Adiposity Predicts Cognitive Decline in Older Persons with Diabetes A 2-Year Follow-Up 英文参考文献.docVIP

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Adiposity Predicts Cognitive Decline in Older Persons with Diabetes A 2-Year Follow-Up 英文参考文献.doc

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Adiposity Predicts Cognitive Decline in Older Persons with Diabetes A 2-Year Follow-Up 英文参考文献

AdiposityPredictsCognitiveDeclineinOlderPersons withDiabetes:A2-YearFollow-Up AngelaMarieAbbatecola1,FabriziaLattanzio1,LianaSpazzafumo2,AnnaMariaMolinari3 ,Michele Cioffi3,RaffaeleCanonico4,LuigiDiCioccio5,GiuseppePaolisso4* 1ScientificDirection,ItalianNationalResearchCenteronAging(INRCA),Ancona,Italy,2StatisticandBiometryCenter,DepartmentofGerontologicalResearch,Italian National Institute on Aging, Ancona, Italy, 3Department of General Pathology, Second University of Naples, Naples, Italy, 4Department of Geriatric Medicine and MetabolicDiseases,SecondUniversityofNaples,Naples,Italy,5DepartmentofGeriatricMedicine,SantaScolasticaHospital,Cassino,Italy Abstract Background:ThemechanismsrelatedtocognitiveimpairmentinolderpersonswithType2diabetes(DM)remainsunclear. WetestedifadiposityparametersandbodyfatdistributioncouldpredictcognitivedeclineinolderpersonswithDMvs. normalglucosetolerance(NGT). Methodology:693olderpersonswithnodementiawereenrolled:253withDMingoodmetaboliccontrol;440withNGT (agerange:65–85years).LongitudinalstudycomparingDMandNGTindividualsaccordingtotheassociationofbaseline adiposityparameters(bodymassindex(BMI),waist-hip-ratio(WHR),waistcircumference(WC)andtotalbodyfatmass)to cognitivechange(MiniMentalStateExamination(MMSE),acompositescoreofexecutiveandattentionfunctioning(CCS) overtime. Findings: At baseline, in DM participants, MMSE correlated with WHR (b=20.240; p=0.043), WC (b=20.264; p=0.041) whileCCScorrelatedwithWHR(b=20.238;p=0.041),WC(b=20.326;p=0.013)afteradjustingforconfounders.InNGT subjects,nosignificantcorrelationswerefoundamonganyadiposityparametersandMMSE,whileCCSwasassociatedwith WHR(b=20.194;p=0.036)andWC(b=20.210;p=0.024).ParticipantswithDMinthe3rdtertileoftotalfatmassshowed the greatest decline in cognitive performance compared to those in 1st tertile (tests for trend: MMSE(p=0.007), CCS(p=0.003)).Logisticregressionmodelsshowedthat3rdvs.1sttertileoftotalfatmass,WHR,andWCpredictedanalmost two-folddeclineincognitivefunctioninDMsubje