1. Association of long-term hyperglycaemia and insulin resistance with brain atrophy and cognitive decline: A longitudinal cohort study.
- Author
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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, and Kim NH
- Subjects
- Middle Aged, Adult, Humans, Longitudinal Studies, Glycated Hemoglobin, Cohort Studies, Brain pathology, Atrophy complications, Atrophy pathology, Glucose, Magnetic Resonance Imaging, Hyperglycemia complications, Diabetes Mellitus, Type 2 complications, Insulin Resistance, Cognitive Dysfunction
- 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., (© 2022 John Wiley & Sons Ltd.)
- Published
- 2023
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