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The cross-sectional association of renal dysfunction with tests of cognition in middle-aged adults with early type 2 diabetes: The GRADE Study.

Citation
Barzilay, J. I., et al. “The Cross-Sectional Association Of Renal Dysfunction With Tests Of Cognition In Middle-Aged Adults With Early Type 2 Diabetes: The Grade Study.”. Journal Of Diabetes And Its Complications, p. 107805.
Center University of Michigan Albert Einstein College of Medicine University of Alabama at Birmingham University of Washington
Multicenter
Multicenter
Author Joshua I Barzilay, Naji Younes, Rodica Pop-Busui, Hermes Florez, Elizabeth Seaquist, Corinna Falck-Ytter, José A Luchsinger, GRADE Research Group
Keywords albuminuria, Cognitive impairment, diabetes, Insulin resistance, Reduced eGFR
Abstract

OBJECTIVE: The association of renal dysfunction with tests of cognition in type 2 diabetes has been examined in individuals with moderate and advanced renal disease. Here we examine the association of renal dysfunction with tests of cognition in a cohort of middle-aged adults with short duration diabetes (mean 4.0 ± 2.8 years).

METHODS: Baseline data were examined from the Glycemia Reduction Approaches in Diabetes (GRADE) study (n = 4998). Renal dysfunction was defined by the presence of albumin in the urine or by estimated glomerular filtration rate (eGFR). Cognition was assessed with the Spanish English Verbal Learning Test, Letter and Animal fluency tests, and the Digit Symbol Substitution Test.

RESULTS: Participants with albuminuria or eGFR <60 ml/min/1.73 m had significantly lower test scores of information processing speed and perception, executive function and ability to categorize information, and of verbal learning and memory compared to participants without renal disease. Adjustment for hypertension, dyslipidemia, and waist circumference attenuated many of these findings but markers of impaired learning and executive function continued to remain lower in association with higher urine albumin levels.

CONCLUSION: In type 2 diabetes of short duration, there are already subtle deficiencies in markers of cognition in association with renal disease in middle aged adults.

Year of Publication
2021
Journal
Journal of diabetes and its complications
Volume
35
Issue
3
Number of Pages
107805
Date Published
03/2021
ISSN Number
1873-460X
DOI
10.1016/j.jdiacomp.2020.107805
Alternate Journal
J Diabetes Complications
PMID
33288412
PMCID
PMC7870547
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