Abstract
BackgroundPrevious studies have demonstrated that C-reactive protein (CRP) and glycated hemoglobin (HbA1c) levels are independently associated with neurodegenerative diseases, which can be improved by altering dietary patterns. This study investigates the combined effect of CRP and HbA1c, as well as the influence of dietary patterns, on the risk of dementia.MethodsA cross-sectional study was conducted with 536 participants aged ≥65 years who were recruited from the Nutrition and Health Survey in Taiwan between 2014 and 2016. The high levels of inflammation and glycation were defined as a CRP level of >0.21 mg/dl and a HbA1c level of ≥6.50%, respectively. Mild cognitive impairment (MCI) was evaluated using the Mini-Mental State Examination (MMSE) score. The dietary patterns associated with CRP and HbA1c levels were assessed using the reduced rank regression (RRR). Multivariate logistic regression analysis of both complete and imputed datasets was performed.ResultsParticipants with high levels of both CRP and HbA1c were associated with the highest odds ratio (OR) of MCI (adjusted OR [aOR] = 3.52; 95% CI = 3.48, 3.56; p < 0.001), followed by a high level of only HbA1c (aOR = 1.73; p < 0.001) and a high level of CRP (aOR = 1.49; p < 0.001). Using the reduced rank regression, an inverse relationship between higher consumption nuts and seeds and lower levels of CRP and HbA1c was found (both factors loading < −0.2). Concerning the combined effect of tertiles among the factor 1 and factor 2 analyzed by dietary patterns, group 1 with both T3 (high tertiles) was associated with the greatest OR of MCI (aOR = 4.38; 95% CI = 4.34, 4.42; p < 0.001) using multiple imputation.ConclusionsThe combined effect of high levels of inflammation and hyperglycemia was associated with an increased likelihood of MCI. Moreover, dietary patterns positively related to inflammation and hyperglycemia were associated with MCI, while eating nuts and seeds promoted better cognition.
Highlights
The incidence and prevalence of dementia and Alzheimer’s disease (AD) have increased in recent years [1, 2], leading to critical socioeconomic burdens [3, 4] that will inevitably worsen in the future as the population ages [5, 6]
There were significant differences in the distribution of demographic characteristics based on the status of combined high levels of C-reactive protein (CRP) or HbA1c, except for systolic blood pressure (SBP) (p = 0.197), diastolic blood pressure (DBP) (p = 0.192), sex (p = 0.460), smoking status (p = 0.603), alcohol consumption (p = 0.179), stroke (p = 0.905), and depression (p = 0.170)
Using a nationwide population-based survey, our results demonstrated that the integration of high levels of inflammation, such as CRP, and hyperglycemia, such as HbA1c, showed higher odds of mild cognitive impairment (MCI)
Summary
The incidence and prevalence of dementia and Alzheimer’s disease (AD) have increased in recent years [1, 2], leading to critical socioeconomic burdens [3, 4] that will inevitably worsen in the future as the population ages [5, 6]. The main factor leading to the development of dementia is diabetes mellitus (DM) due to the pathophysiology of insulin resistance (IR) [7, 8]. Glycated hemoglobin (HbA1c) might be treated as a surrogate marker or diagnostic criterion for the glycemic status that is related to IR in DM [9, 10], which still does not completely explain its presentation in DM [11, 12]. Previous studies have demonstrated that C-reactive protein (CRP) and glycated hemoglobin (HbA1c) levels are independently associated with neurodegenerative diseases, which can be improved by altering dietary patterns. This study investigates the combined effect of CRP and HbA1c, as well as the influence of dietary patterns, on the risk of dementia
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