Orthostatic hypotension promotes the progression from mild cognitive impairment to dementia in type 2 diabetes mellitus

Qiao Xiong; Fang Li; Haiyan Chi; Yachao Yang; Mengfan Li; Yingxiao Liu; Yupan Zhang; Bing Leng; Xiaoxiao Qi; Hairong Sun; Zhenguang Li; Jinbiao Zhang

doi:10.1210/clinem/dgad764

Orthostatic hypotension promotes the progression from mild cognitive impairment to dementia in type 2 diabetes mellitus

J Clin Endocrinol Metab. 2024 Jan 2:dgad764. doi: 10.1210/clinem/dgad764. Online ahead of print.

Authors

Qiao Xiong^{1

2}, Fang Li³, Haiyan Chi⁴, Yachao Yang⁴, Mengfan Li², Yingxiao Liu⁴, Yupan Zhang⁴, Bing Leng², Xiaoxiao Qi^{1

2}, Hairong Sun², Zhenguang Li², Jinbiao Zhang²

Affiliations

¹ Department of Clinical Medicine, Weifang Medical University, Weifang, Shandong 261053, China.
² Department of Neurology, Weihai Municipal Hospital, Cheeloo College of Medicine, Shandong University, Weihai, Shandong, 264200, China.
³ Department of Neurology, The First Affiliated Hospital of Jinzhou Medical University, Jinzhou, Liaoning, 121017, China.
⁴ Department of Endocrinology, Weihai Municipal Hospital, Cheeloo College of Medicine, Shandong University, Weihai, Shandong, 264200, China.

PMID: 38165720
DOI: 10.1210/clinem/dgad764

Abstract

Introduction: In type 2 diabetes mellitus (T2DM), orthostatic hypotension (OH) was associated with cognition, but the mechanisms governing the link between OH and cognition are still unclear.

Methods: We recruited T2DM with mild cognitive impairment (MCI) subjects, collected general healthy information and blood samples. Complement proteins of astrocyte-derived exosomes isolated and Alzheimer's disease (AD) biomarkers of neuronal cell-derived exosomes isolated were quantified by ELISA. Cognitive assessments were performed at patient enrollment and follow-up.

Results: Mediation analysis showed that the influence of OH on cognition in T2DM was partly mediated by baseline AD biomarkers and complement proteins. Cox proportional hazards regression proved OH group had a higher risk of developing dementia compared to T2DM without OH group.

Discussion: In T2DM with MCI patients, AD biomarkers and complement proteins mediate the effects of OH on cognitive impairment and OH may be a risk factor of progression from MCI to dementia in T2DM.

Keywords: AD biomarkers; cognitive impairment; complement protein; orthostatic hypotension; type 2 diabetes mellitus.