Abstract
Background and aimsPeople with insulin resistance and type 2 diabetes mellitus (T2DM) are at increased risks of cognitive impairment. We aimed to investigate the association of plasma ghrelin levels and ghrelin rs4684677 polymorphism with mild cognitive impairment (MCI) in T2DM patients.ResultsIn addition to elevated glycosylated hemoglobin (HbA1c), fasting blood glucose (FBG) and homeostasis model assessment of insulin resistance (HOMA-IR), T2DM patients with MCI had decreased plasma ghrelin levels compared with their healthy-cognition subjects (all p < 0.05). Further logistic regression analysis showed that ghrelin level was one of independent factors for MCI in T2DM patients (p < 0.05). Moreover, partial correlation analysis demonstrated that ghrelin levels were positively associated with the scores of Montreal Cognitive Assessment (r = 0.196, p = 0.041) and Auditory Verbal Learning Test-delayed recall (r = 0.197, p = 0.040) after adjustment for HbA1c, FBG and HOMA-IR, wherein the latter represented episodic memory functions. No significant differences were found for the distributions of genotype and allele of ghrelin rs4684677 polymorphism between MCI and control group.Materials and methodsA total of 218 T2DM patients, with 112 patients who satisfied the MCI diagnostic criteria and 106 who exhibited healthy cognition, were enrolled in this study. Demographic characteristics, clinical variables and cognitive performances were extensively assessed. Plasma ghrelin levels and ghrelin rs4684677 polymorphism were also determined.ConclusionsOur results suggest that decreased ghrelin levels are associated with MCI, especially with episodic memory dysfunction in T2DM populations.
Highlights
Type 2 diabetes mellitus (T2DM) is associated with complications, including retinopathy, nephropathy, cardiovascular and cerebrovascular diseases, as well as peripheral neuropathy
Previous studies showed that ghrelin level is lower in individuals showing obesity, insulin resistance, or metabolic syndrome [12,13,14], and all these conditions were proven to be risk factors for cognitive decline in type 2 diabetes mellitus (T2DM) subjects [15, 16]
The mild cognitive impairment (MCI) and control groups were well matched in terms of age, gender, and education levels (p > 0.05)
Summary
Type 2 diabetes mellitus (T2DM) is associated with complications, including retinopathy, nephropathy, cardiovascular and cerebrovascular diseases, as well as peripheral neuropathy. A 28-amino acid gastrointestinal peptide, was first discovered as the endogenous ligand for the growth hormone secretagogue receptor 1a by Kojima and Kangawa in 1999 [4]. Both ghrelin and its receptor are widely expressed in peripheral tissues and multiple regions of the brain, such as the intestine, pancreatic islets, pituitary, hippocampus and arcuate nucleus [5, 6]. People with insulin resistance and type 2 diabetes mellitus (T2DM) are at increased risks of cognitive impairment. We aimed to investigate the association of plasma ghrelin levels and ghrelin rs4684677 polymorphism with mild cognitive impairment (MCI) in T2DM patients
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