TY - JOUR
T1 - Insulin resistance and cognitive performance in type 2 diabetes - The Maastricht study
AU - Geijselaers, Stefan L. C.
AU - Sep, Simone J. S.
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 - Schaper, Nicolaas C.
AU - Dagnelie, Pieter C.
AU - Kallen, Carla J. H. van der
AU - Stehouwer, Coen D. A.
AU - Biessels, Geert Jan
PY - 2017/5
Y1 - 2017/5
N2 - Aims: Type 2 diabetes, hyperinsulinemia, and insulin resistance are associated with cognitive impairment. Experimental studies indicate that insulin signaling in the brain is related to cognitive performance. Here we evaluated whether insulin-related variables contribute to the variance in cognitive performance among individuals with type 2 diabetes. Methods: A total of 806 individuals with type 2 diabetes (mean age 62 +/- 8 years, HbAlc 6.9 +/- 1.1%) completed a neuropsychological test battery. Insulin-related variables evaluated were: fasting plasma insulin, C-peptide, and the Homeostasis Model Assessment (HOMA2-IR; in individuals without insulin treatment; n = 641). The unadjusted coefficient of determination (R-2), obtained from multiple linear regression analyses, was used to estimate the proportion of variance in cognition explained by insulin-related variables. Results: Sex, age, and educational level together explained 18.0% (R-2) of the variance in memory function, 26.5% in information processing speed, and 22.8% in executive function and attention. Fasting insulin, C-peptide, or HOMA2-IR did not increase the explained variance (maximum Delta R-2 0.3%, P >= 0.14). Similar results were obtained when insulin-related variables were added to models that additionally included glycemic control, cardiovascular risk factors, and depression. Conclusions: Our results show that measures of peripheral insulin resistance are unrelated to cognitive performance among individuals with adequately controlled type 2 diabetes.
AB - Aims: Type 2 diabetes, hyperinsulinemia, and insulin resistance are associated with cognitive impairment. Experimental studies indicate that insulin signaling in the brain is related to cognitive performance. Here we evaluated whether insulin-related variables contribute to the variance in cognitive performance among individuals with type 2 diabetes. Methods: A total of 806 individuals with type 2 diabetes (mean age 62 +/- 8 years, HbAlc 6.9 +/- 1.1%) completed a neuropsychological test battery. Insulin-related variables evaluated were: fasting plasma insulin, C-peptide, and the Homeostasis Model Assessment (HOMA2-IR; in individuals without insulin treatment; n = 641). The unadjusted coefficient of determination (R-2), obtained from multiple linear regression analyses, was used to estimate the proportion of variance in cognition explained by insulin-related variables. Results: Sex, age, and educational level together explained 18.0% (R-2) of the variance in memory function, 26.5% in information processing speed, and 22.8% in executive function and attention. Fasting insulin, C-peptide, or HOMA2-IR did not increase the explained variance (maximum Delta R-2 0.3%, P >= 0.14). Similar results were obtained when insulin-related variables were added to models that additionally included glycemic control, cardiovascular risk factors, and depression. Conclusions: Our results show that measures of peripheral insulin resistance are unrelated to cognitive performance among individuals with adequately controlled type 2 diabetes.
KW - Type 2 diabetes mellitus
KW - Cognitive performance
KW - Fasting insulin
KW - C-peptide
KW - Insulin resistance
U2 - 10.1016/j.jdiacomp.2017.01.020
DO - 10.1016/j.jdiacomp.2017.01.020
M3 - Article
C2 - 28319003
SN - 1056-8727
VL - 31
SP - 824
EP - 830
JO - Journal of Diabetes and Its Complications
JF - Journal of Diabetes and Its Complications
IS - 5
ER -