The spectrum of mild cognitive impairment in dyslipidemic non-elderly type 1 diabetics
DOI:
https://doi.org/10.18203/2320-6012.ijrms20161794Keywords:
Mild cognitive impairments, Dementia, Type 1 diabetes, Non elderly diabeticsAbstract
Background: Diabetics often have reduced performance in numerous domains of cognitive function, a process termed as Diabetic encephalopathy. The exact pathophysiology of cognitive dysfunction in diabetes is not completely understood, but it is likely that hyperglycaemia, vascular disease, hypoglycemia, and insulin resistance play significant roles. Although cognitive dysfunction is quite common in elderly, however, its occurrence in non-elderly diabetics is not much investigated. Aim of the study was to identify the correlation among various components of lipid profile with mild cognitive impairment in non-elderly type 1 diabetics.
Methods: 98 type 1 diabetics were enrolled justifying relevant inclusion &exclusion criteria. Anthropometric indices, biochemical and clinical parameters were measured. MoCA test was employed for the assessment of cognitive dysfunction. Receiver operating characteristic, partial correlation, and logistic regression analyzes were employed for evaluation.
Results: 71.42% of enrolled diabetics had some degree of cognitive dysfunction. Duration of the disease had a significant impact on cognitive functioning (p=0.032).Gender, residential area as well as the age of onset of diabetes appeared to have an insignificant impact on cognitive functioning (p>0.05). Diabetics with poor glycemic control were more prone to develop MCI (p<0.001).On comparison of various component of MoCA test; it was seen that most significant parameter that was affected was attention (p<0.001), followed by delayed recall /memory, naming and abstraction (p<0.05).
Conclusions: The results of our study suggest that dyslipidemia chiefly raised total cholesterol, triglycerides and LDL is quite common in non-elderly type 1 diabetics and are associated with poorer cognitive function. Cognitive dysfunction should be listed as one of the many complications of diabetes, along with retinopathy, neuropathy, nephropathy, and cardiovascular disease in the future.
References
Longo DL, Fauci AS. Harrison’s principles of Internal Medicine. 19th edition. Mc Graw Hill; 2015: 2400.
http://www.diabetesfoundationindia.org/ about.htm.
Rawlings AM, Sharrett AR, Schneider AL, Coresh J, Albert M, Couper D, et al. Diabetes in midlife and cognitive change over 20 years: a cohort study. Ann Intern Med. 2014;161(11):785-93.
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. Journal of the American Geriatric Society. 2005; 53(4):695-99.
Ritchie K, Carrie`re I, Ritchie CW, Berr C, Artero S, Ancelin ML. Designing prevention programs to reduce the incidence of dementia: prospective cohort study of modifiable risk factors. BMJ 2010;341:c3885.
Mehrabian S, Raycheva M, Gateva A, Todorova G, Angelova P, Traykova M et al. Cognitive dysfunction profile and arterial stiffness in type 2 diabetes. J. Neurol. Sci. 2012;322:152-6.
Ruis C, Biessels GJ, Gorter KJ, van den Donk M, kapelle LJ, Rutten GE. Cognition in the early stage of type 2 diabetes. Diabetes Care. 2009;32(7):1261-5.
Kang BS, Yoon JS. Sheet forming apparatus with flexible rollers. PCT Patent Pending, 2013.
Suzuki R, Ferris HA, Chee MJ, Maratos-Flier E, Kahn CR. Reduction of the cholesterol sensor SCAP in the brains of mice causes impaired synaptic transmission and altered cognitive function. PLoS Biology. 2013;11(4):e1001532.
Skenazy JA, Bigler ED. Neuropsychological findings in DM. J Clin Psychol. 1984;40:246-58.
Ford ES, Mokdad AH, Giles WH, Mensah GA. Serum total cholesterol concentrations and awareness, treatment, and control of hypercholesterolemia among US adults: findings from the National Health and Nutrition Examination Survey, 1999 to 2000. Circulation. 2003;107:2185-9.
Imperatore G, Cadwell BL, Geiss L, Saadinne JB, Williams DE, Ford ES, et al. Thirty-year trends in cardiovascular risk factor levels among US adults with diabetes: National Health and Nutrition Examination Surveys, 1971–2000. Am J Epidemiol 2004;160:531–9.
Idzior-Walus B, Mattock MB, Solnica B, Stevens L, Fuller JH. Factors associated with plasma lipids and lipoproteins in type 1 DM: the Eurodiab IDDM Complications Study. Diabet Med. 2001;18:786-96.
Sawant AM, Shetty D, Mankeshwar R, Ashavaid TF. Prevalence of dyslipidemia in young adult Indian population. JAPI. 2008;56:99-102.
Brands AM, Biessels GJ, de Haan EH, kappelle LJ, Kessels RP. The effects of type 1 diabetes on cognitive performance A meta-analysis. Diabetes care. 2005;28(3):726-35.
The Diabetes Control and Complication Trial/Epidemiology of Diabetes Intervention and Complications (DCCT/EDIC) Study Research Group. Long-term effect of diabetes and its treatment on cognitive function. N Engl J Med. 2007;356:1842-52.
Jacobson AM, Ryan CM, Cleary PA, Waberski BH, Weinger K, Musen G, et al. Biomedical risk factors for decreased cognitive functioning in type 1 diabetes: an 18-year follow-up of diabetes control and complications trial (DCCT) cohort. Diabetologia. 2011;54:233-6.
Saydah SH, Fradkin J, Cowie CC. Poor control of risk factors for vascular disease among adults with previously diagnosed diabetes. JAMA. 2004;291:335-42.
Miettinen TA, Gylling H, Tuominen J, Simonen P, Koivisto V. Low synthesis and high absorption of cholesterol characterize type 1 diabetes. Diabetes Care 2004;27:53-8.
