron, Normandy University, Caen, France
- Department of Neurology, CHU de Caen, Caen, France
| | - Gaël Chételat
- UNICAEN, INSERM, U1237, PhIND “Physiopathology and Imaging of Neurological Disorders,” Institut Blood and Brain @ Caen-Normandie, Cyceron, Normandy University, Caen, France
- Gaël Chételat,
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22
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Kim WJ, Lee SJ, Lee E, Lee EY, Han K. Risk of Incident Dementia According to Glycemic Status and Comorbidities of Hyperglycemia: A Nationwide Population-Based Cohort Study. Diabetes Care 2022; 45:134-141. [PMID: 34711638 DOI: 10.2337/dc21-0957] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2021] [Accepted: 10/07/2021] [Indexed: 02/03/2023]
Abstract
OBJECTIVE To investigate the risk of incident dementia according to fasting glucose levels and presence of comorbidities. RESEARCH DESIGN AND METHODS Using a health insurance claims database and the results of biennial health examinations in South Korea, we selected 8,400,950 subjects aged ≥40 years who underwent health examinations in 2009-2010. We followed them until 2016. Subjects' baseline characteristics were categorized by presence of diabetes (yes/no) and glycemic status as normoglycemia, impaired fasting glucose (IFG), new-onset diabetes, or known diabetes (duration <5 years or ≥5 years). We estimated adjusted hazard ratios (aHRs) for dementia occurrence in each category. RESULTS During the observation period of 48,323,729 person-years, all-cause dementia developed in 353,392 subjects (4.2%). Compared with normoglycemia, aHRs (95% CI) were 1.01 (1.01-1.02) in IFG, 1.45 (1.44-1.47) in new-onset diabetes, 1.32 (1.30-1.33) in known diabetes <5 years, and 1.62 (1.60-1.64) in known diabetes ≥5 years. We found that associations between ischemic heart disease and chronic kidney disease with incident dementia were affected by the presence of diabetes. Ischemic stroke showed a greater association with incident dementia than diabetes. CONCLUSIONS Mild degrees of hyperglycemia and presence of comorbidities were associated with incident dementia. Intervention during the prodromal stage of a chronic disease (e.g., prediabetes) could be considered for dementia prevention.
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Affiliation(s)
- Woo Jung Kim
- 1Department of Psychiatry, Yongin Severance Hospital, Yonsei University College of Medicine, Yongin, Republic of Korea.,2Institute of Behavioral Sciences in Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Seo Jung Lee
- 3Department of Psychiatry, Myongji Hospital, Goyang, Republic of Korea
| | - Eun Lee
- 2Institute of Behavioral Sciences in Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea.,4Department of Psychiatry, Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Eun Young Lee
- 5Division of Endocrinology and Metabolism, Department of Internal Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Kyungdo Han
- 6Department of Statistics and Actuarial Science, Soongsil University, Seoul, Republic of Korea
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23
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Kirvalidze M, Hodkinson A, Storman D, Fairchild TJ, Bała M, Beridze G, Zuriaga A, Brudasc NI, Brini S. The role of glucose on cognition, risk of dementia, and related biomarkers in individuals without type 2 diabetes mellitus or the metabolic syndrome: a systematic review of observational studies. Neurosci Biobehav Rev 2022; 135:104551. [DOI: 10.1016/j.neubiorev.2022.104551] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2021] [Revised: 01/24/2022] [Accepted: 01/24/2022] [Indexed: 01/14/2023]
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24
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Garfield V, Farmaki A, Eastwood SV, Mathur R, Rentsch CT, Bhaskaran K, Smeeth L, Chaturvedi N. HbA1c and brain health across the entire glycaemic spectrum. Diabetes Obes Metab 2021; 23:1140-1149. [PMID: 33464682 PMCID: PMC8261644 DOI: 10.1111/dom.14321] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/03/2020] [Revised: 01/12/2021] [Accepted: 01/15/2021] [Indexed: 12/20/2022]
Abstract
AIM To understand the relationship between HbA1c and brain health across the entire glycaemic spectrum. MATERIALS AND METHODS We used data from the UK Biobank cohort consisting of 500,000 individuals aged 40-69 years. HbA1c and diabetes diagnosis were used to define baseline glycaemic categories. Our outcomes included incident all-cause dementia, vascular dementia (VD), Alzheimer's dementia (AD), hippocampal volume (HV), white matter hyperintensity (WMH) volume, cognitive function and decline. The reference group was normoglycaemic individuals (HbA1c ≥35 & <42 mmol/mol). Our maximum analytical sample contained 449,973 individuals with complete data. RESULTS Prediabetes and known diabetes increased incident VD (HR 1.54; 95% CI = 1.04, 2.28 and HR 2.97; 95% CI = 2.26, 3.90, respectively). Known diabetes increased all-cause and AD risk (HR 1.91; 95% CI = 1.66, 2.21 and HR 1.84; 95% CI = 1.44, 2.36, respectively). Prediabetes and known diabetes elevated the risks of cognitive decline (OR 1.42; 1.48, 2.96 and OR 1.39; 1.04, 1.75, respectively). Prediabetes, undiagnosed and known diabetes conferred higher WMH volumes (3%, 22% and 7%, respectively) and lower HV (36, 80 and 82 mm3 , respectively), whereas low-normal HbA1c had 1% lower WMH volume and 12 mm3 greater HV. CONCLUSION Both prediabetes and known diabetes are harmful in terms of VD, cognitive decline and AD risks, as well as lower HV. Associations appeared to be somewhat driven by antihypertensive medication, which implies that certain cardiovascular drugs may ameliorate some of the excess risk. Low-normal HbA1c levels, however, are associated with more favourable brain health outcomes and warrant more in-depth investigation.
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Affiliation(s)
- Victoria Garfield
- MRC Unit for Lifelong Health and Ageing at UCLInstitute of Cardiovascular Science, University College LondonLondonUK
| | - Aliki‐Eleni Farmaki
- MRC Unit for Lifelong Health and Ageing at UCLInstitute of Cardiovascular Science, University College LondonLondonUK
| | - Sophie V. Eastwood
- MRC Unit for Lifelong Health and Ageing at UCLInstitute of Cardiovascular Science, University College LondonLondonUK
| | - Rohini Mathur
- Department of Non‐communicable Disease EpidemiologyLondon School of Hygiene & Tropical MedicineLondonUK
| | - Christopher T. Rentsch
- Department of Non‐communicable Disease EpidemiologyLondon School of Hygiene & Tropical MedicineLondonUK
| | - Krishnan Bhaskaran
- Department of Non‐communicable Disease EpidemiologyLondon School of Hygiene & Tropical MedicineLondonUK
| | - Liam Smeeth
- Department of Non‐communicable Disease EpidemiologyLondon School of Hygiene & Tropical MedicineLondonUK
| | - Nish Chaturvedi
- MRC Unit for Lifelong Health and Ageing at UCLInstitute of Cardiovascular Science, University College LondonLondonUK
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