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Insulin Resistance Is a Risk Factor for Mild Cognitive Impairment in Elderly Adults with T2DM

Hongjun Zhao¹, Chenglong Wu¹, Xiaoping Zhang²

¹Department of Neurology, The People's Hospital of Shaoxing City, Shaoxing Zhejiang, No.568 Zhongxingbei Road Shaoxing City Zhejiang Province, 312000 PR China.

Open Life Sciences

|April 5, 2021

Abstract

Objective:

The aim of this study was to investigate the clinical effects of insulin resistance (IR) in the development of mild cognitive impairment (MCI) in elderly adults with Type 2 diabetes mellitus (T2DM).

Methods:

Seventy-eight patients with T2DM were recruited and divided into MCI group (<26, n=48) and normal group (≥26, n=30) according to the Montreal Cognitive Assessment (MoCA) score. The fasting plasma glucose (FPG), HbA1c, and fasting plasma C-peptide (FPC) were examined and compared between the two groups. The Pancreatic islets function (HOMA-islet) and Insulin Resistance Index (HOMA-IR) were also calculated for the two groups. Using the HOMA-IR and HOMA-islet as the reference, the predicted values for MCI in T2DM patients were calculated by sensitivity, specificity and area under the receiver operating characteristic (ROC) curve.

Results:

The MoCA scores were statistically different between the MCI and control groups (23.79±1.15 vs 28.50±1.01, p<0.05). The serum FPG and FPC were 10.38±2.36 mmol/L and 0.79±0.34 ng/mL in the MCI group which were significant different from those of the control group (8.96±2.55 mmol/L and 1.04±0.38 ng/mL; p<0.05). The HOMA-IR and HOMA-islet were 10.08±2.64 and 94.67±29.12 for the MCI group and 8.16±2.46 and 130.30±38.43 for the control group; both were statistically different (p<0.05). The serum HbA1c was 11.02±2.59% and 9.37±2.00% for the MCI and control groups (significantly different with p<0.5). A significant positive correlation was found between MoCA score and HOMA-islet (rpearson=0.44; p<0.001). A significant negative correlation existed between MoCA score and serum HbA1c (r=-0.25; p=0.03). The areas under the ROC curve were 0.70 (0.57~0.82), 0.69 (0.57~0.81), 0.69 (0.57~0.80), 0.72 (0.60~0.84), 0.72 (0.60~0.84) and 0.76 (0.65~0.88) respectively for FPG, FPC, HbA1c, HOMA-IR and HOMA-islet.

Conclusion:

Insulin resistance is a risk factor for mild cognitive impairment and can be a biomarker for prediction of MCI in patients with T2DM.

Insights

Insulin resistance (IR) is a significant risk factor for mild cognitive impairment (MCI) in elderly adults with Type 2 diabetes mellitus (T2DM). Higher IR levels correlate with increased MCI risk, suggesting IR can predict MCI in T2DM patients.

Area of Science:

Endocrinology
Neuroscience
Geriatrics

Background:

Type 2 diabetes mellitus (T2DM) is prevalent in elderly populations.
Mild cognitive impairment (MCI) poses a significant health concern in aging individuals.
The relationship between T2DM, insulin resistance (IR), and cognitive decline requires further investigation.

Purpose of the Study:

To investigate the clinical effects of insulin resistance (IR) in the development of mild cognitive impairment (MCI).
To assess the predictive value of IR for MCI in elderly adults with T2DM.

Main Methods:

Seventy-eight T2DM patients were categorized into MCI and normal cognitive groups based on MoCA scores.
Fasting plasma glucose (FPG), HbA1c, fasting plasma C-peptide (FPC), HOMA-islet, and HOMA-IR were measured and compared.
Receiver operating characteristic (ROC) curve analysis was used to evaluate the predictive accuracy of HOMA-IR and HOMA-islet for MCI.

Main Results:

MCI group showed significantly lower MoCA scores and higher FPG, FPC, HbA1c, HOMA-IR, and lower HOMA-islet compared to the normal group.
Significant positive correlation between MoCA score and HOMA-islet (r=0.44, p<0.001).
Significant negative correlation between MoCA score and HbA1c (r=-0.25, p=0.03).
HOMA-IR and HOMA-islet demonstrated good predictive value for MCI with ROC AUC values of 0.72 and 0.76, respectively.

Conclusions:

Insulin resistance is a significant risk factor for MCI in elderly patients with T2DM.
IR indices like HOMA-IR and HOMA-islet can serve as valuable biomarkers for predicting MCI in this population.
Early identification and management of IR may be crucial for preventing cognitive decline in T2DM patients.

Read full analysis

Keywords:

T2DM elderly adults insulin resistance mild cognitive impairment

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