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Glycemia and cognitive function in metabolic syndrome and coronary heart disease

Radhika Avadhani1, Kristen Fowler1, Corinne Barbato1

  • 1Joslin Diabetes Center, Boston, Mass.

The American Journal of Medicine
|September 16, 2014
PubMed

Insights

Higher hemoglobin A1c (HbA1c) is linked to poorer cognitive function in men with cardiovascular disease. These findings suggest that even slightly elevated blood sugar may impact brain health, highlighting the importance of glucose control.

Area of Science:

  • Cardiovascular Disease Research
  • Neuroscience
  • Metabolic Syndrome Studies

Background:

  • Elevated hemoglobin A1c (HbA1c) correlates with cognitive decline in type 2 diabetes.
  • The association between HbA1c and cognitive function at lower dysglycemia levels in patients with established cardiovascular disease (CVD) is not well-established.

Purpose of the Study:

  • To investigate the relationship between HbA1c levels and cognitive performance in men with metabolic syndrome and stable coronary artery disease.
  • To determine if associations between HbA1c and cognitive function persist across a spectrum of glycemic control, including normoglycemia.

Main Methods:

  • Cognitive performance was assessed using multiple tests: Mini-Mental State Examination, Digit Symbol Substitution Test, Rey Auditory Verbal Learning Test, Trail Making Test, and Categorical Verbal Fluency.
  • The study included 226 men with metabolic syndrome and established coronary artery disease, with HbA1c levels analyzed in relation to cognitive test scores.
  • Statistical models adjusted for age and other cardiovascular covariates to evaluate the independent association of HbA1c with cognitive function.

Main Results:

  • Hemoglobin A1c (HbA1c) was significantly associated with performance on the Digit Symbol Substitution Test, Rey Auditory Verbal Learning Test, Trail Making Test, and Categorical Verbal Fluency, but not the Mini-Mental State Examination.
  • In age-adjusted analyses, a 1% increase in HbA1c was linked to lower scores on the Digit Symbol Substitution Test and Rey Auditory Verbal Learning Test, and higher scores on the Trail Making Test, indicating poorer cognitive function.
  • Multivariate models confirmed HbA1c's association with Rey Auditory Verbal Learning Test, Trail Making Test, and Categorical Verbal Fluency, even after accounting for age, education, and cardiovascular factors.

Conclusions:

  • Higher HbA1c levels are associated with reduced cognitive function across several domains in men with metabolic syndrome and coronary artery disease.
  • These findings indicate that glycemic control, even within or near the normal range, may be important for maintaining cognitive health in this population.
  • Further research is warranted to explore whether interventions aimed at lowering glucose levels can improve cognitive outcomes in individuals with cardiovascular disease.
Abstract

Keywords:
Cardiovascular diseaseCognitive functionGlycemiaHemoglobin A(1c)

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