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Xie J, You Y, Zheng P, Chen Y, Guo S, Xu Y, Huang J, Liu Z, Tao J. Gender differences in the association between physical activity and cognitive subdomains among elders with type 2 diabetes and mild cognitive impairment: a cross-sectional study. BMJ Open 2024; 14:e080789. [PMID: 38806426 PMCID: PMC11138272 DOI: 10.1136/bmjopen-2023-080789] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/10/2023] [Accepted: 04/21/2024] [Indexed: 05/30/2024] Open
Abstract
OBJECTIVES The objective of this study was to evaluate the gender differences in the correlation between physical activity (PA) and cognitive subdomains in elderly individuals with type 2 diabetes (T2D) and mild cognitive impairment (MCI). DESIGN Cross-sectional study. SETTING The research was carried out in communities located in Fuzhou, Fujian Province and Beijing Municipality. PARTICIPANTS Community-dwelling elders with T2D and MCI aged 60 years or older were eligible for this study. PRIMARY OUTCOME MEASURES AND ANALYSES The weekly PA score was assessed using the International Physical Activity Questionnaire (IPAQ). The cognitive subdomains were evaluated through a battery of cognitive assessments, including the Rey Auditory Verbal Learning Test (RAVLT), Trail Making Test Part B, Digit Symbol Substitution Test (DSST) and the Stroop Color-Word Test (SCWT). Multiple linear regression models were employed to examine the association between PA and cognitive subdomains in both male and female individuals. RESULTS In older men, higher total IPAQ score was positively correlated with higher RAVLT (P=0.011) and SCWT (P=0.049). There was a significant interaction between the total PA score and gender in relation to RAVLT (P=0.008) and SCWT (P=0.027). Moreover, there was a positive correlation between moderate-vigorous PA level and RAVLT in older men (P=0.007). Additionally, a positive correlation was found between moderate-vigorous PA level and DSST in older women (P=0.038). CONCLUSION In older individuals with T2D and MCI, the association between PA and cognitive subdomains differs between men and women. This discrepancy may impact the customisation of exercise recommendations.
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Affiliation(s)
- Jinjin Xie
- Fujian University of Traditional Chinese Medicine, Fuzhou, Fujian, China
| | - Yue You
- Fujian University of Traditional Chinese Medicine, Fuzhou, Fujian, China
| | - Peiyun Zheng
- Fujian University of Traditional Chinese Medicine, Fuzhou, Fujian, China
| | - Yannan Chen
- Fujian University of Traditional Chinese Medicine, Fuzhou, Fujian, China
| | - Shuai Guo
- Fujian University of Traditional Chinese Medicine, Fuzhou, Fujian, China
| | - Ying Xu
- Fujian University of Traditional Chinese Medicine, Fuzhou, Fujian, China
- National-Local Joint Engineering Research Center of Rehabilitation Medicine Technology, Fujian University of Traditional Chinese Medicine, Fuzhou, China
| | - Jia Huang
- Fujian University of Traditional Chinese Medicine, Fuzhou, Fujian, China
- National-Local Joint Engineering Research Center of Rehabilitation Medicine Technology, Fujian University of Traditional Chinese Medicine, Fuzhou, China
| | - Zhizhen Liu
- Fujian University of Traditional Chinese Medicine, Fuzhou, Fujian, China
- National-Local Joint Engineering Research Center of Rehabilitation Medicine Technology, Fujian University of Traditional Chinese Medicine, Fuzhou, China
| | - Jing Tao
- Fujian University of Traditional Chinese Medicine, Fuzhou, Fujian, China
- National-Local Joint Engineering Research Center of Rehabilitation Medicine Technology, Fujian University of Traditional Chinese Medicine, Fuzhou, China
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Li YS, Li JB, Wang JJ, Wang XH, Jiang WR, Qiu HN, Xia LF, Wu F, Lin CY, Liu YL, Lin JN. Risk factors for cognitive impairment in middle-aged type 2 diabetic patients: a cross-sectional study. BMJ Open 2024; 14:e074753. [PMID: 38167287 PMCID: PMC10773412 DOI: 10.1136/bmjopen-2023-074753] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/17/2023] [Accepted: 12/11/2023] [Indexed: 01/05/2024] Open
Abstract
OBJECTIVE The aim of this study was to investigate risk factors for cognitive impairment (CI) and explore the relationship between obesity and cognition in hospitalised middle-aged patients with type 2 diabetes (T2DM). METHODS Subjects were divided into normal cognitive function (NCF) (n=320) and CI (n=204) groups based on the results of the Montreal Cognitive Assessment (MoCA) and Mini-Mental State Examination (MMSE). The risk factors for CI were determined by logistic regression analysis and generalised linear modelling. The associations between obesity parameters (body mass index (BMI) and waist circumference (WC)) and cognitive ability were studied with the use of linear regression analysis, piecewise regression modelling and interaction analysis. The receiver operating characteristic curve analysis was used to examine the diagnostic value of influencing factors for cc RESULTS: The prevalence of CI was 38.9% in hospitalised middle-aged T2DM patients (median age, 58 years). Age, WC, hypoglycaemic episode within past 3 months and cerebrovascular disease (CVD) were identified as independent risk factors for CI, while the independent protective factors were education, diabetic dietary pattern, overweight and obesity. BMI was a protective factor for the MoCA score within a certain range, whereas WC was a risk factor for the MMSE and MoCA scores. The area under the curve for the combination of BMI and WC was 0.754 (p<0.001). CONCLUSION Age, education, diabetic dietary pattern, WC, overweight, obesity, hypoglycaemic episode in 3 months and CVD may be potential influencing factors for the occurrence of CI in hospitalised middle-aged population with T2DM. The combination of BMI and WC may represent a good predictor for early screening of CI in this population. Nevertheless, more relevant prospective studies are still needed.
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Affiliation(s)
- Yao-Shuang Li
- Tianjin Union Medical Center, Tianjin Medical University, Heping, Tianjin, China
- Department of Endocrinology, Tianjin Union Medical Center Tianjin People's Hospital, Hongqiao, Tianjin, China
| | - Jing-Bo Li
- Department of Endocrinology, Tianjin Union Medical Center Tianjin People's Hospital, Hongqiao, Tianjin, China
| | - Jun-Jia Wang
- Department of Endocrinology, Tianjin Union Medical Center Tianjin People's Hospital, Hongqiao, Tianjin, China
- Tianjin Union Medical Center, Tianjin University of Traditional Chinese Medicine, Jinghai, Tianjin, China
| | - Xiao-He Wang
- Institute of Non-Communicable Diseases Control and Prevention, Tianjin Centers for Disease Control and Prevention, Hedong, Tianjin, China
| | - Wei-Ran Jiang
- Eastman Institute for Oral Health, University of Rochester Medical Center, Rochester, New York, USA
| | - Hui-Na Qiu
- Department of Endocrinology, Tianjin Union Medical Center Tianjin People's Hospital, Hongqiao, Tianjin, China
| | - Long-Fei Xia
- Tianjin Union Medical Center, Tianjin Medical University, Heping, Tianjin, China
- Department of Endocrinology, Tianjin Union Medical Center Tianjin People's Hospital, Hongqiao, Tianjin, China
| | - Fan Wu
- Department of Endocrinology, Tianjin Union Medical Center Tianjin People's Hospital, Hongqiao, Tianjin, China
| | - Chen-Ying Lin
- Tianjin Union Medical Center, Tianjin Medical University, Heping, Tianjin, China
- Department of Endocrinology, Tianjin Union Medical Center Tianjin People's Hospital, Hongqiao, Tianjin, China
| | - Yan-Lan Liu
- Department of Endocrinology, Tianjin Union Medical Center Tianjin People's Hospital, Hongqiao, Tianjin, China
| | - Jing-Na Lin
- Department of Endocrinology, Tianjin Union Medical Center Tianjin People's Hospital, Hongqiao, Tianjin, China
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Pietrabissa G, Cammisuli DM, Scarpina F, Volpi C, Crotti L, Mauro A, Gondoni LA, Castelnuovo G. Executive Attentional Dyscontrol as a Core Cognitive and Behavioral Feature of Individuals with Obesity and Cardiovascular Disease: A Cross-Sectional Investigation. Brain Sci 2023; 13:1182. [PMID: 37626538 PMCID: PMC10452331 DOI: 10.3390/brainsci13081182] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Revised: 08/03/2023] [Accepted: 08/08/2023] [Indexed: 08/27/2023] Open
Abstract
Executive attention as a frontal domain ability that is effective in potentially blocking distracting information, reconciling conflicts among simultaneous attentional demands, and regulating impulsive behavior may be impaired in individuals with obesity and cardiovascular disease (CVD). This study aimed (i) to explore the presence of selected cognitive (global cognitive impairment, sensitivity to interference, and attention) and psychological (quality of life, depression, anxiety, and impulsivity) dimensions and (ii) to examine the interactive relationship between attentional dyscontrol-both as a psychological and as a cognitive measure-and the above-mentioned variables in a sample of patients with CVD attending a cardiac rehabilitation program across different body mass index (BMI) levels. Clinical information of 104 patients with CVD was retrospectively collected. Participants were classified into three groups according to their BMI as follows: normal weight (NW = 30), overweight (OW = 19), and obese (OB = 55). Individuals with CVD and a higher BMI showed problems in controlling executive attention-through both neuropsychological and behavioral measures. Specifically, OB patients demonstrated reduced sensitivity to cognitive interference, lower capabilities in divided attention during visual-tracking tasks, and greater impulsivity compared to NW patients. This behavioral characteristic was also found to be correlated with higher levels of anxiety and depression and a lower quality of life. Implications for cognitive rehabilitation were discussed to offer directions for better management of patients with CVD and obesity.
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Affiliation(s)
- Giada Pietrabissa
- Department of Psychology, Catholic University of Milan, 20123 Milan, Italy; (G.P.); (G.C.)
- I.R.C.C.S. Istituto Auxologico Italiano, Clinical Psychology Research Laboratory, 20149 Milan, Italy
| | - Davide Maria Cammisuli
- Department of Psychology, Catholic University of Milan, 20123 Milan, Italy; (G.P.); (G.C.)
| | - Federica Scarpina
- I.R.C.C.S. Istituto Auxologico Italiano, Neurology and Neurorehabilitation Department, San Giuseppe Hospital, 28824 Piancavallo, VCO, Italy; (F.S.); (A.M.)
- Department of Neuroscience “Rita Levi Montalicini”, University of Turin, 10126 Turin, Italy
| | - Clarissa Volpi
- I.R.C.C.S. Istituto Auxologico Italiano, Cardiac Rehabilitation Department, San Luca Hospital, 20149 Milan, Italy; (C.V.); (L.C.)
| | - Lia Crotti
- I.R.C.C.S. Istituto Auxologico Italiano, Cardiac Rehabilitation Department, San Luca Hospital, 20149 Milan, Italy; (C.V.); (L.C.)
- Department of Medicine and Surgery, Milano Bicocca University, 20126 Milan, Italy
| | - Alessandro Mauro
- I.R.C.C.S. Istituto Auxologico Italiano, Neurology and Neurorehabilitation Department, San Giuseppe Hospital, 28824 Piancavallo, VCO, Italy; (F.S.); (A.M.)
- Department of Neuroscience “Rita Levi Montalicini”, University of Turin, 10126 Turin, Italy
| | - Luca Alessandro Gondoni
- I.R.C.C.S. Istituto Auxologico Italiano, Cardiac Rehabilitation Department, San Giuseppe Hospital, 28824 Piancavallo, VCO, Italy;
| | - Gianluca Castelnuovo
- Department of Psychology, Catholic University of Milan, 20123 Milan, Italy; (G.P.); (G.C.)
- I.R.C.C.S. Istituto Auxologico Italiano, Clinical Psychology Research Laboratory, 20149 Milan, Italy
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Jo D, Yoon G, Lim Y, Kim Y, Song J. Profiling and Cellular Analyses of Obesity-Related circRNAs in Neurons and Glia under Obesity-like In Vitro Conditions. Int J Mol Sci 2023; 24:ijms24076235. [PMID: 37047207 PMCID: PMC10094513 DOI: 10.3390/ijms24076235] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2023] [Revised: 03/23/2023] [Accepted: 03/24/2023] [Indexed: 03/29/2023] Open
Abstract
Recent evidence indicates that the pathogenesis of neurodegenerative diseases, including Alzheimer’s disease, is associated with metabolic disorders such as diabetes and obesity. Various circular RNAs (circRNAs) have been found in brain tissues and recent studies have suggested that circRNAs are related to neuropathological mechanisms in the brain. However, there is a lack of interest in the involvement of circRNAs in metabolic imbalance-related neuropathological problems until now. Herein we profiled and analyzed diverse circRNAs in mouse brain cell lines (Neuro-2A neurons, BV-2 microglia, and C8-D1a astrocytes) exposed to obesity-related in vitro conditions (high glucose, high insulin, and high levels of tumor necrosis factor-alpha, interleukin 6, palmitic acid, linoleic acid, and cholesterol). We observed that various circRNAs were differentially expressed according to cell types with many of these circRNAs conserved in humans. After suppressing the expression of these circRNAs using siRNAs, we observed that these circRNAs regulate genes related to inflammatory responses, formation of synaptic vesicles, synaptic density, and fatty acid oxidation in neurons; scavenger receptors in microglia; and fatty acid signaling, inflammatory signaling cyto that may play important roles in metabolic disorders associated with neurodegenerative diseases.
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Affiliation(s)
- Danbi Jo
- Department of Anatomy, Chonnam National University Medical School, Hwasun 58128, Republic of Korea
| | - Gwangho Yoon
- Department of Anatomy, Chonnam National University Medical School, Hwasun 58128, Republic of Korea
| | - Yeonghwan Lim
- Department of Biochemistry, Chonnam National University Medical School, Hwasun 58128, Republic of Korea
| | - Youngkook Kim
- Department of Biochemistry, Chonnam National University Medical School, Hwasun 58128, Republic of Korea
- Correspondence: (Y.K.); (J.S.)
| | - Juhyun Song
- Department of Anatomy, Chonnam National University Medical School, Hwasun 58128, Republic of Korea
- Correspondence: (Y.K.); (J.S.)
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Koufakis T, Liberopoulos EN, Kokkinos A, Zebekakis P, Kotsa K. Weight Loss Versus Glycemic Control as the Primary Treatment Target in Newly Diagnosed Type 2 Diabetes: Why Choose When You Can Have Both? Drugs 2023; 83:469-477. [PMID: 36941489 DOI: 10.1007/s40265-023-01852-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/19/2023] [Indexed: 03/23/2023]
Abstract
Weight loss has been associated with significant improvements in glycemic control, quality of life, and comorbidities in people with type 2 diabetes. Furthermore, achieving diabetes remission can reduce the risk of microvascular complications and mitigate the burden of diabetes on healthcare systems. However, preventing weight regain is challenging in the long term. Strict glycemic control, particularly in the early stages of the disease, can reduce the subsequent risk of microvascular complications and specific macrovascular endpoints in the long run; however, its impact on cardiovascular and all-cause mortality remains controversial. New classes of antidiabetic agents, namely glucagon-like peptide 1 receptor agonists and sodium-glucose cotransporter 2 inhibitors, have been shown to reduce cardiorenal risk and induce weight loss, in addition to effectively lowering blood glucose with a minimal risk of hypoglycemia. Recently, it has been debated whether weight loss or glycemic control should be the first priority in people with a recent diagnosis of type 2 diabetes. This article aims to discuss the debate from a clinical perspective, evaluate the advantages and disadvantages of each therapeutic strategy, and assess the impact of both approaches on the future risk of diabetic complications, based on the latest evidence. Given that both goals are equally important, the authors suggest that merging the two strategies, with the early and aggressive use of combination therapies consisting of glucagon-like peptide 1 receptor agonists and sodium-glucose cotransporter 2 inhibitors, will confer maximum benefits in terms of weight loss and glycemic control, and will reduce the future risk of complications from diabetes. A personalized approach that takes into account specific patient characteristics, including age, sex, race, frailty, and cognitive status, among others, can lead to more effective diabetes care.
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Affiliation(s)
- Theocharis Koufakis
- Division of Endocrinology and Metabolism and Diabetes Center, First Department of Internal Medicine, Medical School, Aristotle University of Thessaloniki, AHEPA University Hospital, 1 St. Kiriakidi Street, 54636, Thessaloniki, Greece
| | - Evangelos N Liberopoulos
- First Department of Propaedeutic Internal Medicine, Medical School, National and Kapodistrian University of Athens, Laiko General Hospital, Athens, Greece
| | - Alexander Kokkinos
- First Department of Propaedeutic Internal Medicine, Medical School, National and Kapodistrian University of Athens, Laiko General Hospital, Athens, Greece
| | - Pantelis Zebekakis
- Division of Endocrinology and Metabolism and Diabetes Center, First Department of Internal Medicine, Medical School, Aristotle University of Thessaloniki, AHEPA University Hospital, 1 St. Kiriakidi Street, 54636, Thessaloniki, Greece
| | - Kalliopi Kotsa
- Division of Endocrinology and Metabolism and Diabetes Center, First Department of Internal Medicine, Medical School, Aristotle University of Thessaloniki, AHEPA University Hospital, 1 St. Kiriakidi Street, 54636, Thessaloniki, Greece.
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