Diabetes control, dyslipidemia, hsCRP and mild cognitive impairment in non-elderly people with type 2 diabetes mellitus

Authors

  • Naveen Kumar Department of General Medicine, Sardar Patel Medical College, Bikaner, Rajasthan, India http://orcid.org/0000-0002-6748-3188
  • Veer Bahadur Singh Department of General Medicine, Sardar Patel Medical College, Bikaner, Rajasthan, India
  • Babu Lal Meena Department of General Medicine, Sardar Patel Medical College, Bikaner, Rajasthan, India
  • Deepak Kumar Department of General Medicine, Sardar Patel Medical College, Bikaner, Rajasthan, India
  • Harish Kumar Department of General Medicine, Sardar Patel Medical College, Bikaner, Rajasthan, India
  • Arun Tiwari Department of General Medicine, Sardar Patel Medical College, Bikaner, Rajasthan, India

DOI:

https://doi.org/10.18203/2320-6012.ijrms20190337

Keywords:

Dyslipidemia, HbA1c, High sensitivity C-reactive protein, Mild cognitive impairment, Montreal cognitive assessment, Type 2 diabetes mellitus

Abstract

Background: Mild Cognitive Impairment (MCI) a transitional stage between normal aging and dementia has been observed more in people with diabetes when compared with general population. The risk factors for MCI in type 2 diabetes mellitus (T2DM) have been defined in elderly patients and aging may itself contribute to declining in cognitive functions. As the large number people with T2DM are under 60years, the prevalence of MCI and factors contributing to it are not much studied. So, this study aimed to find out the factors contributing to MCI in non-elderly T2DM patients.

Methods: In this cross-sectional study, 257 patients with T2DM underwent cognitive assessment by Montreal cognitive assessment test and the cognitive levels were correlated with their glycosylated hemoglobin, lipid profile, and highly sensitive C-reactive protein (hsCRP).

Results: The prevalence of mild cognitive impairment (MCI) was 64.2%.  MCI significantly correlated with duration of diabetes, socioeconomic status, HbA1c, serum triglycerides, low-density lipoprotein, very low-density lipoprotein and hsCRP levels. The factors that were statistically insignificant were body mass index and high-density lipoprotein levels.

Conclusions: Cognitive impairment is seen even in non-elderly T2DM patients. It should be considered along with the other complications of diabetes and individuals with T2DM should be screened for cognitive impairment to prevent progression to dementia.

References

Rawlings AM, Sharrett AR, Schneider AL, Coresh J, Albert M, Couper D, et al. Diabetes in midlife and cognitive change over 20years: a cohort study. Ann Inter Med. 2014;161(11):785-93.

Biessels GJ. Diabetic encephalopathy. In: Veves A, Malik RA, eds. Diabetic Neuropathy, Clinical Management. 2nd ed. Totowa: Humana; 2007:187-205.

Kodl CT, Seaquist ER. Cognitive dysfunction and diabetes mellitus. Endocrine Rev. 2008;29:494-511.

Cosway R, Strachan MW, Dougall A, Frier BM, Deary IJ. Cognitive function and information processing in type 2 diabetes. Diab Med. 2001;18(10):803-10.

Cukierman T, Gerstein HC, Williamson JD. Cognitive decline and dementia in diabetes-systematic overview of prospective observational studies. Diabetol. 2005;48(12):2460-9.

Biessels GJ, Staekenborg S, Brunner E, Brayne C, Scheltens P. Risk of dementia in diabetes mellitus: a systematic review. Lancet Neurol. 2006;5(1):64-74.

International Diabetes Federation. IDF Diabetes Atlas, 8th ed. Brussels, Belgium: International Diabetes Federation; 2017.

Sharma R. Revision of prasad's social classification and provision of an online tool for real-time updating. South Asian J Cancer. 2013;2(3):157.

Sharma R. Online interactive calculator for real-time update of the prasad’s social classification. Available at: www.prasadscaleupdate.weebly.com. Accessed 30 January 2017.

American Diabetes Association. Classification and diagnosis of diabetes. Diabetes Care. 2017;40(1):S11-24.

Gray SL, Lai KV, Larson EB. Drug-induced cognition disorders in the elderly. Drug Safety. 1999;21(2):101-22.

Moore AR, O’Keeffe ST. Drug-induced cognitive impairment in the elderly. Drugs Aging. 1999;15(1):15-28.

Nasreddine ZS, Phillips NA, Bédirian V, Charbonneau S, Whitehead V, Collin I, et al. The Montreal Cognitive Assessment, MoCA: a brief screening tool for mild cognitive impairment. J Am Geriatrics Soc. 2005;53(4):695-9.

Nasreddine ZS, Phillips NA, Bédirian V, Charbonneau S, Whitehead V, Collin I, et al. The Montreal Cognitive Assessment, MoCA: a brief screening tool for mild cognitive impairment. J Am Geriatr Soc.2005;53(4):695-9.

Ryan CM, Geckle MO. Circumscribed cognitive dysfunction in middle-aged adults with type 2 diabetes. Diabetes Care. 2000;23(10):1486-93.

Spauwen PJ, Köhler S, Verhey FR, Stehouwer CD, van Boxtel MP. Effects of type 2 diabetes on 12-year cognitive change: results from the Maastricht aging study. Diabetes Care. 2013;36(6):1554-61.

Roy S, Kim N, Desai A, Komaragiri M, Baxi N, Jassil N, et al. Cognitive function and control of type 2 diabetes mellitus in young adults. North Am J Med Sci. 2015;7(5):220.

Roberts RO, Geda YE, Knopman DS, Christianson TJ, Pankratz VS, Boeve BF, et al. Association of duration and severity of diabetes mellitus with mild cognitive impairment. Arch Neurol. 2008;65(8):1066-73.

Ruis C, Biessels GJ, Gorter KJ, Van Den Donk M, Kappelle LJ, Rutten GE. Cognition in the early stage of type 2 diabetes. Diabetes Care. 2009;32(7):1261-5.

Brownlee M. Biochemistry and molecular cell biology of diabetic complications. Nature. 2001;414(6865):813.

Wurtman RJ. Effects of their nutrient precursors on the synthesis and release of serotonin, the catecholamines, and acetylcholine: implications for behavioral disorders. Clin Neuropharmacol. 1988;11:S187-93.

Figlewicz DP, Brot MD, McCall AL, Szot P. Diabetes causes differential changes in CNS noradrenergic and dopaminergic neurons in the rat: a molecular study. Brain Res. 1996;736(1-2):54-60.

Cukierman-Yaffe T, Gerstein HC, Williamson JD, Lazar RM, Lovato L, Miller ME, et al. Relationship between baseline glycaemic control and cognitive function in individuals with type 2 diabetes and other cardiovascular risk factors: the action to control cardiovascular risk in diabetes-memory in diabetes (accord-mind) trial. Diabetes Care. 2009;32(2):221-6.

Elias MF, Elias PK, Sullivan LM, Wolf PA, D'agostino RB. Lower cognitive function in the presence of obesity and hypertension: the Framingham heart study. Inter J Obes. 2003;27(2):260.

Chen G, Cai L, Chen B, Liang J, Lin F, Li L, et al. Serum level of endogenous secretory receptor for advanced glycation end products and other factors in type 2 diabetic patients with mild cognitive impairment. Diabetes Care. 2011;34(12):2586-90.

Perlmuter LC, Nathan DM, Goldfinger SH, Russo PA, Yates J, Larkin M. Triglyceride levels affect cognitive function in noninsulin-dependent diabetics. J Diab Complications. 1988;2(4):210-3.

Nguyen DV, Shaw L, Grant M. Inflammation in the pathogenesis of microvascular complications in diabetes. Frontiers Endocrinol. 2012;3:170.

Frostegard J. Immune mechanisms in atherosclerosis, especially in diabetes type 2. Frontiers Endocrinol. 2013;4:162.

Marioni RE, Strachan MW, Reynolds RM, Lowe GD, Mitchell RJ, Fowkes FG, et al. Association between raised inflammatory markers and cognitive decline in elderly people with type 2 diabetes: the Edinburgh type 2 diabetes study. Diab. 2010;59(3):710-3.

Zheng T, Qin L, Chen B, Hu X, Zhang X, Liu Y, et al. Association of plasma DPP4 activity with mild cognitive impairment in elderly patients with type 2 diabetes: results from the GDMD study in China. Diab Care. 2016;39(9):1594-601.

Gorska-Ciebiada M, Saryusz-Wolska M, Borkowska A, Ciebiada M, Loba J. Adiponectin, leptin and IL-1 β in elderly diabetic patients with mild cognitive impairment. Metab Brain Dis. 2016;31(2):257-66.

Cai R, Huang R, Han J, Sun H, Sun J, Xia W, et al. Lipoprotein-associated phospholipase A2 is associated with risk of mild cognitive impairment in chinese patients with type 2 diabetes. Sci Rep. 2017;7(1):12311.

Yogi-Morren D, Galioto R, Strandjord SE, Kennedy L, Manroa P, Kirwan JP, et al. Duration of type 2 diabetes and very low-density lipoprotein levels are associated with cognitive dysfunction in metabolic syndrome. Cardiovas Psychiatry Neurol. 2014.

Downloads

Published

2019-01-25

How to Cite

Kumar, N., Singh, V. B., Meena, B. L., Kumar, D., Kumar, H., & Tiwari, A. (2019). Diabetes control, dyslipidemia, hsCRP and mild cognitive impairment in non-elderly people with type 2 diabetes mellitus. International Journal of Research in Medical Sciences, 7(2), 372–377. https://doi.org/10.18203/2320-6012.ijrms20190337

Issue

Section

Original Research Articles