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Biomarkers of Renal Function and Cognitive Impairment in Patients With Diabetes
Oleh:
Murray, Anne M.
;
Barzilay, Joshua I.
;
Lovato, James F.
;
Williamson, Jeff D.
Jenis:
Article from Journal - ilmiah internasional
Dalam koleksi:
Diabetes Care vol. 34 no. 08 (Aug. 2011)
,
page 1827-1832 .
Topik:
DIABETES
;
Control Cardiovascular Risk
;
Diabetes Memory
Ketersediaan
Perpustakaan FK
Nomor Panggil:
D05.K
Non-tandon:
1 (dapat dipinjam: 0)
Tandon:
tidak ada
Lihat Detail Induk
Isi artikel
OBJECTIVE Kidney disease is associated with cognitive impairment in studies of nondiabetic adults. We examined the cross-sectional relation between three measures of renal function and performance on four measures of cognitive function in the Action to Control Cardiovascular Risk in Diabetes Memory in Diabetes (ACCORD-MIND) study. RESEARCH DESIGN AND METHODS The relationships among estimated glomerular filtration rate (eGFR) <60 mL/min/1.73 m2 (n = 2,968), albumin/creatinine ratio (ACR) =30 µg/mg (n = 2,957), and cystatin C level >1.0 mg/L (n = 532) with tertile of performance on the Mini-Mental State Examination, Rey Auditory Verbal Learning Test (RAVLT), Digit Symbol Substitution Test (DSST), and Stroop Test of executive function were measured. RESULTS In adjusted logistic regression models, ACR =30 µg/mg was associated with performance in the lowest tertile, compared with the highest two tertiles, on the RAVLT (odds ratio 1.30, 95% CI 1.09–1.56, P = 0.006), equivalent to 3.6 years of aging, and on the DSST (1.47, 1.20–1.80, P = 0.001), equivalent to 3.7 years of aging. Cystatin C >1.0 mg/L was borderline associated with the lowest tertile on the DSST (1.81, 0.93–3.55, P = 0.08) and Stroop (1.78, 0.97–3.23, P = 0.06) in adjusted models. eGFR was not associated with any measure of cognitive performance. CONCLUSIONS In diabetic people with HbA1c >7.5% at high risk for cardiovascular disease, decreased cognitive function was associated with kidney disease as measured by ACR, a measure of microvascular endothelial pathology, and cystatin C, a marker of eGFR.
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