Abstract
Type-2 diabetes mellitus (T2DM) is strongly associated with various complications, including cognitive impairment. Diabetic complication is related with structural and functional changes of brain. Studies investigated that homocysteine as an independent risk factor of several organ complications. This marker might have a role in pathogenesis of cognitive impairment in T2DM patients. We aimed to know the association between serum homocysteine level and cognitive impairment in middle-aged T2DM populations. The study was a cross-sectional study involving 97 T2DM patients aged <60 years old. Cognitive assessment was based on validated Indonesian version of Montreal Cognitive Assessment (MoCA-INA) test. Besides, serum homocysteine level (Hcy) was measured based on standard laboratory assay. Filling out the questionnaire of MoCA-INA was conducted when patients came to take the blood sample. This study used independent t-test, chi-square and multivariate logistic regression model to analyze the data. There were 47 subjects (48.5%) with mild cognitive impairment (MCI). Delayed recall was the most impaired domain (94.8%). There was no significant mean difference of serum Hcy level in MCI and non-MCI group (11.99±3.27 μmol/L vs 12.36±4.07 μmol/L respectively, p = 0.62). Final model of logistic regression showed no association between serum Hcy and cognitive function after adjusting confounding variables (OR: 1.778; 95%CI: 0.69–4.54). Further investigation involving slight elderly T2DM patients with larger sample size should be conducted to confirm this finding.
Highlights
Hyperglycemia, insulin resistance, and relative lack of insulin were key features of Type-2 Diabetes Mellitus (T2DM)
A meta-analysis estimated that patients with T2DM had risk for vascular dementia (RR 2.5, 95% CI: 2.1–3.0) and Alzheimer disease (RR 1.5, 95% CI 1.2–1.8) compared to individuals without diabetes.[2]
This study aimed to investigate association between homocysteine level and cognitive impairment in middle aged T2DM patients
Summary
Hyperglycemia, insulin resistance, and relative lack of insulin were key features of Type-2 Diabetes Mellitus (T2DM). T2DM has been associated with many chronic complications involving many organs, including brain and nervous system.[1,2,3,4] Epidemiological evidences suggest that T2DM is strongly associated with impaired cognitive function and structural abnormalities of brain.[2,5,6,7,8,9,10] Primary pathological mechanism of T2DM cognitive impairment is brain insulin resistance.[11,12] Ten years cohort study of 1617 non-dementia older participant showed an increased risk of dementia and mild cognitive impairment compared healthy control group.[13] A meta-analysis estimated that patients with T2DM had risk for vascular dementia (RR 2.5, 95% CI: 2.1–3.0) and Alzheimer disease (RR 1.5, 95% CI 1.2–1.8) compared to individuals without diabetes.[2] In structural abnormalities, T2DM is associated with total gray matter volume and middle temporal gyrus (MTG) volume.[7]
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