The chicken or the egg? Does glycaemic control predict cognitive function or the other way around?
The chicken or the egg? Does glycaemic control predict cognitive function or the other way around?
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DOI：
10.1007/s00125-018-4689-9
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发表时间：
2018-09-01
期刊：
影响因子：
8.2
通讯作者：
Beeri，Michal Schnaider
中科院分区：
文献类型：
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作者：
Ganmore，Ithamar;Beeri，Michal Schnaider
2型糖尿病与认知功能障碍之间的关系已经得到了很好的证实。预防2型糖尿病及其并发症的发展，以及认知功能障碍和痴呆，是这些领域的主要目标。解读2型糖尿病和认知功能障碍之间相互作用的因果关系方向，并了解疾病进展的时间轴，对于制定有效的预防策略至关重要。目前流行的看法是2型糖尿病会导致认知功能障碍和痴呆。有大量证据表明，2型糖尿病的认知能力加速下降始于中年（平均年龄40-60岁），甚至可能在糖尿病前期阶段开始。然而，在本期《糖尿病学》中，Altschul等人（doi： https://doi.org/10.1007/s00125-018-4645-8 ）显示了反向因果关系假说的证据，即认知功能低下先于血糖控制不良。他们发现，青少年早期（11岁）的认知功能可以预测70岁时的HbA 1c水平和认知功能。此外，他们发现，70岁时认知功能较低与70岁至79岁时HbA 1c的增加有关。基于这些发现，未来的研究应该探讨针对认知功能低下的青少年制定预防策略是否会预防2型糖尿病，打破2型糖尿病和认知功能障碍的恶性循环。
The association between type 2 diabetes and cognitive dysfunction is well established. Prevention of the development of type 2 diabetes and its complications, as well as cognitive dysfunction and dementia, are leading goals in these fields. Deciphering the causality direction of the interplay between type 2 diabetes and cognitive dysfunction, and understanding the timeline of disease progression, are crucial for developing efficient prevention strategies. The prevailing perception is that type 2 diabetes leads to cognitive dysfunction and dementia. There is substantial evidence showing that accelerated cognitive decline in type 2 diabetes starts in midlife (mean age 40–60 years) and that it may even begin at the prediabetes stage. However, in this issue of Diabetologia, Altschul et al (doi: https://doi.org/10.1007/s00125-018-4645-8 ) show evidence for the reverse causality hypothesis, i.e. that lower cognitive function precedes poor glycaemic control. They found that cognitive function at early adolescence (age 11 years) predicts both HbA1clevels and cognitive function at age 70 years. Moreover, they found that lower cognitive function at age 70 is associated with an increase in HbA1cfrom age 70 to 79 years. Based on these findings, future studies should explore whether developing prevention strategies that target young adolescents with lower cognitive function will result in prevention of type 2 diabetes, breaking the vicious cycle of type 2 diabetes and cognitive dysfunction.