TY - JOUR
T1 - The role of hyperglycemia, insulin resistance, and blood pressure in diabetes
T2 - Associated differences in cognitive performance-The Maastricht Study
AU - Geijselaers, Stefan L. C.
AU - Sep, Simone J. S.
AU - Claessens, Danny
AU - Schram, Miranda T.
AU - van Boxtel, Martin P. J.
AU - Henry, Ronald M. A.
AU - Verhey, Frans R. J.
AU - Kroon, Abraham A.
AU - Dagnelie, Pieter C.
AU - Schalkwijk, Casper G.
AU - van der Kallen, Carla J. H.
AU - Biessels, Geert Jan
AU - Stehouwer, Coen D. A.
PY - 2017/11/1
Y1 - 2017/11/1
N2 - OBJECTIVE To study to what extent differences in cognitive performance between individuals with different glucose metabolism status are potentially attributable to hyperglycemia, insulin resistance, and blood pressure-related variables. RESEARCH DESIGN AND METHODS We used cross-sectional data from 2,531 participants from the Maastricht Study (mean +/- age SD, 60 +/- 8 years; 52% men; n = 666 with type 2 diabetes), all of whom completed a neuropsychological test battery. Hyperglycemia was assessed by a composite index of fasting glucose, postload glucose, glycated hemoglobin (HbA(1c)), and tissue advanced glycation end products; insulin resistance by the HOMA of insulin resistance index; and blood pressure-related variables included 24-h ambulatory pressures, their weighted SDs, and the use of antihypertensive medication. Linear regression analyses were used to estimate mediating effects. RESULTS After adjustment for age, sex, and education, individuals with type 2 diabetes, compared with those with normal glucose metabolism, performed worse in all cognitive domains (mean differences in composite z scores for memory -0.087, processing speed -0.196, executive function and attention -0.182; P values
AB - OBJECTIVE To study to what extent differences in cognitive performance between individuals with different glucose metabolism status are potentially attributable to hyperglycemia, insulin resistance, and blood pressure-related variables. RESEARCH DESIGN AND METHODS We used cross-sectional data from 2,531 participants from the Maastricht Study (mean +/- age SD, 60 +/- 8 years; 52% men; n = 666 with type 2 diabetes), all of whom completed a neuropsychological test battery. Hyperglycemia was assessed by a composite index of fasting glucose, postload glucose, glycated hemoglobin (HbA(1c)), and tissue advanced glycation end products; insulin resistance by the HOMA of insulin resistance index; and blood pressure-related variables included 24-h ambulatory pressures, their weighted SDs, and the use of antihypertensive medication. Linear regression analyses were used to estimate mediating effects. RESULTS After adjustment for age, sex, and education, individuals with type 2 diabetes, compared with those with normal glucose metabolism, performed worse in all cognitive domains (mean differences in composite z scores for memory -0.087, processing speed -0.196, executive function and attention -0.182; P values
U2 - 10.2337/dc17-0330
DO - 10.2337/dc17-0330
M3 - Article
C2 - 28842522
SN - 0149-5992
VL - 40
SP - 1537
EP - 1547
JO - Diabetes Care
JF - Diabetes Care
IS - 11
ER -