Por favor, use este identificador para citar o enlazar este ítem:
http://conacyt.repositorioinstitucional.mx/jspui/handle/1000/253| Is glycaemia associated with poorer brain health and risk of dementia? Cross sectional and follow-up analysis of the UK Biobank | |
| Victoria Garfield Aliki-Eleni Farmaki Sophie V Eastwood Rohini Mathur Christopher T Rentsch Krishnan Bhaskaran Liam Smeeth Nish Chaturvedi | |
| Novel Coronavirus | |
| Acceso Abierto | |
| Atribución-NoComercial-SinDerivadas | |
| 10.1101/2020.02.18.20024471 | |
| Objective: To understand the relationship across the glycaemic spectrum with incident dementia, brain structure, and cognitive decline. Research Design and Methods: UK Biobank participants, aged 40-69 at recruitment. HbA1c and diabetes diagnosis define baseline glycaemic categories. Outcomes included incident vascular dementia (VD), Alzheimers dementia (AD), hippocampal volume (HV), white matter hyperintensity (WMH) volume, cognitive function and decline. All results are in reference to normoglycaemic individuals (HbA1c 35-<42 mmol/mol). Results: 210433 (47%), 15246 (3%), 3280 (0.7%), 20793 (5%) individuals had low HbA1c, pre-diabetes, undiagnosed diabetes, and known diabetes, respectively. Pre- and known diabetes markedly increased incident VD, (hazard ratios (HR) 1.51, 95%CI=1.01;2.25 and 1.96, 95%CI=1.49;2.58, respectively), less so AD (1.18, 0.92;1.52 and 1.13 0.95,1.33), adjusting for demographic and socioeconomic variables. For VD, multivariate adjustment, driven by antihypertensives, attenuated associations, HR 1.27, 0.84;1.91 and 1.45,1.07;1.97. Pre- and known diabetes conferred elevated risks of cognitive decline (odds ratio OR 1.53, 1.02;2.29 and 1.49, 1.02;2.18, respectively). People with pre-diabetes, undiagnosed and known diabetes had higher WMH volumes (4%, 30%, 3%, respectively), and lower HV (34.51 mm3, 11.73 mm3 and 61.13 mm3 respectively). People with low-normal HbA1c (<35 mmol/mol) had 5% lower WMH volume and 13.6 mm3 greater HV than normoglycaemic individuals. Conclusions: Pre and known diabetes increase VD risks, less so AD. Excess VD risks were largely accounted for by treated hypertension. Hyperglycaemic states were associated with adverse, whereas low normal HbA1c was associated with favourable brain structure compared to normoglycaemic individuals. Our findings have implications for cardiovascular medication in hyperglycaemia for brain health. ### Competing Interest Statement Author contributions: literature search: VG; study design: VG, NC; data analysis: VG, SVE, A-EF; data interpretation: VG, NC, LS, KB; Writing: VG, NC; commenting on the draft: VG, A-EF, SVE, RM, CTR, KB, LS, NC. KB reports grants from Diabetes UK, grants from British Heart Foundation, during the conduct of the study; grants from Medical Research Council, outside the submitted work. KB holds a Sir Henry Dale Fellowship funded by Wellcome and the Royal Society (grant number 107731/Z/15/Z). LS reports grants from BHF and Diabetes UK, during the conduct of the study; grants from Wellcome, grants from MRC, grants from NIHR, grants from GSK, grants from BHF, outside the submitted work; and is a Trustee of the British Heart Foundation. NC reports grants from Diabetes UK, grants from British Heart Foundation, during the conduct of the study; personal fees from AstraZeneca, grants from Medical Research Council, outside the submitted work. The remaining authors declare that there are no conflicts of interest. ### Funding Statement This work was jointly funded by Diabetes UK and British Heart Foundation grant 15/0005250. ### Author Declarations All relevant ethical guidelines have been followed; any necessary IRB and/or ethics committee approvals have been obtained and details of the IRB/oversight body are included in the manuscript. Yes All necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived. Yes I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance). Yes I have followed all appropriate research reporting guidelines and uploaded the relevant EQUATOR Network research reporting checklist(s) and other pertinent material as supplementary files, if applicable. Yes Data to support this study are available directly from the UK Biobank. | |
| Cold Spring Harbor Laboratory Press | |
| 2020 | |
| Preimpreso | |
| https://www.medrxiv.org/content/10.1101/2020.02.18.20024471v2 | |
| Inglés | |
| VIRUS RESPIRATORIOS | |
| Aparece en las colecciones: | Artículos científicos |
Cargar archivos:
| Fichero | Tamaño | Formato | |
|---|---|---|---|
| In glycaemia associated.pdf | 245.64 kB | Adobe PDF | Visualizar/Abrir |