Metformin, Lifestyle Intervention, and Cognition in the Diabetes Prevention Program Outcomes Study

Autor: Karol E. Watson, F. Xavier Pi-Sunyer, Hermes Florez, Jill P. Crandall, Yong Ma, Helen P. Hazuda, José A. Luchsinger, Susan Jeffries, Sherita Hill Golden, Elizabeth M. Venditti, Costas A. Christophi, Jennifer J. Manly
Rok vydání: 2016
Předmět:
Research design
Blood Glucose
Male
medicine.medical_specialty
endocrine system diseases
Endocrinology
Diabetes and Metabolism
030209 endocrinology & metabolism
Type 2 diabetes
Placebo
Verbal learning
Polymorphism
Single Nucleotide
law.invention
03 medical and health sciences
0302 clinical medicine
Cognition
Randomized controlled trial
law
Internal medicine
Diabetes mellitus
Internal Medicine
medicine
Ethnicity
Humans
Hypoglycemic Agents
Pathophysiology/Complications
Life Style
Triglycerides
Aged
Advanced and Specialized Nursing
Glycated Hemoglobin
business.industry
nutritional and metabolic diseases
Middle Aged
medicine.disease
Metformin
Cholesterol
Treatment Outcome
Diabetes Mellitus
Type 2
Digit symbol substitution test
Female
business
030217 neurology & neurosurgery
medicine.drug
Follow-Up Studies
Zdroj: Diabetes Care
ISSN: 1935-5548
Popis: OBJECTIVE We examined the association of the Diabetes Prevention Program (DPP) intervention arms (lifestyle intervention, metformin, and placebo) with cognition in the Diabetes Prevention Program Outcomes Study (DPPOS). We also examined metformin use, incident type 2 diabetes, and glycemia as exposures. RESEARCH DESIGN AND METHODS The DPP lasted 2.8 years, followed by a 13-month bridge to DPPOS. Cognition was assessed in DPPOS years 8 and 10 (12 and 14 years after randomization) with the Spanish English Verbal Learning Test (SEVLT), letter fluency and animal fluency tests, Digit Symbol Substitution Test (DSST), and a composite cognitive score. RESULTS A total of 2,280 participants (749 lifestyle, 776 metformin, and 755 placebo) aged 63.1 ± 10.7 years underwent cognitive assessments; 67.7% women, 54.6% non-Hispanic white, 20.7% non-Hispanic black, 14.6% Hispanic, 5.5% American Indian, and 4.6% Asian; 26.6% were homozygous or heterozygous for APOE-ε4. At the time of cognitive assessment, type 2 diabetes was higher in the placebo group (57.9%; P < 0.001) compared with lifestyle (47.0%) and metformin (50.4%). Metformin exposure was higher in the metformin group (8.72 years; P < 0.001) compared with placebo (1.43 years) and lifestyle (0.96 years). There were no differences in cognition across intervention arms. Type 2 diabetes was not related to cognition, but higher glycated hemoglobin at year 8 was related to worse cognition after confounder adjustment. Cumulative metformin exposure was not related to cognition. CONCLUSIONS Exposure to intensive lifestyle intervention or metformin was not related to cognition among DPPOS participants. Higher glycemia was related to worse cognitive performance. Metformin seemed cognitively safe among DPPOS participants.
Databáze: OpenAIRE
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