The Prevalence and Determinants of Cognitive Deficits and Traditional Diabetic Complications in the Severely Obese

Callaghan, Brian C.; Reynolds, Evan; Banerjee, Mousumi; Chant, Ericka; Villegas-Umana, Emily; Gardner, Thomas W.; Votruba, Kristen; Giordani, Bruno; Pop‐Busui, Rodica; Pennathur, Subramaniam; Feldman, Eva L.

doi:10.2337/dc19-1642

Cited by 40 publications

(46 citation statements)

References 39 publications

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“…Summary of studies The majority of studies were carried out in European populations (n = 7) [25,[36][37][38][39][40][41]; other locations were China (n = 1) [42], Brazil (n = 1) [43], USA (n = 1) [44] and Australia (n = 1) [45]. The studies sample sizes ranged from 52 to 1638 participants [25,[36][37][38][39][40][41][42][43][44][45][46][47]. All studies included tests of cardiac autonomic function.…”

Section: Study Characteristicsmentioning

confidence: 99%

“…Study design and participants Eight studies were cross sectional [25,36,37,39,[41][42][43][44], two were cohort studies [38,40] and one was a prospective observational study [45]. CAN prevalence data were presented for a total of 1730 participants with prediabetes, 1999 participants with NGT and 702 participants with predominantly type 2 diabetes.…”

Section: Study Characteristicsmentioning

confidence: 99%

“…CAN prevalence data were presented for a total of 1730 participants with prediabetes, 1999 participants with NGT and 702 participants with predominantly type 2 diabetes. The mean age of participants in the studies varied from 39 years to 65 years [25,[36][37][38][39][40][41][42][43][44][45]. In general, there was similar recruitment of participants based on sex.…”

Section: Study Characteristicsmentioning

confidence: 99%

“…CVD characteristics of the recruited participants varied between the selected studies. Five studies excluded participants suffering from ischaemic heart disease, [25,41,[43][44][45] five studies included participants with ischaemic heart disease [36][37][38][39]42] and one study did not specify [40].…”

Section: Study Characteristicsmentioning

confidence: 99%

“…CAN prevalence was reported for NGT groups in eight studies [25,36,[39][40][41][42][43][44] and for diabetes groups in ten studies [25,36,37,[40][41][42][43][44][45].…”

Section: Study Characteristicsmentioning

confidence: 99%

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The prevalence of cardiac autonomic neuropathy in prediabetes: a systematic review

et al. 2020

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Aims/hypothesis Cardiac autonomic neuropathy (CAN) is independently associated with silent myocardial ischaemia, major cardiovascular events, myocardial dysfunction and cardiovascular mortality. Several studies have highlighted the increased prevalence of CAN in prediabetes (impaired glucose tolerance and/or impaired fasting glucose). Considering the exponential rise of prediabetes, we aimed to determine the prevalence of CAN through a systematic literature review. Methods This systematic review was registered with PROSPERO (CRD42019125447). An electronic literature search was performed using MEDLINE, EMBASE, PubMed, Web of Science, Scopus and Cochrane databases. Published full text, English language articles that provide CAN prevalence data of studies in individuals with prediabetes and aged over 18 years were included. Prevalence data for normal glucose tolerance and diabetes were also extracted from the selected articles, if present. All articles were screened by two independent reviewers using a priori criteria. Methodological quality and risk of bias were evaluated using a critical appraisal tool. Results Database searches found 4500 articles; subsequently, 199 full text articles were screened, 11 of which fulfilled the inclusion criteria (4431 total participants, 1730 people with prediabetes, 1999 people with normal glucose tolerance [NGT] and 702 people with predominantly type 2 diabetes). Six of the selected studies reported definite CAN prevalence data (9–39%). Only a single large population-based study by Ziegler et al (KORA S4 study, 1332 participants) determined definite CAN based on two or more positive autonomic function tests (AFTs), with a mean prevalence of 9% in all prediabetes groups (isolated impaired glucose tolerance 5.9%; isolated impaired fasting glucose 8.1%; impaired fasting glucose plus impaired glucose tolerance 11.4%), which was higher than NGT (4.5%). This study is most likely to provide a reliable population-specific estimate of CAN in prediabetes. There was a higher than expected prevalence of CAN in prediabetes (9–38%) when compared with normal glucose tolerance (0–18%) within the same studies (n = 8). There was a wide prevalence of possible CAN based on one positive AFT (n = 5). There was heterogeneity between the studies with variations in the definition of CAN, methodology and characteristics of the populations, which likely contributed to the diversity of prevalence estimates. The overall risk of bias was low. Conclusions/interpretation There is a higher than expected prevalence of CAN in prediabetes. Early detection of CAN in prediabetes through population screening needs careful consideration in view of the excess morbidity and mortality risk associated with this condition.

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Section: Study Characteristicsmentioning

confidence: 99%

Section: Study Characteristicsmentioning

confidence: 99%

Section: Study Characteristicsmentioning

confidence: 99%

Section: Study Characteristicsmentioning

confidence: 99%

“…CAN prevalence was reported for NGT groups in eight studies [25,36,[39][40][41][42][43][44] and for diabetes groups in ten studies [25,36,37,[40][41][42][43][44][45].…”

Section: Study Characteristicsmentioning

confidence: 99%

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The prevalence of cardiac autonomic neuropathy in prediabetes: a systematic review

et al. 2020

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Serum lipidomic determinants of human diabetic neuropathy in type 2 diabetes

Afshinnia

Reynolds

Rajendiran

et al. 2022

Ann Clin Transl Neurol

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Objective The serum lipidomic profile associated with neuropathy in type 2 diabetes is not well understood. Obesity and dyslipidemia are known neuropathy risk factors, suggesting lipid profiles early during type 2 diabetes may identify individuals who develop neuropathy later in the disease course. This retrospective cohort study examined lipidomic profiles 10 years prior to type 2 diabetic neuropathy assessment. Methods Participants comprised members of the Gila River Indian community with type 2 diabetes ( n = 69) with available stored serum samples and neuropathy assessment 10 years later using the combined Michigan Neuropathy Screening Instrument (MNSI) examination and questionnaire scores. A combined MNSI index was calculated from examination and questionnaire scores. Serum lipids (435 species from 18 classes) were quantified by mass spectrometry. Results The cohort included 17 males and 52 females with a mean age of 45 years (SD = 9 years). Participants were stratified as with (high MNSI index score > 2.5407) versus without neuropathy (low MNSI index score ≤ 2.5407). Significantly decreased medium‐chain acylcarnitines and increased total free fatty acids, independent of chain length and saturation, in serum at baseline associated with incident peripheral neuropathy at follow‐up, that is, participants had high MNSI index scores, independent of covariates. Participants with neuropathy also had decreased phosphatidylcholines and increased lysophosphatidylcholines at baseline, independent of chain length and saturation. The abundance of other lipid classes did not differ significantly by neuropathy status. Interpretation Abundance differences in circulating acylcarnitines, free fatty acids, phosphatidylcholines, and lysophosphatidylcholines 10 years prior to neuropathy assessment are associated with neuropathy status in type 2 diabetes.

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Association between brain health outcomes and metabolic risk factors in persons with diabetes

Reynolds,

Votruba,

Jack

et al. 2023

Ann Clin Transl Neurol

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We performed a cross‐sectional study to determine associations between cognition and MRI‐derived brain outcomes, with obesity, diabetes duration, and metabolic risk factors in 51 Pima American Indians with longstanding type 2 diabetes (T2d) (mean [SD] age: 48.4 [11.3] years, T2d duration: 20.1 [9.1] years). Participants had similar cognition (NIH Toolbox Cognition Battery composite: 45.3 [9.8], p = 0.64, n = 51) compared to normative data. T2d duration, but not other metabolic risk factors, associated with decreased cortical thickness (Point Estimate (PE): −0.0061, 95%CI: −0.0113, −0.0009, n = 45), gray matter volume (PE: −830.39, 95%CI: −1503.14, −157.64, n = 45), and increased white matter hyperintensity volume (PE: 0.0389, 95%CI: 0.0049, 0.0729, n = 45).

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The Prevalence and Determinants of Cognitive Deficits and Traditional Diabetic Complications in the Severely Obese

Cited by 40 publications

References 39 publications

The prevalence of cardiac autonomic neuropathy in prediabetes: a systematic review

The prevalence of cardiac autonomic neuropathy in prediabetes: a systematic review

Serum lipidomic determinants of human diabetic neuropathy in type 2 diabetes

Association between brain health outcomes and metabolic risk factors in persons with diabetes

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