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Associations of insulin resistance with cognition in individuals without diagnosed diabetes: Results from the Hispanic Community Health Study/Study of Latinos.

TitleAssociations of insulin resistance with cognition in individuals without diagnosed diabetes: Results from the Hispanic Community Health Study/Study of Latinos.
Publication TypePublication
Year2019
AuthorsGonzales MM, Durazo-Arvizu RA, Sachdeva S, Unterman TG, O'Brien MJ, Gallo LC, Talavera GA, Kaplan RC, Cai J, Schneiderman N, Giacinto RAEspinoza, González HM, Daviglus ML, Lamar M
JournalDiabetes Res Clin Pract
Volume150
Pagination38-47
Date Published2019 Apr
ISSN1872-8227
KeywordsAdolescent, Adult, Aged, Cognition Disorders, Community Health Services, Diabetes Mellitus, Female, Hispanic Americans, Humans, Hyperinsulinism, insulin resistance, Male, Middle Aged, Prognosis, Prospective Studies, Young Adult
Abstract

AIMS: Insulin resistance (IR) adversely impacts memory and executive functioning in non-Hispanic whites without diabetes. Less is known in Hispanics/Latinos, despite the fact that Hispanics/Latinos have higher rates of insulin resistance than non-Hispanic whites. We investigated the association between IR and cognition and its variation by age.METHODS: Data from 5987 participants 45-74 years old without diabetes from the Hispanic Community Health Study/Study of Latinos. IR was considered continuously using homeostasis model assessment for insulin resistance (HOMA-IR) and also dichotomized based on clinically relevant thresholds for hyperinsulinemia (fasting insulin > 84.73 pmol/L or HOMA-IR > 2.6) and sample-based norms (75th percentile of fasting insulin or HOMA-IR). Cognitive testing included the Brief Spanish English Verbal Learning Test (B-SEVLT), Verbal Fluency, and Digit Symbol Substitution.RESULTS: There was 90% overlap in participant categorization comparing clinically relevant and sample-based thresholds. In separate fully-adjusted linear regression models, age modified the association between HOMA-IR and Digit Symbol Substitution (p = 0.02); advancing age combined with higher HOMA-IR levels resulted in higher scores. Age also modified the association between clinically relevant hyperinsulinemia and B-SEVLT recall (p = 0.03); with increasing age came worse performance for individuals with hyperinsulinemia.CONCLUSION: The relationship of IR with cognition in Hispanics/Latinos without diabetes may reflect an age- and test-dependent state.

DOI10.1016/j.diabres.2019.01.030
Alternate JournalDiabetes Res Clin Pract
PubMed ID30779969
PubMed Central IDPMC7236611
Grant ListN01HC65235 / HL / NHLBI NIH HHS / United States
N01HC65234 / HL / NHLBI NIH HHS / United States
N01 HC065235 / HC / NHLBI NIH HHS / United States
N01HC65237 / HL / NHLBI NIH HHS / United States
N01 HC065236 / HC / NHLBI NIH HHS / United States
K01 AG040192 / AG / NIA NIH HHS / United States
N01HC65236 / HL / NHLBI NIH HHS / United States
P30 DK111022 / DK / NIDDK NIH HHS / United States
N01HC65233 / HL / NHLBI NIH HHS / United States
N01 HC065234 / HC / NHLBI NIH HHS / United States
N01 HC065237 / HC / NHLBI NIH HHS / United States
MS#: 
0478
Manuscript Lead/Corresponding Author Affiliation: 
Field Center: Chicago (University of Illinois at Chicago)
ECI: 
Yes
Manuscript Affiliation: 
Field Center: Chicago (University of Illinois at Chicago)
Manuscript Status: 
Published