The ApoE4 genotype modifies the relationship of long-term glycemic control with cognitive functioning in elderly with type 2 diabetes |
| |
| Institution: | 1. Memory clinic, Sheba Medical Center, Tel Hashomer, Ramat Gan, Israel;2. Department of Family Medicine, University of Tel Aviv, Israel;3. Department of Psychiatry, Icahn School of Medicine at Mount Sinai, NY, USA;4. Maccabi Health Services, Israel;5. Josef Sagol Neuroscience Center, Sheba Medical Center, Tel Hashomer, Ramat Gan, Israel;1. Neuropsychopharmacology Research Group, School of Pharmacy & Pharmaceutical Sciences, Trinity College Dublin, Dublin 2, Ireland;2. Trinity College Institute of Neuroscience, Trinity College Dublin, Dublin 2, Ireland;3. Neuroimmunology Research Group, Department of Physiology, School of Medicine, Trinity College, Dublin 2, Ireland;1. University of Haifa, Haifa, Israel;2. Department of Information and Evaluation, Ministry of Health, Jerusalem, Israel;3. Departments of Psychiatry and Preventive Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA;1. Department of Neurosurgery, University Hospital Münster, Münster, Germany;2. Institute of Clinical Radiology, University Hospital Münster, Münster, Germany;3. Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Münster, Münster, Germany;1. University Children’s Hospital, University of Wuerzburg, Germany;2. Department of Obstetrics and Gynecology, University of Wuerzburg, Germany;3. Department of Molecular Medicine and Surgery, Karolinska Institutet at Karolinska, University Hospital, Stockholm, Sweden |
| |
| Abstract: | AimTo assess whether the APOE4 genotype affects the relationship of long-term glycemic control with cognitive function in elderly with type 2 diabetes (T2D).MethodsParticipants were cognitively normal and pertained to a Diabetes Registry which provided access to HbA1c levels and other T2D related factors since 1998. Glycemic control was defined as the mean of all HbA1c measurements available (averaging 18 measurements) per subject. Four cognitive domains (episodic memory, semantic categorization, attention/working memory and executive function), based on factor analysis and an overall cognitive score (the sum of the 4 cognitive domains) were the outcome measures.ResultsThe analysis included 808 subjects; 107 (11.9%) subjects had ≥1ApoE4 allele. In ApoE4 carriers, higher mean HbA1c level was significantly associated with lower scores on all cognitive measures except attention/working memory (p-values ranging from 0.047 to 0.003). In ApoE4 non-carriers, higher mean HbA1c level was significantly associated with lower scores on executive function, but not with other cognitive measures—despite the larger sample size. Compared to non-carriers, there were significantly stronger associations in ApoE4 carriers for overall cognition (p=0.02), semantic categorization (p=0.03) and episodic memory (p=0.02), and the difference for executive function approached statistical significance (p=0.06).ConclusionIn this cross-sectional study of cognitively normal T2D subjects, higher mean HbA1c levels were generally associated with lower cognitive performance in ApoE4 carriers, but not in non-carriers, suggesting that ApoE4 affects the relationship between long-term glycemic control and cognition, so APOE4 carriers may be more vulnerable to the insults of poor glycemic control. |
| |
| Keywords: | ApoE Glycemic control HbA1c Cognition Type 2 diabetes |
| 本文献已被 ScienceDirect 等数据库收录！ |
|
