Association between Leptin/Adiponectin Ratio and Type 2 Diabetes Mellitus with Mild Cognitive Impairment

Abstract

Objective: To explore the association between leptin/adiponectin (L/A) ratio and type 2 diabetes mellitus (T2DM) with mild cognitive impairment (MCI).

Methods: We enrolled 30 T2DM patients in Endocrinology Department of the First Affiliated Hospital of Anhui Medical University from March to July in 2016 as T2DM group, 30 T2DM patients with macroangiopathy as T2DM+V group and 30 T2DM patients with obesity as T2DM+OB group, another 30 healthy individuals who received physical examination as control group. We compared the obtained clinical data (gender, age, years of education, height, weight, BMI, waistline, hip circumference, waist-to-hip ratio (WHR), systolic blood pressure (SBP) and diastolic blood pressure (DBP)) and results of laboratory testing (fasting blood glucose (FBG), total cholesterol (TC), triacylglycerol (TG), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), very low-density lipoprotein cholesterol (VLDL-C), HbA1c, serum creatinine (Scr), urea nitrogen (BUN), LEP, APN and L/A ratio) among the four groups. We evaluated cognitive function of the four groups with the Montreal Cognitive Assessment (MoCA) (MoCA score ＜26 points was defined as MCI). Pearson correlation analysis and multivariable linear regression analysis were used to study the factors related to MoCA score.

Results: The differences in weight, BMI, waistline, hip circumference, WHR, SBP, DBP, FBG, TG, HDL-C, VLDL-C, HbA1c, BUN, LEP, APN, L/A ratio among the four groups were statistically significant (P＜0.05). The differences in MoCA score and positive rate of MCI among the four groups were statistically significant (P＜0.05); MoCA score in T2DM group, T2DM+V group, T2DM+OB group was lower than that in control group (P＜0.05); positive rate of MCI in T2DM+V group, T2DM+OB group was higher than that in control group (P＜0.007). Pearson correlation analysis showed that MoCA score was positively correlated with years of education (r=0.532, P＜0.001) and APN (r=0.652, P＜0.001) while negatively correlated with BMI (r=-0.192, P=0.035), waistline (r=-0.182, P=0.046), hip circumference (r=-0.184, P=0.045), FBG (r=-0.297, P=0.001), HbA1c (r=-0.297, P=0.001), LEP (r=-0.722, P＜0.001) and L/A ratio (r=-0.793, P＜0.001). The results of multivariable linear regression analysis demonstrated that MoCA score was positively correlated with years of education (β=0.197, 95%CI (0.109, 0.284), P＜0.001), while negatively correlated with L/A ratio (β=-2.532, 95%CI (-2.966, -2.099), P＜0.001).

Conclusion: Macroangiopathy and obesity may be the risk factors aggravating the severity of MCI. L/A ratio may become a new pre-clinical sign of T2DM patients with MCI, which is of important reference significance in the early detection and prevention of MCI.