Plasma C peptide level and cognitive function among older women without diabetes mellitus
Plasma C peptide level and cognitive function among older women without diabetes mellitus
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DOI：
10.1001/archinte.165.14.1651
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发表时间：
2005-07-25
影响因子：
--
通讯作者：
Grodstein, F
中科院分区：
文献类型：
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作者：
Okereke, O;Hankinson, SE;Grodstein, F
背景：越来越多的证据表明，2型糖尿病和高胰岛素血症可能与认知能力下降有关。为了帮助区分糖尿病和胰岛素的影响，我们研究了Nurses' Health Study.Methods的非糖尿病参与者中胰岛素与认知功能的关系：我们测量了1989年6月14日至1990年10月4日718名女性提供的血液样本中代表胰岛素分泌的C肽水平，当时她们的年龄为61至69岁。我们在采血后平均10年进行电话访谈，测试一般认知、非文字记忆、类别流畅性和注意力; 2年后进行第二次认知评估。主要结果是所有测试的整体认知功能和非文字记忆。我们使用回归模型来估计不同C肽水平的认知功能和认知下降的多变量调整平均差异，以及认知障碍的几率。与第一个四分位数的女性相比，第四个四分位数的女性的认知功能更差（例如，在结合所有认知测试的总体评分中，多变量调整的平均差异为-1.7标准单位[95%置信区间，-2.9至-0.6标准单位]; P= 0.002）;第四个四分位数的女性认知障碍的几率（定义为分布中最差的10%）比第一个四分位数的女性高3倍（95%置信区间，1.3-7.8）。在非文字记忆方面，第四个四分位数的女性得分明显低于第一个四分位数的女性;受损的几率高出2.8倍（95%置信区间，1.1-7.0）。一致的结果，观察认知能力下降。结论：高胰岛素分泌可能与认知能力较差，即使在那些没有糖尿病。
Background: Growing evidence suggests that type 2 diabetes mellitus and hyperinsulinemia may be related to diminished cognition. To help differentiate between the effects of diabetes and insulin, we examined the relation of insulin to cognitive function among nondiabetic participants of the Nurses' Health Study.Methods: We measured the C peptide level, representing insulin secretion, in blood samples provided by 718 women from June 14, 1989, to October 4, 1990, when they were aged 61 to 69 years. We administered telephone interviews an average of 10 years after blood collection, testing general cognition, verbal memory, category fluency, and attention; second cognitive assessments were conducted 2 years later. The primary outcomes were global cognitive function across all tests and verbal memory. We used regression models to estimate multivariable-adjusted mean differences in cognitive function and cognitive decline, and odds of cognitive impairment, across C peptide levels.Results: Cognitive function was worse among women in the fourth C peptide quartile compared with those in the first quartile (eg, on the global score combining all cognitive tests, the multivariable-adjusted mean difference was -1.7 standard units [95% confidence interval, -2.9 to -0.6 standard units]; P=.002); the odds of cognitive impairment (defined as the worst 10% of the distribution) were 3-fold higher among women in the fourth vs first quartile (95% confidence interval, 1.3-7.8). On verbal memory, women in the fourth quartile scored significantly worse than those in the first quartile; the odds of impairment were 2.8-fold higher (95% confidence interval, 1.1-7.0). Consistent findings were observed for cognitive decline.Conclusion: Higher insulin secretion may be related to worse cognition, even among those without diabetes.