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      Relationship between inflammatory markers and mild cognitive impairment in Chinese patients with type 2 diabetes: a case-control study

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          Abstract

          Background

          Several studies have indicated that inflammatory markers were associated with the risk of mild cognitive impairment (MCI) in type 2 diabetes (T2D). Serum folate was related to MCI as well as inflammation. However, no studies have investigated the association between inflammatory markers and MCI taking account of serum folate level in T2D patients. This study aimed to conduct a case-control study to evaluate the association between inflammatory markers and MCI taking account of serum folate level in Chinese patients with T2D.

          Methods

          This study consisted of 126 T2D patients (63 cases with MCI and 63 controls without MCI). Clinical parameters, serum folate, high-sensitivity C-reactive protein (hs-CRP), interleukin-6 (IL-6), tumor necrosis factor-α (TNF-α) were measured. Spearman correlation analysis and logistic regression analysis were used to analyze the association between the inflammatory markers and the risk of MCI in T2D patients.

          Results

          There were higher serum hs-CRP, IL-6 and TNF-α in T2D cases with MCI compared with the controls. Serum folate was negatively correlated with hs-CRP, TNF-α, and IL-6 ( P < 0.05). In multivariate analysis, there were significant associations between serum IL-6 or hs-CRP and MCI after adjusting for the confounding variables, however, the association between hs-CRP and MCI disappeared after further adjusting for serum folate. Further subgroup analysis revealed that the significant association between hs-CRP and MCI only existed in the low folate subgroup (< 7.0 μg/L; OR = 3.34, 95% CI: 1.05–10.64), not in the high folate subgroup (≥7.0 μg/L; OR = 2.16, 95% CI: 0.68–6.88) after adjusting for the confounding variables.

          Conclusions

          Serum IL-6 and hs-CRP were associated with the risk of MCI in Chinese patients with T2D. Serum folate might modify the association between serum hs-CRP and MCI in T2D patients.

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          Most cited references34

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          Evaluation and management of chronic kidney disease: synopsis of the kidney disease: improving global outcomes 2012 clinical practice guideline.

          The Kidney Disease: Improving Global Outcomes (KDIGO) organization developed clinical practice guidelines in 2012 to provide guidance on the evaluation, management, and treatment of chronic kidney disease (CKD) in adults and children who are not receiving renal replacement therapy. The KDIGO CKD Guideline Development Work Group defined the scope of the guideline, gathered evidence, determined topics for systematic review, and graded the quality of evidence that had been summarized by an evidence review team. Searches of the English-language literature were conducted through November 2012. Final modification of the guidelines was informed by the KDIGO Board of Directors and a public review process involving registered stakeholders. The full guideline included 110 recommendations. This synopsis focuses on 10 key recommendations pertinent to definition, classification, monitoring, and management of CKD in adults.
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            Meta-analysis of Alzheimer's disease risk with obesity, diabetes, and related disorders.

            Late-onset Alzheimer's disease (AD) is a multifactorial and heterogeneous disorder with major risk factors including advanced age, presence of an apolipoprotein E epsilon4 (APOE4) allele, and family history of AD. Other risk factors may be obesity and diabetes and related disorders, which are highly prevalent. We reviewed longitudinal epidemiological studies of body mass, diabetes, metabolic syndrome, and glucose and insulin levels on risk for AD. We conducted meta-analyses of the results from these studies. For obesity assessed by body mass index, the pooled effect size for AD was 1.59 (95% confidence interval [CI] 1.02-2.5; z = 2.0; p = .042), and for diabetes, the pooled effect size for AD was 1.54 (95% CI 1.33-1.79; z = 5.7; p < .001). Egger's test did not find significant evidence for publication bias in the meta-analysis for obesity (t = -1.4, p = .21) or for diabetes (t = -.86, p = .42). Since these disorders are highly comorbid, we conducted a meta-analysis combining all studies of obesity, diabetes, and abnormal glucose or insulin levels, which yielded a highly significant pooled effect size for AD of 1.63 (95% CI 1.39-1.92; z = 5.9; p < .001). Obesity and diabetes significantly and independently increase risk for AD. Though the level of risk is less than that with the APOE4 allele, the high prevalence of these disorders may result in substantial increases in future incidence of AD. Physiological changes common to obesity and diabetes plausibly promote AD. Published by Elsevier Inc.
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                Author and article information

                Contributors
                myzheng73@163.com
                changbc1970@126.com
                defjmmm@163.com
                chunyanshan@hotmail.com
                602090529@qq.com
                gaoyuxia@medmail.com.cn
                tjgwhuang@126.com
                zhangmeilin@tmu.edu.cn
                Journal
                BMC Endocr Disord
                BMC Endocr Disord
                BMC Endocrine Disorders
                BioMed Central (London )
                1472-6823
                11 July 2019
                11 July 2019
                2019
                : 19
                : 73
                Affiliations
                [1 ]ISNI 0000 0000 9792 1228, GRID grid.265021.2, NHC Key Laboratory of Hormones and Development, Tianjin Key Laboratory of Metabolic Diseases, Metabolic Diseases Hospital & Institute of Endocrinology, , Tianjin Medical University, ; Tianjin, China
                [2 ]GRID grid.417020.0, Department of Clinical Laboratory, , Tianjin Chest Hospital, ; Tianjin, China
                [3 ]ISNI 0000 0000 9792 1228, GRID grid.265021.2, School of Nursing, , Tianjin Medical University, ; Tianjin, China
                [4 ]ISNI 0000 0004 1757 9434, GRID grid.412645.0, Department of Cardiology, , Tianjin Medical University General Hospital, ; Tianjin, China
                [5 ]ISNI 0000 0000 9792 1228, GRID grid.265021.2, Department of Nutrition and Food Science, School of Public Health, , Tianjin Medical University, ; Tianjin, China
                [6 ]Tianjin Key Laboratory of Environment, Nutrition and Public Health, Tianjin, China
                [7 ]Center for International Collaborative Research on Environment, Nutrition and Public Health, Tianjin, China
                Article
                402
                10.1186/s12902-019-0402-3
                6624933
                31296192
                20cf9936-210d-41d7-b999-30e5656de8eb
                © The Author(s). 2019

                Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

                History
                : 10 January 2019
                : 25 June 2019
                Funding
                Funded by: FundRef http://dx.doi.org/10.13039/501100001809, National Natural Science Foundation of China;
                Award ID: 81730091
                Award ID: 81502809
                Award Recipient :
                Categories
                Research Article
                Custom metadata
                © The Author(s) 2019

                Endocrinology & Diabetes
                type 2 diabetes,mild cognitive impairment,inflammation,folate,high-sensitivity c-reactive protein

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