Diabetes Mellitus, Elevated Hemoglobin A1c, and Glycated Albumin Are Associated with the Presence of All-Cause Dementia and Alzheimer’s Disease: The JPSC-AD Study

2021 ◽  
pp. 1-13
Author(s):  
Moeko Noguchi-Shinohara ◽  
Sohshi Yuki-Nozaki ◽  
Chiemi Abe ◽  
Ayaka Mori ◽  
Mai Horimoto ◽  
...  

Background: Glucose dysmetabolism is an important risk factor for dementia. Objective: We investigated the associations of diabetes mellitus, the levels of glycemic measures, and insulin resistance and secretion measures with dementia and its subtypes in a cross-sectional study. Methods: In this study, 10,214 community-dwelling participants were enrolled. Hemoglobin A1c (HbA1c), the homeostasis model assessment (HOMA) for insulin resistance (HOMA-IR), the HOMA of percent β-cell function (HOMA-β), and the glycated albumin (GA) was evaluated. The associations of each measure with Alzheimer’s disease (AD) and vascular dementia (VaD) were investigated. Results: The multivariable-adjusted odds ratios (ORs) of AD were significantly higher in participants with diabetes mellitus than in those without diabetes (1.46 [95% CI: 1.08–1.97]). Higher HbA1c levels were significantly associated with AD at diabetes (≥6.5%) and even at prediabetes (5.7 %–6.4 %) levels; multivariable-adjusted ORs for AD in participants at the diabetes level were 1.72 (95% CI: 1.19–2.49), and those in participants at the prediabetes level were 1.30 (95% CI: 1.00–1.68), compared with those in normal participants. Moreover, higher GA levels were associated with AD. No associations were observed between the diabetic status or the levels of glycemic measures and VaD. In addition, no significant relationships were observed between insulin resistance and secretion measurements and AD and VaD. Conclusion: Our findings indicate that diabetes mellitus and hyperglycemia are significantly associated with AD, even in individuals at the prediabetes level.

2020 ◽  
Vol 2020 ◽  
pp. 1-7
Author(s):  
Kunrong Wu ◽  
Xiaoli Li ◽  
Yuedong Xu ◽  
Xiaoqian Zhang ◽  
Ziwan Guan ◽  
...  

Background. Metformin is the most widely used oral antidiabetic agent and can reduce insulin resistance (IR) effectively. Organic cation transporter 1 (encoded by SLC22A1) is responsible for the transport of metformin, and ataxia-telangiectasia-mutated (ATM) is a gene relating to the DNA repair and cell cycle control. The aim of this study was to evaluate if the genetic variants in SLC22A1 rs622342 and ATM rs11212617 could be effective predictors of islet function improvement in patients with type 2 diabetes mellitus (T2DM) on metformin treatment. Methods. This cross-sectional study included 111 patients with T2DM treated with metformin. Genotyping was performed by the dideoxy chain-termination method. The homeostatic indexes of IR (HOMA-IR) and beta-cell function (HOMA-BCF) were determined according to the homeostasis model assessment. Results. Fasting plasma glucose (FPG) levels, HbA1c levels, and HOMA-IR were significantly higher in patients with the rs622342 AA genotype than in those with C allele (P<0.05). However, these significant differences were not observed between rs11212617 genotype groups. Further data analysis revealed that the association between the rs622342 polymorphism and HOMA-IR was gender related, and so was rs11212617 polymorphism and HOMA-BCF. HOMA-IR was significantly higher in males with rs622342 AA genotype than in those with C allele (P=0.021), and HOMA-BCF value was significantly higher in females carrying rs11212617 CC genotype than in those with A allele (P=0.038). The common logarithm (Lg10) of HOMA-BCF was positively correlated with the reciprocal of HbA1c (r = 0.629, P<0.001) and negatively associated with Lg10 FPG (r = −0.708, P<0.001). Conclusions. The variant of rs622342 could be a predictor of insulin sensitivity in patients with T2DM treated with metformin. The association between the rs622342 polymorphism and HOMA-IR and the association between the rs11212617 polymorphism and HOMA-BCF were both gender related.


Cells ◽  
2021 ◽  
Vol 10 (5) ◽  
pp. 1236
Author(s):  
Jesús Burillo ◽  
Patricia Marqués ◽  
Beatriz Jiménez ◽  
Carlos González-Blanco ◽  
Manuel Benito ◽  
...  

Type 2 diabetes mellitus is a progressive disease that is characterized by the appearance of insulin resistance. The term insulin resistance is very wide and could affect different proteins involved in insulin signaling, as well as other mechanisms. In this review, we have analyzed the main molecular mechanisms that could be involved in the connection between type 2 diabetes and neurodegeneration, in general, and more specifically with the appearance of Alzheimer’s disease. We have studied, in more detail, the different processes involved, such as inflammation, endoplasmic reticulum stress, autophagy, and mitochondrial dysfunction.


2020 ◽  
Vol 3 (2) ◽  
pp. 67
Author(s):  
Dian Araminta Ramadhania ◽  
Diana Sunardi ◽  
Ali Sungkar

Introduction: Insulin resistance is a condition that underlies the development of diabetes mellitus. The prevalence of diabetes mellitus keeps rising, including in Indonesia. A higher proportion of diabetes was found in women. Physiological changes during pregnancy can cause insulin resistance that may persist until postpartum period. Lactation and nutrient like zinc may improve insulin resistance. This study aimed to measure the correlation between zinc serum level and insulin resistance of lactating mothers in Jakarta.Methods: This study used cross-sectional design, was conducted in Puskesmas Kecamatan Grogol Petamburan, West Jakarta and Puskesmas Kecamatan Cilincing, North Jakarta from February to April 2019. A total of 75 lactating mothers at 3–6 months postpartum were selected using consecutive sampling method. Zinc serum was analyzed using atomic absorption spectrophotometry (AAS) method. Insulin resistance was assessed using the homeostasis model assessment-insulin resistance (HOMA-IR).Results: Approximately 76% (n = 57) subjects had low serum zinc level. Spearman correlation test between serum zinc level and HOMA-IR was done (r = 0.003, p = 0.977). Also, correlation test between BMI and HOMA-IR (r = 0.563, p <0.001).Conclusion: No correlation was found between serum zinc level and HOMA-IR however, there was a significant moderate positive correlation between BMI and HOMA-IR.Keywords: Lactation, zinc, insulin resistance, HOMA-IR, BMI


2016 ◽  
Vol 43 (4) ◽  
pp. 117
Author(s):  
Caroline Mulawi ◽  
Bambang Tridjaja ◽  
Maria Abdulsalam ◽  
Zakiudin Munasir

Background Diabetes mellitus is a common complication in pa-tients with thalassemia major. Iron overload plays an important roleby damaging the pancreatic β-cell and the liver cell, with the con-sequences of insulin deficiency and insulin resistance. Family his-tory of diabetes mellitus is one of the critical factors for the devel-opment of glucose metabolism derangement. However, the patho-genesis of glucose metabolism derangement remains unclear.Objective To evaluate the prevalence of impaired glucose toler-ance, diabetes mellitus, and insulin resistance in patients with β-thalassemia major treated in the Thalassemia Outpatient Clinic,Department of Child Health, Cipto Mangunkusumo Hospital,Jakarta.Methods This was a descriptive cross sectional study conductedin May 2002. Forty-eight subjects aged 10 to 18 years, grouped bytotal volume of transfusions and family history of diabetes mellitus,underwent an oral glucose tolerance test (OGTT), serum transfer-rin saturation, and insulin level examinations. Insulin resistancewas calculated from fasting plasma glucose and insulin concen-trations using the homeostasis model assessment (HOMA).Results One of 48 patients (2%) had impaired glucose toleranceat the age of 17 years. Diabetes mellitus occurred in three of 48patients (6%) at the age of 15.5 years in one patient and 18 yearsin two patients. Family history of diabetes mellitus was found in 2patients with diabetes mellitus and in the only one with impairedglucose tolerance. Insulin resistance was not detected in this study.Conclusion The prevalence of glucose metabolism derangementin patients with thalassemia major was low. No insulin resistancewas found in this study


2010 ◽  
Vol 23 (1) ◽  
pp. 73-85 ◽  
Author(s):  
Niklas Bergvall ◽  
Per Brinck ◽  
Daniel Eek ◽  
Anders Gustavsson ◽  
Anders Wimo ◽  
...  

ABSTRACTBackground: Cognition, abilities in activities of daily living (ADL), and behavioral disturbances in patients with Alzheimer's disease (AD) all influence the number of hours informal caregivers spend caring for their patients, and the burden caregivers experience. However, the direct effect and relative importance of each disease severity measure remains unclear.Methods: Cross-sectional interviews were conducted with 1,222 AD patients and primary caregivers in Spain, Sweden, the U.K. and the U.S.A. Assessments included informal care hours, caregiver burden (Zarit Burden Inventory; ZBI), cognition (Mini-mental State Examination; MMSE), ADL-abilities (Disability Assessment for Dementia scale; DAD), and behavioral symptoms (Neuropsychiatric Inventory Questionnaire; NPI-severity).Results: Multivariate analyses of 866 community-dwelling patients revealed that ADL-ability was the strongest predictor of informal care hours (36% decrease in informal care hours per standard deviation (SD) increase in DAD scores). Severity of behavioral disturbances was the strongest predictor of caregiver burden (0.35 SD increase in ZBI score per SD increase in NPI-Q severity score). In addition, the effect of ADL-abilities was, although attenuated, not negligible (0.28 SD increase in ZBI score per SD increase in DAD score). Decreasing cognition (MMSE) was associated with more informal care hours and increased caregiver burden in univariate, but not in adjusted analyses.Conclusions: For patients residing in community dwellings, the direct influence of patients’ cognition on caregiver burden is limited and rather mediated by other disease indicators. Instead, the patients’ ADL-abilities are the main predictor of informal care hours, and both ADL-abilities and behavioral disturbances are important predictors of perceived caregiver burden, where the latter has the strongest effect. These results were consistent across Sweden, U.K. and the U.S.A.


2011 ◽  
Vol 24 (1) ◽  
pp. 108-116 ◽  
Author(s):  
Inge Cantegreil-Kallen ◽  
Stéphanie Pin

ABSTRACTBackground: The negative image of Alzheimer's disease (AD) in our society has a substantial impact on treating, caring for and integrating those suffering from the disease and their relatives. Little research has been conducted on social perception of AD in the community.Methods: The aim of this study was to investigate the perception, knowledge, opinions and beliefs about AD in the French population. A cross-sectional telephone survey of 2013 randomly selected community-dwelling people aged 18 years and over was conducted. Multivariate logistic regressions were used for identifying predictors of the personal fear of developing AD, both for the global sample and for different age groups.Results: Sixty percent of the sample reported personal fear of developing AD. This attitude was strongly related to age, becoming predominant among the elderly. In the middle-aged group, personal fear of developing AD was highest in women with poor self-perceived health and, in particular, those who cared for someone with AD. Being a caregiver or knowing someone with the disease was also strongly associated with fear among younger adults aged 18–34.Conclusions: These results serve as an incentive for developing special education and prevention programs focused on different age groups and caregivers of AD.


2021 ◽  
Author(s):  
Fábio Dias Nogueira ◽  
Ana Klara Rodrigues Alves ◽  
Barbara Beatriz Lira da Silva ◽  
Ana Kamila Rodrigues Alves ◽  
Marlilia Moura Coelho Sousa ◽  
...  

Introduction: Alzheimer’s disease (AD) is closely related to diabetes mellitus (DM), and AD is also considered to be type 3 diabetes (T3D). Glycogen synthase kinase-3β (GSK-3β) may be the potential link between DM and AD. GSK-3β is one of the main factors that lead to insulin deficiency and insulin resistance, and insulin resistance is a characteristic of the development of DM. In AD, GSK-3β plays an important role in hyperphosphorylation of the tau protein (tau) associated with microtubules, which is one of the pathological features in AD. Objective: To analyze DM as a factor for the development of AD. METHODOLOGY: This is an integrative review of the literature, which is a construction of a comprehensive analysis of the literature with pre-defined steps, carried out through PubMed, 1.501 articles were found, of which 10 were selected, through the simultaneous crossing between the descriptors “Diabetes mellitus”, “Alzheimer “. Articles written in Portuguese and English published between 2016 and 2021 were inserted. Results: DM associated with insulin resistance affects psychomotor efficiency, attention, learning memory, mental flexibility, speed and executive function of the brain, thus being an independent risk factor for cognitive impairment and damage to the central nervous system, hyperglycemia, which can cause increased oxidative stress leading to progressive functional and structural abnormalities in the brain. Conclusion:The risk of dementia in patients with DM is higher than in nondiabetic patients and it is also well known that DM2 / insulin resistance is involved in AD.


Nutrients ◽  
2020 ◽  
Vol 12 (6) ◽  
pp. 1783
Author(s):  
Sohyae Lee ◽  
Jin-young Min ◽  
Kyoung-bok Min

The relationship between caffeine and insulin resistance (IR) has been assessed only in terms of caffeine intake, and the association between caffeine and beta cell function (BCF) remains unclear. This study examines the association between urinary caffeine and its metabolites, IR, and BCF in nondiabetic, noninstitutionalized US adults in order to account for the inter-individual differences in caffeine metabolism. Data on urinary caffeine and its metabolites, IR and BCF from adults aged 20 years and older who participated in the 2009–2010 and 2011–2012 National Health and Nutrition Examination Surveys were analyzed (n for caffeine = 994). IR and BCF were assessed using homeostatic model assessment (HOMA) and urinary caffeine and its metabolites were measured using high-performance liquid chromatography-electrospray ionization-tandem quadrupole mass spectrometry. After adjusting for all covariates, increases in urinary 1,3-DMU, 1,7-DMU, 1,3,7-TMU, theophylline, paraxanthine, caffeine, and AAMU were significantly associated with increased HOMA-IR and HOMA-β (HOMA of insulin resistance and beta cell function). Compared with individuals in the lowest quartile of urinary 1,3-DMU, 1,7-DMU, 1,3,7-TMU, theophylline, paraxanthine, caffeine, and AAMU, the regression coefficients for HOMA-IR and HOMA-β were significantly higher among those in the highest quartile. After stratification by prediabetes status, HOMA-IR and HOMA-β showed significant positive associations with urinary caffeine and its metabolites among subjects with normal fasting plasma glucose levels. Our cross-sectional study showed that caffeine and its metabolites were positively related to IR and BCF.


2020 ◽  
Author(s):  
Hao Dai ◽  
Qi Fu ◽  
Heng Chen ◽  
Mei Zhang ◽  
Min Sun ◽  
...  

Abstract Background The C-peptide-to-insulin ratio (C/I) is associated with hepatic insulin clearance and insulin resistance. We established a novel C-peptide-to-insulin ratio index (CPIRI) and explored its application in the heterogeneity of non-autoimmune diabetes.Methods A total of 865 adults diagnosed with new-onset diabetes mellitus (DM) within 1 year and 54 healthy controls (HC) were recruited. Our CPIRI model was established with fasting C/I as the independent variable and homeostasis model assessment of insulin resistance (HOMA-IR) as the dependent variable. Patients with negative-autoantibodies against pancreatic islets were subclassified according to CPIRI, age of onset , hemoglobin A1c (HbA1c), body mass index (BMI) and homeostatic model assessment of β-cell function (HOMA-β) via cluster analysis.Results Fasting C/I and HOMA-IR in both diabetic and healthy subjects were hyperbolically correlated, and log(C/I) and log(HOMA-IR) were linearly and negatively correlated; the correlation coefficient was −0.83 (P = 0.000) and −0.76 (P = 0.000), respectively. Finally, we obtained the equations CPIRI(DM) = 670/(C/I) 2.24 + 0.25 and CPIRI(HC) = 670/(C/I) 2.24 − 1 (F = 1904.39, P = 0.000). Pancreatic islet autoantibody-negative patients were further subclassified into three subtypes; subtype 1 (13.8%) had severe insulin resistance, subtype 2 (42.1%) suffered elderly-onset DM with slight symptoms, and subtype 3 (44.1%) suffered severe dysfunction of pancreatic islets. Each subtype exhibited different clinical characteristics and complications.Conclusions CPIRI can be used to effectively evaluate insulin resistance. Adult-onset non-autoimmune diabetes can be subclassified into 3 subtypes according to CPIRI along with other symptom-based characteristics of diabetic progression.


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