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
IntroductionType 2 diabetes has been linked to greater cognitive decline, but other glycemic parameters such as prediabetes, diabetes control and treatment, and HOMA-IR and HbA1c diabetes-related biomarkers have shown inconsistent results. Furthermore, there is limited research assessing these relat...
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Frontiers Media S.A.
2021-10-01
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| Series: | Frontiers in Endocrinology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fendo.2021.754347/full |
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| author | Carlos Gómez-Martínez Carlos Gómez-Martínez Carlos Gómez-Martínez Nancy Babio Nancy Babio Nancy Babio Nancy Babio Jordi Júlvez Nerea Becerra-Tomás Nerea Becerra-Tomás Nerea Becerra-Tomás Miguel Á. Martínez-González Miguel Á. Martínez-González Miguel Á. Martínez-González Dolores Corella Dolores Corella Olga Castañer Olga Castañer Dora Romaguera Dora Romaguera Jesús Vioque Jesús Vioque Jesús Vioque Ángel M. Alonso-Gómez Ángel M. Alonso-Gómez Julia Wärnberg Julia Wärnberg José A. Martínez José A. Martínez José A. Martínez Luís Serra-Majem Luís Serra-Majem Ramón Estruch Ramón Estruch Francisco J. Tinahones Francisco J. Tinahones José Lapetra José Lapetra Xavier Pintó Xavier Pintó Xavier Pintó Josep A. Tur Josep A. Tur José López-Miranda José López-Miranda Aurora Bueno-Cavanillas Aurora Bueno-Cavanillas Aurora Bueno-Cavanillas José J. Gaforio José J. Gaforio Pilar Matía-Martín Lidia Daimiel Vicente Martín-Sánchez Vicente Martín-Sánchez Josep Vidal Josep Vidal Clotilde Vázquez Clotilde Vázquez Emilio Ros Emilio Ros Søren Dalsgaard Søren Dalsgaard Carmen Sayón-Orea José V. Sorlí José V. Sorlí Rafael de la Torre Rafael de la Torre Rafael de la Torre Itziar Abete Itziar Abete Lucas Tojal-Sierra Lucas Tojal-Sierra Francisco J. Barón-López Francisco J. Barón-López Noelia Fernández-Brufal Jadwiga Konieczna Jadwiga Konieczna Antonio García-Ríos Antonio García-Ríos Emilio Sacanella Emilio Sacanella M. Rosa Bernal-López M. Rosa Bernal-López José M. Santos-Lozano José M. Santos-Lozano Cristina Razquin Cristina Razquin Andrea Alvarez-Sala Andrea Alvarez-Sala Albert Goday Albert Goday M. Angeles Zulet M. Angeles Zulet Jessica Vaquero-Luna Jessica Vaquero-Luna Javier Diez-Espino Javier Diez-Espino Javier Diez-Espino Aida Cuenca-Royo Aida Cuenca-Royo Fernando Fernández-Aranda Fernando Fernández-Aranda Fernando Fernández-Aranda Mònica Bulló Mònica Bulló Mònica Bulló Jordi Salas-Salvadó Jordi Salas-Salvadó Jordi Salas-Salvadó Jordi Salas-Salvadó |
| author_facet | Carlos Gómez-Martínez Carlos Gómez-Martínez Carlos Gómez-Martínez Nancy Babio Nancy Babio Nancy Babio Nancy Babio Jordi Júlvez Nerea Becerra-Tomás Nerea Becerra-Tomás Nerea Becerra-Tomás Miguel Á. Martínez-González Miguel Á. Martínez-González Miguel Á. Martínez-González Dolores Corella Dolores Corella Olga Castañer Olga Castañer Dora Romaguera Dora Romaguera Jesús Vioque Jesús Vioque Jesús Vioque Ángel M. Alonso-Gómez Ángel M. Alonso-Gómez Julia Wärnberg Julia Wärnberg José A. Martínez José A. Martínez José A. Martínez Luís Serra-Majem Luís Serra-Majem Ramón Estruch Ramón Estruch Francisco J. Tinahones Francisco J. Tinahones José Lapetra José Lapetra Xavier Pintó Xavier Pintó Xavier Pintó Josep A. Tur Josep A. Tur José López-Miranda José López-Miranda Aurora Bueno-Cavanillas Aurora Bueno-Cavanillas Aurora Bueno-Cavanillas José J. Gaforio José J. Gaforio Pilar Matía-Martín Lidia Daimiel Vicente Martín-Sánchez Vicente Martín-Sánchez Josep Vidal Josep Vidal Clotilde Vázquez Clotilde Vázquez Emilio Ros Emilio Ros Søren Dalsgaard Søren Dalsgaard Carmen Sayón-Orea José V. Sorlí José V. Sorlí Rafael de la Torre Rafael de la Torre Rafael de la Torre Itziar Abete Itziar Abete Lucas Tojal-Sierra Lucas Tojal-Sierra Francisco J. Barón-López Francisco J. Barón-López Noelia Fernández-Brufal Jadwiga Konieczna Jadwiga Konieczna Antonio García-Ríos Antonio García-Ríos Emilio Sacanella Emilio Sacanella M. Rosa Bernal-López M. Rosa Bernal-López José M. Santos-Lozano José M. Santos-Lozano Cristina Razquin Cristina Razquin Andrea Alvarez-Sala Andrea Alvarez-Sala Albert Goday Albert Goday M. Angeles Zulet M. Angeles Zulet Jessica Vaquero-Luna Jessica Vaquero-Luna Javier Diez-Espino Javier Diez-Espino Javier Diez-Espino Aida Cuenca-Royo Aida Cuenca-Royo Fernando Fernández-Aranda Fernando Fernández-Aranda Fernando Fernández-Aranda Mònica Bulló Mònica Bulló Mònica Bulló Jordi Salas-Salvadó Jordi Salas-Salvadó Jordi Salas-Salvadó Jordi Salas-Salvadó |
| author_sort | Carlos Gómez-Martínez |
| collection | DOAJ |
| description | IntroductionType 2 diabetes has been linked to greater cognitive decline, but other glycemic parameters such as prediabetes, diabetes control and treatment, and HOMA-IR and HbA1c 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.MethodsWe 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 ≥5-year diabetes duration), and also by diabetes control. Furthermore, insulin resistance (HOMA-IR) and glycated hemoglobin (HbA1c) 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.ResultsPrediabetes status was unrelated to cognitive decline. However, compared to participants without diabetes, those with ≥5-year diabetes duration had greater reductions in GCF (β=-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 [β=-0.0094 (95%CI -0.0164;-0.0023)], but also between HbA1c levels and changes in GCF [β=-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 [β=-0.31 (95%CI -0.44, -0.18)], and other cognitive tests.ConclusionsInsulin 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.Clinical Trial Registrationhttp://www.isrctn.com/ISRCTN89898870, identifier ISRCTN: 89898870. |
| first_indexed | 2024-12-14T07:48:24Z |
| format | Article |
| id | doaj.art-564d825bcc5541d1b6de249b1d1439aa |
| institution | Directory Open Access Journal |
| issn | 1664-2392 |
| language | English |
| last_indexed | 2024-12-14T07:48:24Z |
| publishDate | 2021-10-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Endocrinology |
| spelling | doaj.art-564d825bcc5541d1b6de249b1d1439aa2022-12-21T23:10:48ZengFrontiers Media S.A.Frontiers in Endocrinology1664-23922021-10-011210.3389/fendo.2021.754347754347Glycemic Dysregulations Are Associated With Worsening Cognitive Function in Older Participants at High Risk of Cardiovascular Disease: Two-Year Follow-up in the PREDIMED-Plus StudyCarlos Gómez-Martínez0Carlos Gómez-Martínez1Carlos Gómez-Martínez2Nancy Babio3Nancy Babio4Nancy Babio5Nancy Babio6Jordi Júlvez7Nerea Becerra-Tomás8Nerea Becerra-Tomás9Nerea Becerra-Tomás10Miguel Á. Martínez-González11Miguel Á. Martínez-González12Miguel Á. Martínez-González13Dolores Corella14Dolores Corella15Olga Castañer16Olga Castañer17Dora Romaguera18Dora Romaguera19Jesús Vioque20Jesús Vioque21Jesús Vioque22Ángel M. Alonso-Gómez23Ángel M. Alonso-Gómez24Julia Wärnberg25Julia Wärnberg26José A. Martínez27José A. Martínez28José A. Martínez29Luís Serra-Majem30Luís Serra-Majem31Ramón Estruch32Ramón Estruch33Francisco J. Tinahones34Francisco J. Tinahones35José Lapetra36José Lapetra37Xavier Pintó38Xavier Pintó39Xavier Pintó40Josep A. Tur41Josep A. Tur42José López-Miranda43José López-Miranda44Aurora Bueno-Cavanillas45Aurora Bueno-Cavanillas46Aurora Bueno-Cavanillas47José J. Gaforio48José J. Gaforio49Pilar Matía-Martín50Lidia Daimiel51Vicente Martín-Sánchez52Vicente Martín-Sánchez53Josep Vidal54Josep Vidal55Clotilde Vázquez56Clotilde Vázquez57Emilio Ros58Emilio Ros59Søren Dalsgaard60Søren Dalsgaard61Carmen Sayón-Orea62José V. Sorlí63José V. Sorlí64Rafael de la Torre65Rafael de la Torre66Rafael de la Torre67Itziar Abete68Itziar Abete69Lucas Tojal-Sierra70Lucas Tojal-Sierra71Francisco J. Barón-López72Francisco J. Barón-López73Noelia Fernández-Brufal74Jadwiga Konieczna75Jadwiga Konieczna76Antonio García-Ríos77Antonio García-Ríos78Emilio Sacanella79Emilio Sacanella80M. Rosa Bernal-López81M. Rosa Bernal-López82José M. Santos-Lozano83José M. Santos-Lozano84Cristina Razquin85Cristina Razquin86Andrea Alvarez-Sala87Andrea Alvarez-Sala88Albert Goday89Albert Goday90M. Angeles Zulet91M. Angeles Zulet92Jessica Vaquero-Luna93Jessica Vaquero-Luna94Javier Diez-Espino95Javier Diez-Espino96Javier Diez-Espino97Aida Cuenca-Royo98Aida Cuenca-Royo99Fernando Fernández-Aranda100Fernando Fernández-Aranda101Fernando Fernández-Aranda102Mònica Bulló103Mònica Bulló104Mònica Bulló105Jordi Salas-Salvadó106Jordi Salas-Salvadó107Jordi Salas-Salvadó108Jordi Salas-Salvadó109Universitat Rovira i Virgili, Departament de Bioquímica i Biotecnologia, Unitat de Nutrició Humana, Reus, SpainInstitut d’Investigació Sanitària Pere Virgili (IISPV), Hospital Universitari San Joan de Reus, Reus, SpainConsorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III (ISCIII), Madrid, SpainUniversitat Rovira i Virgili, Departament de Bioquímica i Biotecnologia, Unitat de Nutrició Humana, Reus, SpainInstitut d’Investigació Sanitària Pere Virgili (IISPV), Hospital Universitari San Joan de Reus, Reus, SpainConsorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III (ISCIII), Madrid, SpainNutrition Unit, University Hospital of Sant Joan de Reus, Reus, SpainInstitut d’Investigació Sanitària Pere Virgili (IISPV), Hospital Universitari San Joan de Reus, Reus, SpainUniversitat Rovira i Virgili, Departament de Bioquímica i Biotecnologia, Unitat de Nutrició Humana, Reus, SpainInstitut d’Investigació Sanitària Pere Virgili (IISPV), Hospital Universitari San Joan de Reus, Reus, SpainConsorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III (ISCIII), Madrid, SpainConsorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III (ISCIII), Madrid, SpainDepartment of Preventive Medicine and Public Health, Instituto de Investigación Sanitaria de Navarra (IdISNA), University of Navarra, Pamplona, SpainDepartment of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, United StatesConsorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III (ISCIII), Madrid, SpainDepartment of Preventive Medicine, University of Valencia, Valencia, SpainConsorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III (ISCIII), Madrid, SpainCardiovascular Risk and Nutrition Research Group (CARIN), Hospital del Mar Research Institute (IMIM), Barcelona, SpainConsorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III (ISCIII), Madrid, SpainHealth Research Institute of the Balearic Islands (IdISBa), University Hospital Son Espases, Palma, Spain0CIBER de Epidemiología y Salud Pública (CIBERESP), ISCIII, Madrid, Spain1Nutritional Epidemiology Unit, Miguel Hernandez University, Alicante, Spain2Instituto de Investigación Sanitaria y Biomédica de Alicante-Universidad Miguel Hernández (ISABIAL-UMH), Alicante, SpainConsorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III (ISCIII), Madrid, Spain3Bioaraba 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, SpainConsorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III (ISCIII), Madrid, Spain4EpiPHAAN Research Group, School of Health Sciences, Instituto de Investigación Biomédica de Málaga (IBIMA), University of Malaga, Malaga, SpainConsorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III (ISCIII), Madrid, Spain5Department of Nutrition, Food Science and Physiology, Instituto de Investigación Sanitaria de Navarra (IdISNA), University of Navarra, Pamplona, Spain6Cardiometabolic 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, SpainConsorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III (ISCIII), Madrid, Spain7Research 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, SpainConsorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III (ISCIII), Madrid, Spain8Department of Internal Medicine, Institut d’Investigacions Biomèdiques August Pi Sunyer (IDIBAPS), Hospital Clinic, University of Barcelona, Barcelona, SpainConsorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III (ISCIII), Madrid, Spain9Department of Endocrinology, Instituto de Investigación Biomédica de Málaga (IBIMA), Virgen de la Victoria Hospital, University of Malaga, Malaga, SpainConsorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III (ISCIII), Madrid, Spain0Research Unit, Department of Family Medicine, Distrito Sanitario Atención Primaria Sevilla, Sevilla, SpainConsorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III (ISCIII), Madrid, Spain1Lipids and Vascular Risk Unit, Internal Medicine, Hospital Universitario de Bellvitge-IBIDELL, Hospitalet de Llobregat, Barcelona, Spain2Universitat de Barcelona, Barcelona, SpainConsorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III (ISCIII), Madrid, Spain3Research 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, SpainConsorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III (ISCIII), Madrid, Spain4Department of Internal Medicine, Maimonides Biomedical Research Institute of Cordoba (IMIBIC), Reina Sofia University Hospital, University of Cordoba, Cordoba, Spain0CIBER de Epidemiología y Salud Pública (CIBERESP), ISCIII, Madrid, Spain5Department of Preventive Medicine, University of Granada, Granada, Spain6Instituto de Investigación Biosanitaria ibs.GRANADA, Granada, Spain0CIBER de Epidemiología y Salud Pública (CIBERESP), ISCIII, Madrid, Spain7Departamento de Ciencias de la Salud, Instituto Universitario de Investigación en Olivar y Aceites de Oliva, Universidad de Jaén, Jaén, Spain8Department of Endocrinology and Nutrition, Instituto de Investigación Sanitaria Hospital Clínico San Carlos (IdISSC), Madrid, Spain9Nutritional Control of the Epigenome Group, Precision Nutrition and Obesity Program, IMDEA Food, CEI UAM + CSIC, Madrid, SpainConsorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III (ISCIII), Madrid, Spain0Institute of Biomedicine (IBIOMED), University of León, León, Spain1CIBER Diabetes y Enfermedades Metabólicas (CIBERDEM), ISCIII, Madrid, Spain2Departament of Endocrinology, Instituto de Investigaciones Biomédicas August Pi i Sunyer (IDIBAPS), Hospital Clínic, University of Barcelona, Barcelona, SpainConsorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III (ISCIII), Madrid, Spain3Department of Endocrinology, Fundación Jiménez-Díaz, Madrid, SpainConsorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III (ISCIII), Madrid, Spain4Lipid Clinic, Department of Endocrinology and Nutrition, IDIBAPS, Hospital Clínic, Barcelona, Spain5Lundbeck Foundation Initiative for Integrative Psychiatric Research, iPSYCH, Aarhus, Denmark6National Centre for Register-Based Research, Aarhus University, Aarhus, DenmarkDepartment of Preventive Medicine and Public Health, Instituto de Investigación Sanitaria de Navarra (IdISNA), University of Navarra, Pamplona, SpainConsorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III (ISCIII), Madrid, SpainDepartment of Preventive Medicine, University of Valencia, Valencia, SpainConsorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III (ISCIII), Madrid, Spain7Integrated Pharmacology and Systems Neurosciences Research Group, Hospital del Mar Medical Research Institute (IMIM), Barcelona, Spain8Departamento de Ciencias Experimentales y de la Salud (CEXS), Universitat Pompeu Fabra, Barcelona, SpainConsorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III (ISCIII), Madrid, Spain5Department of Nutrition, Food Science and Physiology, Instituto de Investigación Sanitaria de Navarra (IdISNA), University of Navarra, Pamplona, SpainConsorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III (ISCIII), Madrid, Spain3Bioaraba 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, SpainConsorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III (ISCIII), Madrid, Spain4EpiPHAAN Research Group, School of Health Sciences, Instituto de Investigación Biomédica de Málaga (IBIMA), University of Malaga, Malaga, Spain9Centro de Salud San Fermín, Elche, SpainConsorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III (ISCIII), Madrid, SpainHealth Research Institute of the Balearic Islands (IdISBa), University Hospital Son Espases, Palma, SpainConsorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III (ISCIII), Madrid, Spain4Department of Internal Medicine, Maimonides Biomedical Research Institute of Cordoba (IMIBIC), Reina Sofia University Hospital, University of Cordoba, Cordoba, SpainConsorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III (ISCIII), Madrid, Spain8Department of Internal Medicine, Institut d’Investigacions Biomèdiques August Pi Sunyer (IDIBAPS), Hospital Clinic, University of Barcelona, Barcelona, SpainConsorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III (ISCIII), Madrid, Spain0Department of Internal Medicine, Regional University Hospital of Malaga, Instituto de Investigación Biomédica de Málaga (IBIMA), University of Malaga, Malaga, SpainConsorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III (ISCIII), Madrid, Spain0Research Unit, Department of Family Medicine, Distrito Sanitario Atención Primaria Sevilla, Sevilla, SpainConsorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III (ISCIII), Madrid, SpainDepartment of Preventive Medicine and Public Health, Instituto de Investigación Sanitaria de Navarra (IdISNA), University of Navarra, Pamplona, SpainConsorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III (ISCIII), Madrid, SpainDepartment of Preventive Medicine, University of Valencia, Valencia, SpainConsorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III (ISCIII), Madrid, SpainCardiovascular Risk and Nutrition Research Group (CARIN), Hospital del Mar Research Institute (IMIM), Barcelona, SpainConsorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III (ISCIII), Madrid, Spain5Department of Nutrition, Food Science and Physiology, Instituto de Investigación Sanitaria de Navarra (IdISNA), University of Navarra, Pamplona, SpainConsorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III (ISCIII), Madrid, Spain3Bioaraba 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, SpainConsorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III (ISCIII), Madrid, SpainDepartment of Preventive Medicine and Public Health, Instituto de Investigación Sanitaria de Navarra (IdISNA), University of Navarra, Pamplona, Spain1Gerencia de Atención Primaria Servicio Navarro de Salud-Osasunbidea, Navarra, SpainConsorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III (ISCIII), Madrid, SpainCardiovascular Risk and Nutrition Research Group (CARIN), Hospital del Mar Research Institute (IMIM), Barcelona, SpainConsorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III (ISCIII), Madrid, Spain2Department of Psychiatry, University Hospital of Bellvitge-Instituto de Investigación Biomédica de Bellvitge (IDIBELL), Barcelona, Spain3Department of Clinical Sciences, School of Medicine and Health Sciences, University of Barcelona, Barcelona, SpainUniversitat Rovira i Virgili, Departament de Bioquímica i Biotecnologia, Unitat de Nutrició Humana, Reus, SpainInstitut d’Investigació Sanitària Pere Virgili (IISPV), Hospital Universitari San Joan de Reus, Reus, SpainConsorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III (ISCIII), Madrid, SpainUniversitat Rovira i Virgili, Departament de Bioquímica i Biotecnologia, Unitat de Nutrició Humana, Reus, SpainInstitut d’Investigació Sanitària Pere Virgili (IISPV), Hospital Universitari San Joan de Reus, Reus, SpainConsorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III (ISCIII), Madrid, SpainNutrition Unit, University Hospital of Sant Joan de Reus, Reus, SpainIntroductionType 2 diabetes has been linked to greater cognitive decline, but other glycemic parameters such as prediabetes, diabetes control and treatment, and HOMA-IR and HbA1c 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.MethodsWe 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 ≥5-year diabetes duration), and also by diabetes control. Furthermore, insulin resistance (HOMA-IR) and glycated hemoglobin (HbA1c) 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.ResultsPrediabetes status was unrelated to cognitive decline. However, compared to participants without diabetes, those with ≥5-year diabetes duration had greater reductions in GCF (β=-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 [β=-0.0094 (95%CI -0.0164;-0.0023)], but also between HbA1c levels and changes in GCF [β=-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 [β=-0.31 (95%CI -0.44, -0.18)], and other cognitive tests.ConclusionsInsulin 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.Clinical Trial Registrationhttp://www.isrctn.com/ISRCTN89898870, identifier ISRCTN: 89898870.https://www.frontiersin.org/articles/10.3389/fendo.2021.754347/fullcognitive functiondiabetes durationglycated (glycosylated) hemoglobininsulin resistancetype 2 diabetesprediabetes |
| spellingShingle | Carlos Gómez-Martínez Carlos Gómez-Martínez Carlos Gómez-Martínez Nancy Babio Nancy Babio Nancy Babio Nancy Babio Jordi Júlvez Nerea Becerra-Tomás Nerea Becerra-Tomás Nerea Becerra-Tomás Miguel Á. Martínez-González Miguel Á. Martínez-González Miguel Á. Martínez-González Dolores Corella Dolores Corella Olga Castañer Olga Castañer Dora Romaguera Dora Romaguera Jesús Vioque Jesús Vioque Jesús Vioque Ángel M. Alonso-Gómez Ángel M. Alonso-Gómez Julia Wärnberg Julia Wärnberg José A. Martínez José A. Martínez José A. Martínez Luís Serra-Majem Luís Serra-Majem Ramón Estruch Ramón Estruch Francisco J. Tinahones Francisco J. Tinahones José Lapetra José Lapetra Xavier Pintó Xavier Pintó Xavier Pintó Josep A. Tur Josep A. Tur José López-Miranda José López-Miranda Aurora Bueno-Cavanillas Aurora Bueno-Cavanillas Aurora Bueno-Cavanillas José J. Gaforio José J. Gaforio Pilar Matía-Martín Lidia Daimiel Vicente Martín-Sánchez Vicente Martín-Sánchez Josep Vidal Josep Vidal Clotilde Vázquez Clotilde Vázquez Emilio Ros Emilio Ros Søren Dalsgaard Søren Dalsgaard Carmen Sayón-Orea José V. Sorlí José V. Sorlí Rafael de la Torre Rafael de la Torre Rafael de la Torre Itziar Abete Itziar Abete Lucas Tojal-Sierra Lucas Tojal-Sierra Francisco J. Barón-López Francisco J. Barón-López Noelia Fernández-Brufal Jadwiga Konieczna Jadwiga Konieczna Antonio García-Ríos Antonio García-Ríos Emilio Sacanella Emilio Sacanella M. Rosa Bernal-López M. Rosa Bernal-López José M. Santos-Lozano José M. Santos-Lozano Cristina Razquin Cristina Razquin Andrea Alvarez-Sala Andrea Alvarez-Sala Albert Goday Albert Goday M. Angeles Zulet M. Angeles Zulet Jessica Vaquero-Luna Jessica Vaquero-Luna Javier Diez-Espino Javier Diez-Espino Javier Diez-Espino Aida Cuenca-Royo Aida Cuenca-Royo Fernando Fernández-Aranda Fernando Fernández-Aranda Fernando Fernández-Aranda Mònica Bulló Mònica Bulló Mònica Bulló Jordi Salas-Salvadó Jordi Salas-Salvadó Jordi Salas-Salvadó Jordi Salas-Salvadó 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 Frontiers in Endocrinology cognitive function diabetes duration glycated (glycosylated) hemoglobin insulin resistance type 2 diabetes prediabetes |
| title | 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 |
| title_full | 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 |
| title_fullStr | 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 |
| title_full_unstemmed | 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 |
| title_short | 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 |
| title_sort | 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 |
| topic | cognitive function diabetes duration glycated (glycosylated) hemoglobin insulin resistance type 2 diabetes prediabetes |
| url | https://www.frontiersin.org/articles/10.3389/fendo.2021.754347/full |
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