Judith R. Gruber, Alea Ruf, Elena D. Süß, Sewin Tariverdian, Kira F. Ahrens, Carmen Schiweck, Ulrich Ebner-Priemer, Sharmili Edwin Thanarajah, Andreas Reif, Silke Matura
{"title":"血糖对胰岛素抵抗认知功能的影响：流动评估的新见解","authors":"Judith R. Gruber, Alea Ruf, Elena D. Süß, Sewin Tariverdian, Kira F. Ahrens, Carmen Schiweck, Ulrich Ebner-Priemer, Sharmili Edwin Thanarajah, Andreas Reif, Silke Matura","doi":"10.1038/s41387-024-00331-0","DOIUrl":null,"url":null,"abstract":"<h3 data-test=\"abstract-sub-heading\">Background/objectives</h3><p>Insulin resistance (IR)-related disorders and cognitive impairment lead to reduced quality of life and cause a significant strain on individuals and the public health system. Thus, we investigated the effects of insulin resistance (IR), and blood glucose fluctuations on cognitive function under laboratory and free-living conditions, using ecological momentary assessment (EMA).</p><h3 data-test=\"abstract-sub-heading\">Subjects/methods</h3><p>Baseline assessments included neuropsychological tests and blood analysis. Individuals were classified as either insulin-sensitive (<2) or insulin-resistant (≥2), based on their Homeostatic Model Assessment (HOMA-IR) values. Continuous glucose monitoring (CGM) using a percutaneous sensor was performed for 1 week. Using multiple linear regression, we examined the effects of HOMA-IR and CGM metrics on cognitive domains. Working memory (WM) performance, which was assessed using EMA, 4 times a day for 3 consecutive days, was matched to short-term pre-task CGM metrics. Multilevel analysis was used to map the within-day associations of HOMA-IR, short-term CGM metrics, and WM.</p><h3 data-test=\"abstract-sub-heading\">Results</h3><p>Analyses included 110 individuals (mean age 48.7 ± 14.3 years, 59% female, <i>n</i> = 53 insulin-resistant). IR was associated with lower global cognitive function (<i>b</i> = −0.267, <i>P</i> = 0.027), and WM (<i>b</i> = −0.316; <i>P</i> = 0.029), but not with executive function (<i>b</i> = −0.216; <i>P</i> = 0.154) during baseline. EMA showed that higher HOMA-IR was associated with lower within-day WM performance (β = −0.20, 95% CI −0.40 to −0.00). CGM metrics were not associated with cognitive performance.</p><h3 data-test=\"abstract-sub-heading\">Conclusions</h3><p>The results confirm the association between IR and decrements in global cognitive functioning and WM, while no effects of CGM metrics were observed, making IR a crucial time point for intervention. Targeting underlying mechanisms (e.g., inflammation) in addition to glycemia could be promising to minimize adverse cognitive effects. Registered under https://drks.de/register/de identifier no. DRKS00022774.</p><figure></figure>","PeriodicalId":19339,"journal":{"name":"Nutrition & Diabetes","volume":null,"pages":null},"PeriodicalIF":4.6000,"publicationDate":"2024-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Impact of blood glucose on cognitive function in insulin resistance: novel insights from ambulatory assessment\",\"authors\":\"Judith R. Gruber, Alea Ruf, Elena D. Süß, Sewin Tariverdian, Kira F. Ahrens, Carmen Schiweck, Ulrich Ebner-Priemer, Sharmili Edwin Thanarajah, Andreas Reif, Silke Matura\",\"doi\":\"10.1038/s41387-024-00331-0\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<h3 data-test=\\\"abstract-sub-heading\\\">Background/objectives</h3><p>Insulin resistance (IR)-related disorders and cognitive impairment lead to reduced quality of life and cause a significant strain on individuals and the public health system. Thus, we investigated the effects of insulin resistance (IR), and blood glucose fluctuations on cognitive function under laboratory and free-living conditions, using ecological momentary assessment (EMA).</p><h3 data-test=\\\"abstract-sub-heading\\\">Subjects/methods</h3><p>Baseline assessments included neuropsychological tests and blood analysis. Individuals were classified as either insulin-sensitive (<2) or insulin-resistant (≥2), based on their Homeostatic Model Assessment (HOMA-IR) values. Continuous glucose monitoring (CGM) using a percutaneous sensor was performed for 1 week. Using multiple linear regression, we examined the effects of HOMA-IR and CGM metrics on cognitive domains. Working memory (WM) performance, which was assessed using EMA, 4 times a day for 3 consecutive days, was matched to short-term pre-task CGM metrics. Multilevel analysis was used to map the within-day associations of HOMA-IR, short-term CGM metrics, and WM.</p><h3 data-test=\\\"abstract-sub-heading\\\">Results</h3><p>Analyses included 110 individuals (mean age 48.7 ± 14.3 years, 59% female, <i>n</i> = 53 insulin-resistant). IR was associated with lower global cognitive function (<i>b</i> = −0.267, <i>P</i> = 0.027), and WM (<i>b</i> = −0.316; <i>P</i> = 0.029), but not with executive function (<i>b</i> = −0.216; <i>P</i> = 0.154) during baseline. EMA showed that higher HOMA-IR was associated with lower within-day WM performance (β = −0.20, 95% CI −0.40 to −0.00). CGM metrics were not associated with cognitive performance.</p><h3 data-test=\\\"abstract-sub-heading\\\">Conclusions</h3><p>The results confirm the association between IR and decrements in global cognitive functioning and WM, while no effects of CGM metrics were observed, making IR a crucial time point for intervention. 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Impact of blood glucose on cognitive function in insulin resistance: novel insights from ambulatory assessment
Background/objectives
Insulin resistance (IR)-related disorders and cognitive impairment lead to reduced quality of life and cause a significant strain on individuals and the public health system. Thus, we investigated the effects of insulin resistance (IR), and blood glucose fluctuations on cognitive function under laboratory and free-living conditions, using ecological momentary assessment (EMA).
Subjects/methods
Baseline assessments included neuropsychological tests and blood analysis. Individuals were classified as either insulin-sensitive (<2) or insulin-resistant (≥2), based on their Homeostatic Model Assessment (HOMA-IR) values. Continuous glucose monitoring (CGM) using a percutaneous sensor was performed for 1 week. Using multiple linear regression, we examined the effects of HOMA-IR and CGM metrics on cognitive domains. Working memory (WM) performance, which was assessed using EMA, 4 times a day for 3 consecutive days, was matched to short-term pre-task CGM metrics. Multilevel analysis was used to map the within-day associations of HOMA-IR, short-term CGM metrics, and WM.
Results
Analyses included 110 individuals (mean age 48.7 ± 14.3 years, 59% female, n = 53 insulin-resistant). IR was associated with lower global cognitive function (b = −0.267, P = 0.027), and WM (b = −0.316; P = 0.029), but not with executive function (b = −0.216; P = 0.154) during baseline. EMA showed that higher HOMA-IR was associated with lower within-day WM performance (β = −0.20, 95% CI −0.40 to −0.00). CGM metrics were not associated with cognitive performance.
Conclusions
The results confirm the association between IR and decrements in global cognitive functioning and WM, while no effects of CGM metrics were observed, making IR a crucial time point for intervention. Targeting underlying mechanisms (e.g., inflammation) in addition to glycemia could be promising to minimize adverse cognitive effects. Registered under https://drks.de/register/de identifier no. DRKS00022774.
期刊介绍：
Nutrition & Diabetes is a peer-reviewed, online, open access journal bringing to the fore outstanding research in the areas of nutrition and chronic disease, including diabetes, from the molecular to the population level.
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