Memory function decline among Nigerian type 2 diabetic patients: Preliminary results from an ongoing multi-centre case control study

IF 13 1区医学 Q1 CLINICAL NEUROLOGY Alzheimer's & Dementia Pub Date : 2025-01-09 DOI:10.1002/alz.085483

Juliet Nnenda Olayinka, Emmanuel Irek, Olusegun Adebayo Adeoluwa, Okechukwu Ezekpo, Benjamin Omiyale, Oluwafemi Ogunniyi, Idowu Adarabioyo, Olakunle Aberejo, Lily Otomewo, Oluwaseyi Akpor, Raymond Ozolua

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Abstract

Background

Type 2 diabetes mellitus (T2DM) is among the modifiable risk factors for Alzheimer's disease (AD) and ranks among the leading chronic diseases globally. It is characterized by elevated blood glucose levels and insulin resistance, which over time may impair memory performance. More so, saliva appears to be a promising biomarker for the diagnosis of AD since conventional methods appear invasive and expensive in the country. Therefore, we investigated the impact of T2DM on memory function in diabetic patients at the Afe Babalola Multisystem Hospital, Nigeria and also determined if saliva may be a reliable diagnostic tool to detect the risk of AD in diabetic patients.

Method

Sixty (60) subjects, consisting of 20 diabetic patients and 40 healthy controls who consented to the study were recruited. A mini-mental state examination (MMSE) was used to assess the participants’ memory performance. Blood samples were collected from the subjects to estimate biochemical parameters, which include: fasting blood glucose, insulin levels, glycated hemoglobin levels oxidative stress markers (malondialdehyde (MDA), sodium dismutase (SOD), and reduced glutathione (GSH)), as well as inflammatory markers (interleukin-6 (IL-6) and tumor necrosis factor-alpha (TNF-α)). Saliva was collected to estimate the level of amyloid beta-42 (Aβ-42). All these parameters were analyzed using enzyme-linked immunosorbent assay.

Result

There were significant differences (p<0.05) between the values for glucose, insulin, Aβ-42, SOD, GSH, MDA, TNF-α, IL-6 amongst diabetic and healthy controls. The MMSE result on severity of cognitive impairment showed that 14 (70%) diabetic patients between the scores of 24 and 30 suffer no cognitive impairment, 4 (20%) diabetic patients within the score of 18–23 have mild cognitive impairment, and 2 (10%) diabetic patients between the scores of 0 and 17 suffer severe cognitive impairment in comparison to the healthy control, who suffered no cognitive impairment.

Conclusion

Our results show that T2DM may impair memory performance later in life and that oxidative stress, insulin resistance, elevated levels of Aβ42, increased glycated hemoglobin and inflammation may be implicated in this decline. This ongoing study also strongly suggests that saliva may be an effective and alternative method for the diagnosis of AD in diabetes patients.

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尼日利亚2型糖尿病患者的记忆功能下降：一项正在进行的多中心病例对照研究的初步结果

背景2型糖尿病（T2DM）是阿尔茨海默病（AD）的可改变危险因素之一，是全球领先的慢性疾病之一。它的特点是血糖水平升高和胰岛素抵抗，随着时间的推移可能会损害记忆力。更重要的是，唾液似乎是一种很有前途的诊断阿尔茨海默病的生物标志物，因为传统的方法在国内显得侵入性和昂贵。因此，我们在尼日利亚Afe Babalola多系统医院调查了T2DM对糖尿病患者记忆功能的影响，并确定唾液是否可以作为检测糖尿病患者AD风险的可靠诊断工具。方法招募60名受试者，包括20名糖尿病患者和40名健康对照者。小心理状态测试（MMSE）用于评估参与者的记忆表现。收集受试者的血液样本以估计生化参数，包括：空腹血糖、胰岛素水平、糖化血红蛋白水平、氧化应激标志物（丙二醛（MDA）、歧化酶钠（SOD）和还原型谷胱甘肽（GSH））以及炎症标志物（白细胞介素- 6 （IL - 6）和肿瘤坏死因子- α (TNF - α)）。收集唾液来评估β - 42淀粉样蛋白（Aβ - 42）的水平。所有参数均采用酶联免疫吸附法进行分析。结果糖尿病患者血糖、胰岛素、β - 42、SOD、GSH、MDA、TNF - α、IL - 6与健康对照组比较，差异均有统计学意义（p < 0.05）。认知障碍严重程度的MMSE结果显示，与健康对照组相比，24 ~ 30分之间的糖尿病患者无认知障碍14例（70%），18 ~ 23分之间的糖尿病患者轻度认知障碍4例（20%），0 ~ 17分之间的糖尿病患者重度认知障碍2例（10%），健康对照组无认知障碍。我们的研究结果表明，T2DM可能会损害生命后期的记忆表现，氧化应激、胰岛素抵抗、Aβ42水平升高、糖化血红蛋白升高和炎症可能与这种下降有关。这项正在进行的研究也强烈表明，唾液可能是诊断糖尿病患者AD的一种有效的替代方法。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Alzheimer's & Dementia 医学-临床神经学

CiteScore

14.50

自引率

5.00%

发文量

299

审稿时长

3 months

期刊介绍： Alzheimer's & Dementia is a peer-reviewed journal that aims to bridge knowledge gaps in dementia research by covering the entire spectrum, from basic science to clinical trials to social and behavioral investigations. It provides a platform for rapid communication of new findings and ideas, optimal translation of research into practical applications, increasing knowledge across diverse disciplines for early detection, diagnosis, and intervention, and identifying promising new research directions. In July 2008, Alzheimer's & Dementia was accepted for indexing by MEDLINE, recognizing its scientific merit and contribution to Alzheimer's research.