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Neurocognitive impairment in type 2 diabetes: evidence for shared genetic aetiology

Josephine Mollon¹, Joanne E Curran^2,3, Samuel R Mathias⁴

¹Department of Psychiatry, Boston Children's Hospital, Harvard Medical School, 1 Autumn Street, BCH 3428, Boston, MA, 02115, USA. josephine.mollon@childrens.harvard.edu.

|February 5, 2020

Abstract

Aims/Hypothesis:

Type 2 diabetes is associated with cognitive impairments, but it is unclear whether common genetic factors influence both type 2 diabetes risk and cognition.

Methods:

Using data from 1892 Mexican-American individuals from extended pedigrees, including 402 with type 2 diabetes, we examined possible pleiotropy between type 2 diabetes and cognitive functioning, as measured by a comprehensive neuropsychological test battery.

Results:

Negative phenotypic correlations (ρ_p) were observed between type 2 diabetes and measures of attention (Continuous Performance Test [CPT d']: ρ_p = -0.143, p = 0.001), verbal memory (California Verbal Learning Test [CVLT] recall: ρ_p = -0.111, p = 0.004) and face memory (Penn Face Memory Test [PFMT]: ρ_p = -0.127, p = 0.002; PFMT Delayed: ρ_p = -0.148, p = 2 × 10^-4), replicating findings of cognitive impairment in type 2 diabetes. Negative genetic correlations (ρ_g) were also observed between type 2 diabetes and measures of attention (CPT d': ρ_g = -0.401, p = 0.001), working memory (digit span backward test: ρ_g = -0.380, p = 0.005), and face memory (PFMT: ρ_g = -0.476, p = 2 × 10^-4; PFMT Delayed: ρ_g = -0.376, p = 0.005), suggesting that the same genetic factors underlying risk for type 2 diabetes also influence poor cognitive performance in these domains. Performance in these domains was also associated with type 2 diabetes risk using an endophenotype ranking value approach. Specifically, on measures of attention (CPT d': β = -0.219, p = 0.005), working memory (digit span backward: β = -0.326, p = 0.035), and face memory (PFMT: β = -0.171, p = 0.023; PFMT Delayed: β = -0.215, p = 0.005), individuals with type 2 diabetes showed the lowest performance, while unaffected/unrelated individuals showed the highest performance, and those related to an individual with type 2 diabetes performed at an intermediate level.

Conclusions/Interpretation:

These findings suggest that cognitive impairment may be a useful endophenotype of type 2 diabetes and, therefore, help to elucidate the pathophysiological underpinnings of this chronic disease.

Data Availability:

The data analysed in this study is available in dbGaP: www.ncbi.nlm.nih.gov/projects/gap/cgi-bin/study.cgi?study_id=phs001215.v2.p2.

Keywords:

Cognitive function Cognitive impairment Genetic correlation Genetic overlap Type 2 diabetes

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