Long-Term Use of Metformin Is Associated With Reduced Risk of Cognitive Impairment With Alleviation of Cerebral Small Vessel Disease Burden in Patients With Type 2 Diabetes
Objective: Type 2 diabetes (T2D) is a risk factor for cognitive impairment and cerebral small vessel disease (CSVD). The relation of metformin use and cognitive impairment or CSVD is not clear. The objective of this study was to investigate the cross-sectional effects of long-term use of metformin o...
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| Format: | Article |
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Frontiers Media S.A.
2021-10-01
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| Series: | Frontiers in Aging Neuroscience |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fnagi.2021.773797/full |
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| author | Zhenjie Teng Zhenjie Teng Jing Feng Qianqian Qi Qianqian Qi Yanhong Dong Yining Xiao Yining Xiao Xiaohua Xie Nan Meng Huifang Chen Wenhui Zhang Peiyuan Lv Peiyuan Lv |
| author_facet | Zhenjie Teng Zhenjie Teng Jing Feng Qianqian Qi Qianqian Qi Yanhong Dong Yining Xiao Yining Xiao Xiaohua Xie Nan Meng Huifang Chen Wenhui Zhang Peiyuan Lv Peiyuan Lv |
| author_sort | Zhenjie Teng |
| collection | DOAJ |
| description | Objective: Type 2 diabetes (T2D) is a risk factor for cognitive impairment and cerebral small vessel disease (CSVD). The relation of metformin use and cognitive impairment or CSVD is not clear. The objective of this study was to investigate the cross-sectional effects of long-term use of metformin on total CSVD burden and cognitive function in patients with T2D.Methods: A total of 234 participants with T2D from the memory clinic in Hebei General Hospital were enrolled in this retrospective study. Duration of metformin use and dosage were recorded. Along with cerebral magnetic resonance imaging (MRI) examination, Mini-Mental State Examination (MMSE) was also performed to assess their cognitive status. We determined the validated total CSVD score (ranging from 0–4) by combining four markers of CSVD that were visually rated. We used binary logistic regression analysis, ordinal logistic regression analysis and mediation analysis to assess the relation of long-term use of metformin with CSVD burden and cognitive function.Results: Binary logistic regression analysis showed long-term use of metformin was associated with reducing the risk of cognitive impairment (OR: 0.446; 95% Confidence Interval (CI): 0.249 to 0.800; P = 0.007), after adjustment of potential confounders, such as total CSVD burden score, age, HbA1c, hypertension, history of stroke, homocysteine, body mass index, TG and HDL-C. Ordinal logistic regression analysis suggested that long-term use of metformin was associated with alleviation of total CSVD burden score (OR: 0.583; 95% CI: 0.359 to 0.943; P = 0.027), after adjusting for age, HbA1c, hypertension, history of stroke, homocysteine, body mass index, TG and HDL-C. Mediation analysis showed significant mediation by the presence of severe CSVD burden score for long-term use of metformin in relation to cognitive impairment.Conclusion: Long-term use of metformin was associated with lower rates of cognitive impairment and lower total CSVD burden score in patients with T2D. A proportion of the relation between long-term use of metformin and cognitive impairment may be attributable to alleviation of CSVD burden. |
| first_indexed | 2024-12-15T00:25:13Z |
| format | Article |
| id | doaj.art-b3671dc1e60342d9a783565866f19fe0 |
| institution | Directory Open Access Journal |
| issn | 1663-4365 |
| language | English |
| last_indexed | 2024-12-15T00:25:13Z |
| publishDate | 2021-10-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Aging Neuroscience |
| spelling | doaj.art-b3671dc1e60342d9a783565866f19fe02022-12-21T22:42:12ZengFrontiers Media S.A.Frontiers in Aging Neuroscience1663-43652021-10-011310.3389/fnagi.2021.773797773797Long-Term Use of Metformin Is Associated With Reduced Risk of Cognitive Impairment With Alleviation of Cerebral Small Vessel Disease Burden in Patients With Type 2 DiabetesZhenjie Teng0Zhenjie Teng1Jing Feng2Qianqian Qi3Qianqian Qi4Yanhong Dong5Yining Xiao6Yining Xiao7Xiaohua Xie8Nan Meng9Huifang Chen10Wenhui Zhang11Peiyuan Lv12Peiyuan Lv13Department of Neurology, Hebei Medical University, Shijiazhuang, ChinaDepartment of Neurology, Hebei General Hospital, Shijiazhuang, ChinaDepartment of Endocrinology, Hebei General Hospital, Shijiazhuang, ChinaDepartment of Neurology, Hebei Medical University, Shijiazhuang, ChinaDepartment of Neurology, Hebei General Hospital, Shijiazhuang, ChinaDepartment of Neurology, Hebei General Hospital, Shijiazhuang, ChinaDepartment of Neurology, Hebei Medical University, Shijiazhuang, ChinaDepartment of Neurology, Hebei General Hospital, Shijiazhuang, ChinaDepartment of Neurology, Hebei General Hospital, Shijiazhuang, ChinaDepartment of Neurology, Hebei General Hospital, Shijiazhuang, ChinaDepartment of Neurology, Hebei General Hospital, Shijiazhuang, ChinaMemory Clinic, Hebei General Hospital, Shijiazhuang, ChinaDepartment of Neurology, Hebei Medical University, Shijiazhuang, ChinaDepartment of Neurology, Hebei General Hospital, Shijiazhuang, ChinaObjective: Type 2 diabetes (T2D) is a risk factor for cognitive impairment and cerebral small vessel disease (CSVD). The relation of metformin use and cognitive impairment or CSVD is not clear. The objective of this study was to investigate the cross-sectional effects of long-term use of metformin on total CSVD burden and cognitive function in patients with T2D.Methods: A total of 234 participants with T2D from the memory clinic in Hebei General Hospital were enrolled in this retrospective study. Duration of metformin use and dosage were recorded. Along with cerebral magnetic resonance imaging (MRI) examination, Mini-Mental State Examination (MMSE) was also performed to assess their cognitive status. We determined the validated total CSVD score (ranging from 0–4) by combining four markers of CSVD that were visually rated. We used binary logistic regression analysis, ordinal logistic regression analysis and mediation analysis to assess the relation of long-term use of metformin with CSVD burden and cognitive function.Results: Binary logistic regression analysis showed long-term use of metformin was associated with reducing the risk of cognitive impairment (OR: 0.446; 95% Confidence Interval (CI): 0.249 to 0.800; P = 0.007), after adjustment of potential confounders, such as total CSVD burden score, age, HbA1c, hypertension, history of stroke, homocysteine, body mass index, TG and HDL-C. Ordinal logistic regression analysis suggested that long-term use of metformin was associated with alleviation of total CSVD burden score (OR: 0.583; 95% CI: 0.359 to 0.943; P = 0.027), after adjusting for age, HbA1c, hypertension, history of stroke, homocysteine, body mass index, TG and HDL-C. Mediation analysis showed significant mediation by the presence of severe CSVD burden score for long-term use of metformin in relation to cognitive impairment.Conclusion: Long-term use of metformin was associated with lower rates of cognitive impairment and lower total CSVD burden score in patients with T2D. A proportion of the relation between long-term use of metformin and cognitive impairment may be attributable to alleviation of CSVD burden.https://www.frontiersin.org/articles/10.3389/fnagi.2021.773797/fullmetformincerebral small vessel diseasecognitive impairmentdiabetesrelationship |
| spellingShingle | Zhenjie Teng Zhenjie Teng Jing Feng Qianqian Qi Qianqian Qi Yanhong Dong Yining Xiao Yining Xiao Xiaohua Xie Nan Meng Huifang Chen Wenhui Zhang Peiyuan Lv Peiyuan Lv Long-Term Use of Metformin Is Associated With Reduced Risk of Cognitive Impairment With Alleviation of Cerebral Small Vessel Disease Burden in Patients With Type 2 Diabetes Frontiers in Aging Neuroscience metformin cerebral small vessel disease cognitive impairment diabetes relationship |
| title | Long-Term Use of Metformin Is Associated With Reduced Risk of Cognitive Impairment With Alleviation of Cerebral Small Vessel Disease Burden in Patients With Type 2 Diabetes |
| title_full | Long-Term Use of Metformin Is Associated With Reduced Risk of Cognitive Impairment With Alleviation of Cerebral Small Vessel Disease Burden in Patients With Type 2 Diabetes |
| title_fullStr | Long-Term Use of Metformin Is Associated With Reduced Risk of Cognitive Impairment With Alleviation of Cerebral Small Vessel Disease Burden in Patients With Type 2 Diabetes |
| title_full_unstemmed | Long-Term Use of Metformin Is Associated With Reduced Risk of Cognitive Impairment With Alleviation of Cerebral Small Vessel Disease Burden in Patients With Type 2 Diabetes |
| title_short | Long-Term Use of Metformin Is Associated With Reduced Risk of Cognitive Impairment With Alleviation of Cerebral Small Vessel Disease Burden in Patients With Type 2 Diabetes |
| title_sort | long term use of metformin is associated with reduced risk of cognitive impairment with alleviation of cerebral small vessel disease burden in patients with type 2 diabetes |
| topic | metformin cerebral small vessel disease cognitive impairment diabetes relationship |
| url | https://www.frontiersin.org/articles/10.3389/fnagi.2021.773797/full |
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