Associations of Prediabetes, Diabetes and Glucose-Related Markers With Cognition and Neuroimaging in a 2-Year Multidomain Lifestyle Randomised Controlled Trial

IF 4.6 2区医学 Q1 ENDOCRINOLOGY & METABOLISM

Diabetes/Metabolism Research and Reviews Pub Date : 2025-06-06 DOI:10.1002/dmrr.70053

Thais Lorenzo, Tiia Ngandu, Jenni Lehtisalo, Riitta Antikainen, Juan Domingo Gispert, Nina Kemppainen, Tiina Laatikainen, Jaana Lindström, Juha Rinne, Hilkka Soininen, Timo Strandberg, Rafael de la Torre, Jaakko Tuomilehto, Alina Solomon, Miia Kivipelto

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引用次数: 0

Abstract

Aims

Few longitudinal studies have explored Oral Glucose Tolerance Test markers (OGTT) and both cognitive and brain changes. We investigated OGTT and other glycaemia and insulin resistance markers, and cognitive and neuroimaging changes in the Finnish Geriatric Intervention Study to Prevent Cognitive Impairment and Disability (FINGER).

Materials and Methods

At-risk individuals aged 60–77 years without dementia (N = 1259) were randomly enrolled in a 2-year multidomain lifestyle intervention or regular health advice program. 1025 participants without previously diagnosed diabetes underwent OGTT. Brain MRI scans were available for 132 participants and amyloid (PiB)-PET and FDG-PET scans for 47. Cognition was assessed using the modified Neuropsychological Test Battery (mNTB).

Results

Higher baseline dysglycaemia measures, particularly those from the OGTT, were connected to less favourable changes in multiple cognitive measures and hippocampal volume. Higher baseline triglyceride-glucose (TyG) index was associated with higher amyloid accumulation and decline in brain glucose metabolism. Higher baseline glycated haemoglobin (HbA1c) was related to favourable changes in processing speed and cortical thickness. There were no significant intervention-control differences in the change in glycaemia markers. Baseline dysglycaemia and glycaemia-related markers did not modify the previously reported intervention benefits on cognition.

Conclusions

Higher baseline dysglycaemia measures are linked to more deleterious changes in cognition. Specifically, OGTT measures may be the most sensitive for detecting subtle glycaemic abnormalities associated with both unfavourable cognitive and neuroimaging changes. However, HbA1c shows mixed associations with cognition and neuroimaging in people at risk of dementia without previously diagnosed diabetes. This study emphasises the importance of more accurate glucose-related markers when investigating early stages of glucose metabolism abnormalities and their relationship to subtle cognitive impairment and its structural brain correlates.

Trial Registration

ID NCT01041989 https://clinicaltrials.gov

查看原文本刊更多论文

在一项为期2年的多领域生活方式随机对照试验中，前驱糖尿病、糖尿病和葡萄糖相关标志物与认知和神经影像学的关联

目的很少有纵向研究探讨口服葡萄糖耐量试验标志物（OGTT）和认知和大脑的变化。我们调查了OGTT和其他血糖和胰岛素抵抗标志物，以及芬兰老年干预研究预防认知障碍和残疾（FINGER）的认知和神经影像学变化。材料与方法将60-77岁无痴呆的高危人群（N = 1259）随机纳入为期2年的多领域生活方式干预或定期健康咨询项目。1025名未确诊糖尿病的参与者接受了OGTT治疗。对132名参与者进行了脑部MRI扫描，对47名参与者进行了淀粉样蛋白(PiB)-PET和FDG-PET扫描。认知评估采用改良的神经心理测试组（mNTB）。结果较高的基线血糖异常测量值，特别是OGTT测量值，与多项认知测量和海马体积的不利变化有关。较高的基线甘油三酯-葡萄糖（TyG）指数与较高的淀粉样蛋白积累和脑葡萄糖代谢下降有关。较高的基线糖化血红蛋白（HbA1c）与处理速度和皮质厚度的有利变化有关。在血糖指标的变化方面，干预与控制没有显著差异。基线血糖异常和血糖相关标志物并没有改变先前报道的干预对认知的益处。结论：较高的血糖异常基线值与更有害的认知变化有关。具体来说，OGTT测量对于检测与不利的认知和神经影像学改变相关的细微血糖异常可能是最敏感的。然而，在没有先前诊断过糖尿病的有痴呆风险的人群中，HbA1c显示出与认知和神经影像学的混合关联。这项研究强调了在研究葡萄糖代谢异常的早期阶段，以及它们与微妙认知障碍及其脑结构相关的关系时，更准确的葡萄糖相关标志物的重要性。试验注册编号NCT01041989 https://clinicaltrials.gov

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来源期刊

Diabetes/Metabolism Research and Reviews 医学-内分泌学与代谢

CiteScore

17.20

自引率

2.50%

发文量

审稿时长

4-8 weeks

期刊介绍： Diabetes/Metabolism Research and Reviews is a premier endocrinology and metabolism journal esteemed by clinicians and researchers alike. Encompassing a wide spectrum of topics including diabetes, endocrinology, metabolism, and obesity, the journal eagerly accepts submissions ranging from clinical studies to basic and translational research, as well as reviews exploring historical progress, controversial issues, and prominent opinions in the field. Join us in advancing knowledge and understanding in the realm of diabetes and metabolism.