Circulating levels of endothelial progenitor cells are associated with better cognitive function in older adults with glucagon-like peptide 1 receptor agonist-treated type 2 diabetes

Abstract

Aims: To evaluate cognitive function in subjects with type 2 diabetes (T2D) treated with glucagon-like peptide 1 receptor agonist (GLP-1RA) plus metformin or metformin alone and its association with endothelial progenitor cells (EPCs).

Methods: Adults with T2D treated with GLP-1RA plus metformin (GLP-1RA + MET) or MET alone for at least 12 months were included. Montreal Cognitive Assessment test (MoCA), Mini-Mental State Examination (MMSE), Mini Nutritional Assessment (MNA) and disability tests were administered. Circulating levels of seven EPCs phenotypes were measured by flow cytometry.

Results: A total of 154 elderly patients were included, of whom 78 in GLP-1RA + MET group and 76 in MET group. The GLP-1RA + MET group showed better cognitive function as indicated by a significant higher MoCA and MMSE scores, and higher levels of CD34⁺ CD133⁺, CD133⁺ KDR⁺, and CD34⁺ CD133⁺ KDR⁺ as compared with MET group. The number of CD34⁺ CD133⁺ KDR⁺ cells was an independent predictor of higher MoCA, MMSE and MNA scores.

Conclusions: People with T2D on GLP-1RA + MET treatment had better cognitive function and higher circulating levels of EPCs as compared with those on MET alone warranting further studies to understand the interrelationship between EPCs, GLP-RA treatment and cognitive health.

Keywords: Cognitive function; EPCs; Elderly patients; Endothelial progenitor cells; GLP-1RA; Glucagon-like peptide 1 receptor agonists; Metformin; Type 2 diabetes.