Glycemic Dysregulations Are Associated With Worsening Cognitive Function in Older Participants at High Risk of Cardiovascular Disease: Two-Year Follow-up in the PREDIMED-Plus Study.
M Rosa Bernal-López, Clotilde Vázquez, Emilio Ros, Søren Dalsgaard, Carmen Sayón-Orea, Rafael de la Torre, Itziar Abete, Lucas Tojal-Sierra, Francisco J Barón-López, Noelia Fernández-Brufal, Jadwiga Konieczna, Antonio García-Ríos, Emilio Sacanella, Josep Vidal, José M Santos-Lozano, Cristina Razquin, Andrea Alvarez-Sala, Albert Goday, M Angeles Zulet, Jessica Vaquero-Luna, Javier Diez-Espino, Aida Cuenca-Royo, Fernando Fernández-Aranda, Mònica Bulló, Jordi Salas-Salvadó, Julia Wärnberg, Lidia Daimiel, Dolores Corella, José V Sorlí, Carlos Gómez-Martínez, Nancy Babio, Jordi Júlvez, Nerea Becerra-Tomás, Miguel Á Martínez-González, Olga Castañer, Dora Romaguera, Jesús Vioque, Ángel M Alonso-Gómez, Pilar Matía-Martín, José A Martínez, Luís Serra-Majem, Ramón Estruch, Francisco J Tinahones, José Lapetra, Xavier Pintó, Josep A Tur, José López-Miranda, Aurora Bueno-Cavanillas, José J Gaforio, Vicente Martín-Sánchez
Journal: Frontiers in endocrinology
2022;12():754347
PMID: 34777250
Abstract
[{"label":"INTRODUCTION","text":"Type 2 diabetes has been linked to greater cognitive decline, but other glycemic parameters such as prediabetes, diabetes control and treatment, and HOMA-IR and HbA diabetes-related biomarkers have shown inconsistent results. Furthermore, there is limited research assessing these relationships in short-term studies. Thus, we aimed to examine 2-year associations between baseline diabetes\/glycemic status and changes in cognitive function in older participants at high risk of cardiovascular disease."},{"label":"METHODS","text":"We conducted a 2-year prospective cohort study (n=6,874) within the framework of the PREDIMED-Plus study. The participants (with overweight\/obesity and metabolic syndrome; mean age 64.9 years; 48.5% women) completed a battery of 8 cognitive tests, and a global cognitive function Z-score (GCF) was estimated. At baseline, participants were categorized by diabetes status (no-diabetes, prediabetes, and <5 or \u22655-year diabetes duration), and also by diabetes control. Furthermore, insulin resistance (HOMA-IR) and glycated hemoglobin (HbA) levels were measured, and antidiabetic medications were recorded. Linear and logistic regression models, adjusted by potential confounders, were fitted to assess associations between glycemic status and changes in cognitive function."},{"label":"RESULTS","text":"Prediabetes status was unrelated to cognitive decline. However, compared to participants without diabetes, those with \u22655-year diabetes duration had greater reductions in GCF (\u03b2=-0.11 (95%CI -0.16;-0.06)], as well as in processing speed and executive function measurements. Inverse associations were observed between baseline HOMA-IR and changes in GCF [\u03b2=-0.0094 (95%CI -0.0164;-0.0023)], but also between HbA levels and changes in GCF [\u03b2=-0.0085 (95%CI -0.0115, -0.0055)], the Mini-Mental State Examination, and other executive function tests. Poor diabetes control was inversely associated with phonologic fluency. The use of insulin treatment was inversely related to cognitive function as measured by the GCF [\u03b2=-0.31 (95%CI -0.44, -0.18)], and other cognitive tests."},{"label":"CONCLUSIONS","text":"Insulin resistance, diabetes status, longer diabetes duration, poor glycemic control, and insulin treatment were associated with worsening cognitive function changes in the short term in a population at high cardiovascular risk."},{"label":"CLINICAL TRIAL REGISTRATION","text":"http:\/\/www.isrctn.com\/ISRCTN89898870, identifier ISRCTN: 89898870."},{"copyright":"Copyright \u00a9 2021 G\u00f3mez-Mart\u00ednez, Babio, J\u00falvez, Becerra-Tom\u00e1s, Mart\u00ednez-Gonz\u00e1lez, Corella, Casta\u00f1er, Romaguera, Vioque, Alonso-G\u00f3mez, W\u00e4rnberg, Mart\u00ednez, Serra-Majem, Estruch, Tinahones, Lapetra, Pint\u00f3, Tur, L\u00f3pez-Miranda, Bueno-Cavanillas, Gaforio, Mat\u00eda-Mart\u00edn, Daimiel, Mart\u00edn-S\u00e1nchez, Vidal, V\u00e1zquez, Ros, Dalsgaard, Say\u00f3n-Orea, Sorl\u00ed, de la Torre, Abete, Tojal-Sierra, Bar\u00f3n-L\u00f3pez, Fern\u00e1ndez-Brufal, Konieczna, Garc\u00eda-R\u00edos, Sacanella, Bernal-L\u00f3pez, Santos-Lozano, Razquin, Alvarez-Sala, Goday, Zulet, Vaquero-Luna, Diez-Espino, Cuenca-Royo, Fern\u00e1ndez-Aranda, Bull\u00f3 and Salas-Salvad\u00f3."}]
Address:
Universitat Rovira i Virgili, Departament de Bioquímica i Biotecnologia, Unitat de Nutrició Humana, Reus, Spain.; Institut d'Investigació Sanitària Pere Virgili (IISPV), Hospital Universitari San Joan de Reus, Reus, Spain.; Consorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III (ISCIII), Madrid, Spain.; Nutrition Unit, University Hospital of Sant Joan de Reus, Reus, Spain.; Department of Preventive Medicine and Public Health, Instituto de Investigación Sanitaria de Navarra (IdISNA), University of Navarra, Pamplona, Spain.; Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, United States.; Department of Preventive Medicine, University of Valencia, Valencia, Spain.; Cardiovascular Risk and Nutrition Research Group (CARIN), Hospital del Mar Research Institute (IMIM), Barcelona, Spain.; Health Research Institute of the Balearic Islands (IdISBa), University Hospital Son Espases, Palma, Spain.; CIBER de Epidemiología y Salud Pública (CIBERESP), ISCIII, Madrid, Spain.; Nutritional Epidemiology Unit, Miguel Hernandez University, Alicante, Spain.; Instituto de Investigación Sanitaria y Biomédica de Alicante-Universidad Miguel Hernández (ISABIAL-UMH), Alicante, Spain.; Bioaraba Health Research Institute, Osakidetza Basque Health Service, Araba University Hospital, University of the Basque Country Universidad del País Vasco / Euskal Herriko Unibertsitatea (UPV/EHU), Vitoria-Gasteiz, Spain.; EpiPHAAN Research Group, School of Health Sciences, Instituto de Investigación Biomédica de Málaga (IBIMA), University of Malaga, Malaga, Spain.; Department of Nutrition, Food Science and Physiology, Instituto de Investigación Sanitaria de Navarra (IdISNA), University of Navarra, Pamplona, Spain.; Cardiometabolic Nutrition Group, Precision Nutrition and Cardiometabolic Health Program, IMDEA Food, Campus de Excelencia Internacional Universidad Autónoma de Madrid + Consejo Superior de Investigaciones Científicas (CEI UAM + CSIC), Madrid, Spain.; Research Institute of Biomedical and Health Sciences (IUIBS), Preventive Medicine Service, Centro Hospitalario Universitario Insular Materno Infantil (CHUIMI), Canarian Health Service, University of Las Palmas de Gran Canaria, Las Palmas, Spain.; Department of Internal Medicine, Institut d'Investigacions Biomèdiques August Pi Sunyer (IDIBAPS), Hospital Clinic, University of Barcelona, Barcelona, Spain.; Department of Endocrinology, Instituto de Investigación Biomédica de Málaga (IBIMA), Virgen de la Victoria Hospital, University of Malaga, Malaga, Spain.; Research Unit, Department of Family Medicine, Distrito Sanitario Atención Primaria Sevilla, Sevilla, Spain.; Lipids and Vascular Risk Unit, Internal Medicine, Hospital Universitario de Bellvitge-IBIDELL, Hospitalet de Llobregat, Barcelona, Spain.; Universitat de Barcelona, Barcelona, Spain.; Research Group on Community Nutrition & Oxidative Stress, University of Balearic Islands-Instituto Universitario de Investigación en Ciencias de la Salud (IUNICS) & Health Research Institute of the Balearic Islands (IdISBa), Palma de Mallorca, Spain.; Department of Internal Medicine, Maimonides Biomedical Research Institute of Cordoba (IMIBIC), Reina Sofia University Hospital, University of Cordoba, Cordoba, Spain.; Department of Preventive Medicine, University of Granada, Granada, Spain.; Instituto de Investigación Biosanitaria ibs.GRANADA, Granada, Spain.; Departamento de Ciencias de la Salud, Instituto Universitario de Investigación en Olivar y Aceites de Oliva, Universidad de Jaén, Jaén, Spain.; Department of Endocrinology and Nutrition, Instituto de Investigación Sanitaria Hospital Clínico San Carlos (IdISSC), Madrid, Spain.; Nutritional Control of the Epigenome Group, Precision Nutrition and Obesity Program, IMDEA Food, CEI UAM + CSIC, Madrid, Spain.; Institute of Biomedicine (IBIOMED), University of León, León, Spain.; CIBER Diabetes y Enfermedades Metabólicas (CIBERDEM), ISCIII, Madrid, Spain.; Departament of Endocrinology, Instituto de Investigaciones Biomédicas August Pi i Sunyer (IDIBAPS), Hospital Clínic, University of Barcelona, Barcelona, Spain.; Department of Endocrinology, Fundación Jiménez-Díaz, Madrid, Spain.; Lipid Clinic, Department of Endocrinology and Nutrition, IDIBAPS, Hospital Clínic, Barcelona, Spain.; Lundbeck Foundation Initiative for Integrative Psychiatric Research, iPSYCH, Aarhus, Denmark.; National Centre for Register-Based Research, Aarhus University, Aarhus, Denmark.; Integrated Pharmacology and Systems Neurosciences Research Group, Hospital del Mar Medical Research Institute (IMIM), Barcelona, Spain.; Departamento de Ciencias Experimentales y de la Salud (CEXS), Universitat Pompeu Fabra, Barcelona, Spain.; Centro de Salud San Fermín, Elche, Spain.; Department of Internal Medicine, Regional University Hospital of Malaga, Instituto de Investigación Biomédica de Málaga (IBIMA), University of Malaga, Malaga, Spain.; Gerencia de Atención Primaria Servicio Navarro de Salud-Osasunbidea, Navarra, Spain.; Department of Psychiatry, University Hospital of Bellvitge-Instituto de Investigación Biomédica de Bellvitge (IDIBELL), Barcelona, Spain.; Department of Clinical Sciences, School of Medicine and Health Sciences, University of Barcelona, Barcelona, Spain.
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MeSH Terms:
Aged,
Cognition,
Cognitive Dysfunction,
Female,
Glucose Metabolism Disorders,
Glycemic Control,
Humans,
Hypoglycemic Agents,
Male,
Middle Aged,
Prospective Studies
