Glycemic variability correlates with medial temporal lobe atrophy and decreased cognitive performance in patients
Shuangmei Zhang1,2, Anrong Wang3, Shen Liu3,4,5
1Department of Pain Rehabilitation, Cancer Hospital of the University of Chinese Academy of Sciences, Zhejiang Cancer Hospital, Hangzhou, China.
Background:
In the past, researchers have observed a significant link between glycemia and dementia. Medial temporal atrophy (MTA) is regarded as a common marker of dementia. The correlation between glycemic variability and MTA is unclear, and it has not been determined whether glycemic variability can be utilized as a biomarker of MTA and cognitive performance.
Methods:
The patients in a memory clinic who underwent brain MRI scans and cognitive assessments within the first week of their hospital visit, were enrolled. All participants underwent three fasting blood glucose and one HBA1c assessments on three self-selected days within 1 week of their first visit. The variability independent of the mean (VIM) was employed. Validated visual scales were used to rate the MTA results. The mini-mental state examination (MMSE) and Montreal Cognitive Assessment (MoCA) scales were employed to assess the cognitive functions of the participants. Spearman's correlation and regression models were used to examine the relationship between the MMSE and MoCA scales, and also determine the link between the MRI characteristics and cognitive status, where vascular risk factors, educational status, age, gender, and mean glucose parameters served as covariates.
Results:
Four hundred sixty-one subjects completed the MMSE scale, while 447 participants completed the MoCA scale. Data analysis revealed that 47.72% of the participants were men (220/461), and the median age of the patients was 69.87 ± 5.37 years. The findings of Spearman's correlation analysis exhibited a strong negative relationship between the VIM and MMSE score (r = -0.729, P < 0.01), and the MoCA score (r = -0.710, P < 0.01). The VIM was regarded as an independent risk factor for determining cognitive impairment in both the MMSE and MoCA assessments. The results were unaffected by sensitivity analysis. In addition, a non-linear relationship was observed between the VIM and MTA scores.
Conclusion:
The variability in the blood glucose levels, which was presented as VIM, was related to the reduced cognitive function, which was reflected by MMSE and MoCA scales. The relationship between the VIM and the MTA score was non-linear. The VIM was positively related to the MTA score when the VIM was less than 2.42.
Insights
High blood glucose variability, measured as VIM, is linked to poorer cognitive function and medial temporal atrophy (MTA) in dementia patients. This variability may serve as a biomarker for cognitive decline and brain changes.
Area of Science:
- Neuroscience
- Endocrinology
- Gerontology
Background:
- Glycemic control is crucial in dementia research, with medial temporal atrophy (MTA) serving as a key indicator.
- The specific relationship between glycemic variability and MTA, and its potential as a biomarker for cognitive performance, remains largely unexplored.
Purpose of the Study:
- To investigate the correlation between glycemic variability and medial temporal atrophy (MTA).
- To determine if glycemic variability can serve as a biomarker for MTA and cognitive function in patients.
- To explore the association between glycemic variability and cognitive assessment scores.
Main Methods:
- Patients from a memory clinic underwent MRI scans, cognitive assessments (MMSE, MoCA), and blood glucose/HbA1c tests.
- Glycemic variability was quantified using the variability independent of the mean (VIM) method.
- Spearman's correlation and regression models analyzed relationships between VIM, MTA scores, and cognitive function, controlling for covariates.
Main Results:
- A significant negative correlation was found between VIM and both MMSE (r = -0.729, P < 0.01) and MoCA (r = -0.710, P < 0.01) scores.
- Glycemic variability (VIM) was identified as an independent risk factor for cognitive impairment.
- A non-linear relationship was observed between VIM and MTA scores, with VIM positively related to MTA when VIM was less than 2.42.
Conclusions:
- Elevated glycemic variability (VIM) is associated with reduced cognitive function as measured by MMSE and MoCA.
- The study suggests VIM is a potential biomarker for cognitive decline and may be linked to medial temporal atrophy (MTA).
- A non-linear association exists between glycemic variability and MTA, highlighting a complex relationship in dementia pathophysiology.
Related Concept Videos
01:26Alzheimer's Disease: Overview
The clinical diagnosis of AD hinges on the presence of memory and other cognitive impairments. Biomarkers, such as changes in Aβ...
01:19Role of Hippocampus in Memory