Plasma homocysteine and cerebral small vessel disease as possible mediators between kidney and cognitive functions in patients with diabetes mellitus
Abstract Cognitive impairment is more prevalent in those with decreased kidney function. We tested a hypothesis that an increased homocysteine and/or cerebral small vessel diseases (SVDs) mediate the link between kidney and cognitive functions in a cross-sectional study in 143 type 2 diabetes patien...
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| Format: | Article |
| Language: | English |
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Nature Portfolio
2017-06-01
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| Series: | Scientific Reports |
| Online Access: | https://doi.org/10.1038/s41598-017-04515-w |
| _version_ | 1818432259125936128 |
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| author | Mika Sonoda Tetsuo Shoji Yukinobu Kuwamura Yujiro Okute Toshihide Naganuma Hideaki Shima Koka Motoyama Tomoaki Morioka Katsuhito Mori Shinya Fukumoto Atsushi Shioi Taro Shimono Hisako Fujii Daijiro Kabata Ayumi Shintani Masanori Emoto Masaaki Inaba |
| author_facet | Mika Sonoda Tetsuo Shoji Yukinobu Kuwamura Yujiro Okute Toshihide Naganuma Hideaki Shima Koka Motoyama Tomoaki Morioka Katsuhito Mori Shinya Fukumoto Atsushi Shioi Taro Shimono Hisako Fujii Daijiro Kabata Ayumi Shintani Masanori Emoto Masaaki Inaba |
| author_sort | Mika Sonoda |
| collection | DOAJ |
| description | Abstract Cognitive impairment is more prevalent in those with decreased kidney function. We tested a hypothesis that an increased homocysteine and/or cerebral small vessel diseases (SVDs) mediate the link between kidney and cognitive functions in a cross-sectional study in 143 type 2 diabetes patients without diagnosis of dementia or prior stroke. The exposure and outcome variables were estimated glomerular filtration rate (eGFR) and cognitive performance evaluated with Modified Mini-Mental State (3 MS) examination, respectively. The candidate mediators were plasma homocysteine concentration, and SVDs including silent cerebral infarction, cerebral microbleed, periventricular hyperintensity, and deep and subcortical white matter hyperintensity by magnetic resonance imaging. In multiple regression models adjusted for 12 potential confounders, eGFR was positively associated with 3 MS score, inversely with homocysteine, but not significantly with the presence of any type of SVD. The association of eGFR with 3 MS remained significant when each of the SVDs was added to the model, whereas it disappeared when homocysteine was included in place of SVD. Mediation analysis indicated nearly significant mediation of homocysteine (P = 0.062) but no meaningful mediations of SVDs (P = 0.842–0.930). Thus, homocysteine, not SVDs, was shown to be the possible mediator between kidney and cognitive functions in patients with type 2 diabetes mellitus. |
| first_indexed | 2024-12-14T16:02:21Z |
| format | Article |
| id | doaj.art-bbf0cdebe86b41b69e1df0f3e709c31b |
| institution | Directory Open Access Journal |
| issn | 2045-2322 |
| language | English |
| last_indexed | 2024-12-14T16:02:21Z |
| publishDate | 2017-06-01 |
| publisher | Nature Portfolio |
| record_format | Article |
| series | Scientific Reports |
| spelling | doaj.art-bbf0cdebe86b41b69e1df0f3e709c31b2022-12-21T22:55:10ZengNature PortfolioScientific Reports2045-23222017-06-017111110.1038/s41598-017-04515-wPlasma homocysteine and cerebral small vessel disease as possible mediators between kidney and cognitive functions in patients with diabetes mellitusMika Sonoda0Tetsuo Shoji1Yukinobu Kuwamura2Yujiro Okute3Toshihide Naganuma4Hideaki Shima5Koka Motoyama6Tomoaki Morioka7Katsuhito Mori8Shinya Fukumoto9Atsushi Shioi10Taro Shimono11Hisako Fujii12Daijiro Kabata13Ayumi Shintani14Masanori Emoto15Masaaki Inaba16Department of Metabolism, Endocrinology and Molecular Medicine, Osaka City University Graduate School of MedicineDepartment of Vascular Medicine, Osaka City University Graduate School of MedicineDepartment of Metabolism, Endocrinology and Molecular Medicine, Osaka City University Graduate School of MedicineDepartment of Metabolism, Endocrinology and Molecular Medicine, Osaka City University Graduate School of MedicineDepartment of Urology, Osaka City University Graduate School of MedicineDepartment of Internal Medicine III, Division of Nephrology, Osaka Medical CollegeDepartment of Metabolism, Endocrinology and Molecular Medicine, Osaka City University Graduate School of MedicineDepartment of Metabolism, Endocrinology and Molecular Medicine, Osaka City University Graduate School of MedicineDepartment of Metabolism, Endocrinology and Molecular Medicine, Osaka City University Graduate School of MedicineDepartment of Premier Preventive Medicine, Osaka City University Graduate School of MedicineDepartment of Vascular Medicine, Osaka City University Graduate School of MedicineDepartment of Diagnostic and Interventional Radiology, Osaka City University Graduate School of MedicineDepartment of Drug and Food Evaluation, Osaka City University Graduate School of MedicineDepartment of Medical Statistics, Osaka City University Graduate School of MedicineDepartment of Medical Statistics, Osaka City University Graduate School of MedicineDepartment of Metabolism, Endocrinology and Molecular Medicine, Osaka City University Graduate School of MedicineDepartment of Metabolism, Endocrinology and Molecular Medicine, Osaka City University Graduate School of MedicineAbstract Cognitive impairment is more prevalent in those with decreased kidney function. We tested a hypothesis that an increased homocysteine and/or cerebral small vessel diseases (SVDs) mediate the link between kidney and cognitive functions in a cross-sectional study in 143 type 2 diabetes patients without diagnosis of dementia or prior stroke. The exposure and outcome variables were estimated glomerular filtration rate (eGFR) and cognitive performance evaluated with Modified Mini-Mental State (3 MS) examination, respectively. The candidate mediators were plasma homocysteine concentration, and SVDs including silent cerebral infarction, cerebral microbleed, periventricular hyperintensity, and deep and subcortical white matter hyperintensity by magnetic resonance imaging. In multiple regression models adjusted for 12 potential confounders, eGFR was positively associated with 3 MS score, inversely with homocysteine, but not significantly with the presence of any type of SVD. The association of eGFR with 3 MS remained significant when each of the SVDs was added to the model, whereas it disappeared when homocysteine was included in place of SVD. Mediation analysis indicated nearly significant mediation of homocysteine (P = 0.062) but no meaningful mediations of SVDs (P = 0.842–0.930). Thus, homocysteine, not SVDs, was shown to be the possible mediator between kidney and cognitive functions in patients with type 2 diabetes mellitus.https://doi.org/10.1038/s41598-017-04515-w |
| spellingShingle | Mika Sonoda Tetsuo Shoji Yukinobu Kuwamura Yujiro Okute Toshihide Naganuma Hideaki Shima Koka Motoyama Tomoaki Morioka Katsuhito Mori Shinya Fukumoto Atsushi Shioi Taro Shimono Hisako Fujii Daijiro Kabata Ayumi Shintani Masanori Emoto Masaaki Inaba Plasma homocysteine and cerebral small vessel disease as possible mediators between kidney and cognitive functions in patients with diabetes mellitus Scientific Reports |
| title | Plasma homocysteine and cerebral small vessel disease as possible mediators between kidney and cognitive functions in patients with diabetes mellitus |
| title_full | Plasma homocysteine and cerebral small vessel disease as possible mediators between kidney and cognitive functions in patients with diabetes mellitus |
| title_fullStr | Plasma homocysteine and cerebral small vessel disease as possible mediators between kidney and cognitive functions in patients with diabetes mellitus |
| title_full_unstemmed | Plasma homocysteine and cerebral small vessel disease as possible mediators between kidney and cognitive functions in patients with diabetes mellitus |
| title_short | Plasma homocysteine and cerebral small vessel disease as possible mediators between kidney and cognitive functions in patients with diabetes mellitus |
| title_sort | plasma homocysteine and cerebral small vessel disease as possible mediators between kidney and cognitive functions in patients with diabetes mellitus |
| url | https://doi.org/10.1038/s41598-017-04515-w |
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