在巴西成人健康纵向研究（ELSA）中，脂联素与认知功能的关联先于显性糖尿病出现。
Association of adiponectin with cognitive function precedes overt diabetes in the Brazilian Longitudinal Study of Adult Health: ELSA.
作者信息
Cezaretto Adriana, Suemoto Claudia Kimie, Bensenor Isabela, Lotufo Paulo A, de Almeida-Pititto Bianca, Ferreira Sandra R G
机构信息
1Department of Epidemiology, School of Public Health, University of Sao Paulo, São Paulo, Brazil.
2Division of Geriatrics, Medical School, University of Sao Paulo, São Paulo, Brazil.
出版信息
Diabetol Metab Syndr. 2018 Jul 9;10:54. doi: 10.1186/s13098-018-0354-1. eCollection 2018.
BACKGROUND
Adiponectin is an insulin-sensitizer adipocytokine endowed with neuroprotective actions. Whether adiponectin regulates neuronal functioning toward delaying cognitive decline independently of the glucose metabolism disturbance has been poorly explored. This study evaluated if the performance in cognitive tests was associated with adiponectin levels prior the development of type 2 diabetes in middle-aged individuals.
METHODS
A sample of 938 non-diabetic participants of ELSA had their cognitive function assessed by the CERAD delayed word recall test, the verbal fluency test and the trail making test. Stepwise multiple linear regression using forward selection had the response to cognitive tests as the dependent variable and adiponectin as the independent variable of main interest, adjusted for glucose tolerance status and confounders.
RESULTS
Mean age was 45.7 ± 4.9 years, 54.5% were women, 43.0% had high education level, 59.3% weight excess and 70.0% prediabetes. In crude model, only the delayed recall memory was associated with adiponectin levels. In an initial regression model, delayed recall memory remained independently associated with adiponectin levels and prediabetes. After complete adjustments, adiponectin but not prediabetes maintained independently associated with delayed recall memory (β 0.067; 95% CI 0.006-0.234; p = 0.040). On the other hand, learning memory showed to be associated with prediabetes (β 0.71 95% CI 0.17; 1.24; p = 0.009) but not with adiponectin.
CONCLUSIONS
The association of memory with adiponectin in middle-aged individuals, prior overt diabetes, suggests that this adipocytokine could anticipate cognitive impairmentρ detection, when preventive strategies could be more effectively implemented. The usefulness of adiponectin to identify increased risk for cognitive dysfunction before advanced age needs to be prospectively investigated in ELSA cohort.
背景
脂联素是一种具有神经保护作用的胰岛素增敏性脂肪细胞因子。脂联素是否独立于糖代谢紊乱调节神经元功能以延缓认知衰退，目前尚未得到充分研究。本研究评估了中年个体在2型糖尿病发生之前，认知测试表现是否与脂联素水平相关。
方法
对938名非糖尿病的欧洲社会经济状况纵向研究（ELSA）参与者进行了认知功能评估，采用CERAD延迟单词回忆测试、语言流畅性测试和连线测验。以认知测试反应为因变量，脂联素作为主要感兴趣的自变量，采用向前选择的逐步多元线性回归，并根据葡萄糖耐量状态和混杂因素进行调整。
结果
平均年龄为45.7±4.9岁，54.5%为女性，43.0%具有高学历，59.3%体重超标，70.0%患有糖尿病前期。在粗模型中，只有延迟回忆记忆与脂联素水平相关。在初始回归模型中，延迟回忆记忆仍然与脂联素水平和糖尿病前期独立相关。经过完全调整后，脂联素而非糖尿病前期与延迟回忆记忆保持独立相关（β0.067；95%置信区间0.006 - 0.234；p = 0.040）。另一方面，学习记忆显示与糖尿病前期相关（β0.71 95%置信区间0.17；1.24；p = 0.009），但与脂联素无关。
结论
在明显糖尿病出现之前，中年个体的记忆与脂联素之间的关联表明，当预防策略能够更有效地实施时，这种脂肪细胞因子可以预测认知障碍的检测。脂联素在识别高龄前认知功能障碍风险增加方面的有用性，需要在ELSA队列中进行前瞻性研究。
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