Cognitive decline in elderly patients with type 2 diabetes is associated with glycated albumin, ratio of Glycated Albumin to glycated hemoglobin, and concentrations of inflammatory and oxidative stress markers

Si-Cong Si; Wei Yang; Hong-Yu Luo; Yi-Xin Ma; Huan Zhao; Jia Liu

doi:10.1016/j.heliyon.2023.e22956

Cognitive decline in elderly patients with type 2 diabetes is associated with glycated albumin, ratio of Glycated Albumin to glycated hemoglobin, and concentrations of inflammatory and oxidative stress markers

Heliyon. 2023 Nov 28;9(12):e22956. doi: 10.1016/j.heliyon.2023.e22956. eCollection 2023 Dec.

Authors

Si-Cong Si¹, Wei Yang¹, Hong-Yu Luo¹, Yi-Xin Ma¹, Huan Zhao¹, Jia Liu¹

Affiliation

¹ Department of Geriatrics, Xuanwu Hospital, Capital Medical University, China National Clinical Research Center for Geriatric Medicine, Beijing 100053, China.

Abstract

Objective: To investigate the correlations of cognitive function with glycated albumin (GA), the ratio of GA to glycated hemoglobin (GA/HbA_1c), and the concentrations of interleukin-6 (IL-6) and superoxide dismutase (SOD) in elderly patients with type 2 diabetes mellitus (T2DM).

Methods: A total of 44 elderly T2DM patients were evaluated for cognitive function using the mini-mental state examination (MMSE) and the Montreal cognitive assessment (MoCA). Patients were then divided into two groups based on the MMSE and MoCA scores: a cognitive dysfunction group and a normal cognitive function group. The correlations of the MMSE and MoCA scores with GA/HbA_1c, GA, IL-6, and SOD were analyzed. Logistic regression analysis was used to identify independent influential factors for cognitive dysfunction. The predictive value of GA and GA/HbA_1c for cognitive dysfunction in elderly T2DM patients was evaluated by receiver operating characteristic (ROC) curve analysis.

Results: Among these patients, 28 had cognitive impairment. They had significantly higher GA/HbA_1c, increased GA and IL-6 levels, and lower SOD concentrations than the normal cognitive function group (all P < 0.05). GA/HbA_1c was negatively correlated with the MMSE (r = -0.430, P = 0.007) and MoCA (r = -0.432, P = 0.007) scores. SOD was positively correlated with the MMSE (r = 0.585, P=0.014) and MoCA (r = 0.635, P=0.006) scores. IL-6 was negatively correlated with the MoCA score (r = -0.421, P=0.015). Age and GA/HbA_1c were independent factors contributing to cognitive dysfunction. The areas under the ROC curves of GA and GA/HbA_1c for the diagnosis of cognitive dysfunction were 0.712 and 0.720, respectively.

Conclusions: GA and GA/HbA_1c are related to cognitive dysfunction in elderly patients with T2DM.

Keywords: Cognitive function; Glycated albumin; Inflammation; Oxidative stress; Ratio of glycated albumin and glycated hemoglobin; T2DM.