Abstract
The aim of the study was to determine the serum levels of adiponectin, leptin and IL-1 β in elderly diabetic patients with and without mild cognitive impairment (MCI) and to examine the associations of these markers with clinical and cognitive parameters. A biochemical evaluation was performed of 62 seniors with type 2 diabetes (T2DM) and MCI, and 132 seniors with T2DM but without MCI (controls). Serum leptin and IL-1 β levels were higher and adiponectin concentration was lower in MCI patients than controls. In MCI subjects, adiponectin level was negatively correlated with leptin, IL-1 β levels and BMI. Leptin concentration was correlated with IL-1 β level. Univariate logistic regression models revealed that the factors which increased the likelihood of diagnosis of MCI in elderly patients with T2DM were higher levels of HbA1c, leptin, IL-1 β and triglycerides, as well as lower levels of adiponectin and HDL cholesterol. Similarly, previous CVD, hypertension, hyperlipidemia, retinopathy, nephropathy, hypoglycemia, longer duration of diabetes, increased number of co-morbidities, older age, fewer years of formal education were found to be associated with MCI. The multivariable model indicated fewer years of formal education, previous CVD, hypertension, increased number of co-morbidities, higher HbA1c and IL-1 β levels and lower adiponectin level. Elderly diabetic patients with MCI have higher levels of leptin and IL-1 β and lower levels of adiponectin. Further prospective studies are needed to determine the role of these markers in the progression to dementia.
Highlights
Type 2 diabetes (T2DM) is a chronic disease with wellestablished cross-sectional and longitudinal associations with cognitive impairment (Cukierman et al 2005; Munshi et al 2006; Ott et al 1996)
The criteria include: cognitive complaints coming from the patients or their families, the reporting of a decline in cognitive functioning relative to previous abilities during the past year by the patient or informant, cognitive disorders as evidenced by clinical evaluation, absence of major repercussions on daily life, and absence of dementia
In the group of diabetic elderly patients with Mild cognitive impairment (MCI) adiponectin level was negatively correlated with leptin level (r=−0.64, p
Summary
Type 2 diabetes (T2DM) is a chronic disease with wellestablished cross-sectional and longitudinal associations with cognitive impairment (Cukierman et al 2005; Munshi et al 2006; Ott et al 1996). Many studies indicate that T2DM is a risk factor for MCI (Gorska-Ciebiada et al 2014; Cheng et al 2012; Kodl and Seaquist 2008). One study performed in rats found that pancreatic tissues expressed elevated levels of IL-1β, and IL-1β-driven inflammatory cascade in diabetes (Ehses et al 2009). This imbalance between IL-1β and IL-1 receptor antagonist leads to pancreatic islet inflammation and release of insulin. Using a recombinant human IL-1 receptor antagonist is one of the novel anti-inflammatory treatments which lead to the correction of beta cells dysfunction and decreased systemic inflammation in T2DM (Akash et al 2012). There is strong evidence that inflammation can pay a
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