Adolescent cognitive function and incident early-onset type 2 diabetes.

Background: Cognitive function among apparently healthy adolescents has been associated with cardiovascular morbidity and mortality. We examined the relationship between global and subdomain cognitive scores in adolescence and early-onset type 2 diabetes (T2D) in men and women.
Methods: A nationwide, population-based study of 971,677 Israeli born adolescents (56% men; mean age 17.4 years) who were medically examined and their cognitive performance was assessed before compulsory military service during 1992-2010. Data included global and subdomain cognitive Z -scores (problem-solving, verbal abstraction and categorization, verbal comprehension, and mathematical abilities). Data were linked to the Israeli National Diabetes Registry. The relations between global and subdomain scores and incident T2D was determined using Cox proportional hazard models and logistic regression models. Analyses were conducted separately for men and women.
Findings: During 16,095,122 person-years, 3,570 individuals developed T2D. After adjustment, those in the low compared to the high quintile of global cognitive Z -score had the highest risk for T2D; HR 2.46, (95% CI 2.10-2.88) for men and 2.33 (95% CI 1.88-2.89) for women. A one-unit lower global cognitive Z -score was associated with 1.41 (95% CI 1.34-1.48) and 1.46 (95% CI 1.36-1.56) increased risks for men and women, respectively. The relationship was noted for the cognitive subdomains scores as well as for the global cognitive score, with no heterogeneity across cognitive subdomains.
Interpretation: This large nationally representative cohort suggests relationship between global, as well as subdomain cognitive scores in late adolescence, and incident early onset T2D in both sexes, which was independent of socioeconomic status.
Competing Interests: All authors have completed the ICMJE uniform disclosure form and declare: no support from any organization for the submitted article. Dr Gerstein reports grants from Sanofi, personal fees from Sanofi, grants from Eli Lilly , personal fees from Eli Lilly, grants from Astra Zeneca, grants from Boehringer Ingelheim, personal fees from Boehringer Ingelheim, personal fees from Abbott, grants from Novo Nordisk, personal fees from Novo Nordisk, grants from Merck, personal fees from Merck, grants from Abbott, personal fees from Kowa Research Institute , personal fees from Pfizer, personal fees from Zuellig, personal fees from DKSH, personal fees from Covance, personal fees from Roche, outside the submitted work. Dr. Raz reports other from AstraZeneca, Eli Lilly and Company, Merck Sharp & Dohme, Novo Nordisk, Inc, Sanofi, other from AstraZeneca, Insuline Medical, Medial EarlySign Ltd, CamerEyes Ltd, Exscopia, Orgenesis Ltd, BOL, Glucome Ltd, DarioHealth, Diabot, Concenter BioPharma, other from AstraZeneca, Eli Lilly and Company, Merck Sharp & Dohme, Novo Nordisk, Inc., Sanofi, other from Glucome Ltd, Orgenesis Ltd, DarioHealth, CamerEyes Ltd, Diabot, BOL, outside the submitted work. All the other authors have no conflicts to declare.
(© 2021 The Author(s).)