Abstract
Type 2 diabetes mellitus (T2DM) is a low-grade chronic inflammatory diseases, which have been implicated in the pathogenesis of cognitive decline. We aim to evaluate associations between inflammatory markers and the risk of mild cognitive impairment (MCI) in T2DM. This study of 140 diabetic patients involved 71 with MCI and 69 controls. Clinical parameters, neuropsychological tests, high sensitivity C reactive protein (hsCRP), interleukin-6 (IL-6), lipoprotein-associated Phospholipase A2 (Lp-PLA2) mass and activity were measured. The results showed significantly higher plasma hsCRP, IL-6, Lp-PLA2 mass and activity in MCI group compared to controls. In T2DM with MCI, the Montreal Cognitive Assessment (MoCA) score was positively correlated with education level and high-density lipoprotein cholesterol (HDL-c), but inversely correlated with age, glycosylated hemoglobin, intima-media thickness (IMT), hsCRP, IL-6, and Lp-PLA2 mass and activity. Correlation analysis showed that both plasma Lp-PLA2 mass and activity were positively correlated with total cholesterol, low-density lipoprotein cholesterol, and IMT but negatively associated with MoCA score. Multivariable logistic regression analysis indicated higher hsCRP, Lp-PLA2 mass, Lp-PLA2 activity, and lower HDL-c to be independent risk factors increasing the possibility of MCI in T2DM. In conclusion, plasma Lp-PLA2 and hsCRP were found to be associated with the risk of MCI among T2DM patients.
Highlights
Lipoprotein-associated phospholipase A2 (Lp-PLA2) is a circulating enzyme produced by inflammatory cells[9]
There were no significant differences between the two groups in history of smoking, diabetes durations, education levels, glycosylated hemoglobin (HbA1c), fasting blood glucose (FBG), triglyceride (TG), and low-density lipoprotein cholesterol (LDL-c)
The Type 2 diabetes mellitus (T2DM) patients with mild cognitive impairment (MCI) had higher total cholesterol (TC) levels, intima-media thickness (IMT), and the percentage of plaque formation, whereas the high-density lipoprotein cholesterol (HDLc) level was lower in the diabetic patients with MCI (P < 0.05, false discovery rate (FDR) < 0.05)
Summary
Lipoprotein-associated phospholipase A2 (Lp-PLA2) is a circulating enzyme produced by inflammatory cells[9]. Heart disease, and vascular mortality which are associated with the development of Alzheimer’s disease (AD) and dementia[19] Considering these findings together, we hypothesized that Lp-PLA2 might be of vital importance in mediating the role of chronic inflammation in the susceptibility of diabetic patients to cognitive impairment. We aimed to explore the plasma levels of inflammatory markers (Lp-PLA2 mass and activity, CRP, and IL-6) in T2DM with and without MCI, and determine potential predictors of MCI among patients with T2DM Such findings will help to clarify the potential mechanism of inflammation in cognitive decline susceptibility in T2DM and support the development of anti-inflammatory treatments for use in T2DM-associated MCI
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