Higher glucose levels associated with lower memory and reduced hippocampal microstructure
Higher glucose levels associated with lower memory and reduced hippocampal microstructure
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DOI：
10.1212/01.wnl.0000435561.00234.ee
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发表时间：
2013-11-12
期刊：
影响因子：
9.9
通讯作者：
Floeel, Agnes
中科院分区：
文献类型：
--
作者：
Kerti, Lucia;Witte, A. Veronica;Floeel, Agnes
目的：在这项横断面研究中，我们的目的是阐明在一组健康、老年、非糖尿病、无痴呆的个体中，较高的糖化血红蛋白（HbA 1c）和葡萄糖水平是否对记忆能力、海马体积和微结构产生负面影响。在141人（72名女性，平均年龄63.1岁+/- 6.9 SD），记忆进行了测试，使用雷伊听觉言语学习测试。外周水平的空腹HbA 1c，葡萄糖，胰岛素和3特斯拉MRI扫描，以评估海马体积和微结构，如灰质屏障密度所示。线性回归和简单的调解模型进行计算，以检查记忆，葡萄糖代谢和海马parameters.Results之间的关联：较低的HbA 1c和葡萄糖水平显着相关的延迟回忆，学习能力和记忆巩固更好的分数。在多元回归模型中，HbA 1c与记忆力表现密切相关。此外，调解分析表明，较低的HbA 1c对记忆的有益影响是部分介导的海马体积和microstructure.Conclusions：我们的研究结果表明，即使在没有明显的2型糖尿病或糖耐量受损，长期较高的血糖水平对认知产生负面影响，可能介导的学习相关的脑区的结构变化。因此，即使在正常范围内，旨在降低血糖水平的策略也可能对老年人群的认知产生有益的影响，这一假设将在未来的干预性试验中进行检验。
Objectives: For this cross-sectional study, we aimed to elucidate whether higher glycosylated hemoglobin (HbA1c) and glucose levels exert a negative impact on memory performance and hippocampal volume and microstructure in a cohort of healthy, older, nondiabetic individuals without dementia.Methods: In 141 individuals (72 women, mean age 63.1 years +/- 6.9 SD), memory was tested using the Rey Auditory Verbal Learning Test. Peripheral levels of fasting HbA1c, glucose, and insulin and 3-tesla MRI scans were acquired to assess hippocampal volume and microstructure, as indicated by gray matter barrier density. Linear regression and simple mediation models were calculated to examine associations among memory, glucose metabolism, and hippocampal parameters.Results: Lower HbA1c and glucose levels were significantly associated with better scores in delayed recall, learning ability, and memory consolidation. In multiple regression models, HbA1c remained strongly associated with memory performance. Moreover, mediation analyses indicated that beneficial effects of lower HbA1c on memory are in part mediated by hippocampal volume and microstructure.Conclusions: Our results indicate that even in the absence of manifest type 2 diabetes mellitus or impaired glucose tolerance, chronically higher blood glucose levels exert a negative influence on cognition, possibly mediated by structural changes in learning-relevant brain areas. Therefore, strategies aimed at lowering glucose levels even in the normal range may beneficially influence cognition in the older population, a hypothesis to be examined in future interventional trials.