1. Insulin resistance and cognitive performance in type 2 diabetes - The Maastricht study.
- Author
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Geijselaers SLC, Sep SJS, Schram MT, van Boxtel MPJ, Henry RMA, Verhey FRJ, Kroon AA, Schaper NC, Dagnelie PC, van der Kallen CJH, Stehouwer CDA, and Biessels GJ
- Subjects
- Adult, Aged, Biomarkers blood, Cognitive Dysfunction epidemiology, Cohort Studies, Cross-Sectional Studies, Diabetes Mellitus, Type 2 blood, Diabetes Mellitus, Type 2 complications, Female, Glycated Hemoglobin analysis, Humans, Hyperinsulinism blood, Hyperinsulinism complications, Linear Models, Male, Middle Aged, Netherlands epidemiology, Neuropsychological Tests, Prospective Studies, Registries, Risk Factors, Aging, Cognitive Dysfunction complications, Diabetes Mellitus, Type 2 metabolism, Hyperinsulinism metabolism
- Abstract
Aims: Type 2 diabetes, hyperinsulinemia, and insulin resistance are associated with cognitive impairment. Experimental studies indicate that insulin signaling in the brain is related to cognitive performance. Here we evaluated whether insulin-related variables contribute to the variance in cognitive performance among individuals with type 2 diabetes., Methods: A total of 806 individuals with type 2 diabetes (mean age 62±8years, HbA1c 6.9±1.1%) completed a neuropsychological test battery. Insulin-related variables evaluated were: fasting plasma insulin, C-peptide, and the Homeostasis Model Assessment (HOMA2-IR; in individuals without insulin treatment; n=641). The unadjusted coefficient of determination (R
2 ), obtained from multiple linear regression analyses, was used to estimate the proportion of variance in cognition explained by insulin-related variables., Results: Sex, age, and educational level together explained 18.0% (R2 ) of the variance in memory function, 26.5% in information processing speed, and 22.8% in executive function and attention. Fasting insulin, C-peptide, or HOMA2-IR did not increase the explained variance (maximum ΔR2 0.3%, P≥0.14). Similar results were obtained when insulin-related variables were added to models that additionally included glycemic control, cardiovascular risk factors, and depression., Conclusions: Our results show that measures of peripheral insulin resistance are unrelated to cognitive performance among individuals with adequately controlled type 2 diabetes., (Copyright © 2017 Elsevier Inc. All rights reserved.)- Published
- 2017
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