The necessity of strengthening glycemic and lipid metabolism management for improving brain structure and cognitive function in people with diabetes: A retrospective study based on UK Biobank
Authors' conclusion
In people with diabetes, higher HbA1c (>8.5 %), as well as elevated TC, LDL-C, and ApoB, are associated with worse brain structure and cognitive function. Conversely, HbA1c < 6.5 % and elevated TG within the range of 0.75∼8.0 mmol/L have a protective effect on cognitive function, and the later exhibited more evident impact in older adults. To prevent or delay the onset of dementia in people with diabetes, it may be necessary to intensify glycemic control, targeting an HbA1c level of <6.5 %. Additionally, the age-specific lipid-lowering strategies shall be considered, with more flexible triglyceride-lowering goals for elderly patients.
Study context
- Population
- People with diabetes diagnosed by doctors 2006–2010, UK Biobank; mean age 59.58 ± 7.21 years, 39 % females
- Participants
- 26,394 people
- Outcome
- Associations of glycemic and lipid metabolism with brain structure and cognitive function
Methodological detailsUK Biobank
- UK Biobank
Main finding
As reported in the abstract
- Higher random blood glucose associated with smaller brain volume
- β = −0.116, p < 0.001
- Higher HbA1c associated with smaller brain volume
- β = −0.062, p = 0.051
- Higher HbA1c related with worse cognitive function
- β = 0.036, p < 0.001; β = 0.023, p = 0.021
- Higher total cholesterol (TC) associated with more brain structural abnormalities
- β = 0.125, p = 0.008
- Higher low density lipoprotein-cholesterol (LDL-C) associated with more brain structural abnormalities
- β = 0.086, p = 0.025
- Higher ApoB associated with more brain structural abnormalities
- β = 0.092, p = 0.026
- Triglyceride (TG) = 0.75∼8.0 mmol/L positively correlated with cognitive function
- β = −0.036, p < 0.001; β = −0.044, p < 0.001; β = 0.058, p = 0.001
- Higher ApoA associated with better cognitive function
- β = −0.032, p < 0.001; β = −0.033, p < 0.001; β = 0.047, p = 0.004
Observational data: associations, not effects.
Further findings
Age-stratified analysis
- Impact of lipids on cognitive function was age-dependent; TC and LDL-C related to brain structural abnormalities at age 55-60; TG had a stronger protective effect in older adults, particularly aged 65-70 years
Original publication
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