The Role of Oxidative Stress and Inflammatory Markers in Cognitive Dysfunction in Diabetes Mellitus
Authors/Creators
- 1. Associate Professor, Department of Biochemistry, Government Medical College, Narsampet, Telangana
- 2. Associate Professor, Department of General Medicine, Government Medical College, Sangareddy, Telangana
- 3. Associate Professor, Department of Neurosurgery, Government Medical College, Nagarkurnool, Telangana
- 4. Bio-Tech solutions, Kurnool, Andhra Pradesh, India
- 5. Associate Professor, Department of Neurology, Government Medical College, Mahabubabad, Telangana
Description
Background: Cognitive decline is a significant complication observed in patients with diabetes mellitus, with increasing evidence pointing to the role of chronic systemic inflammation as a mediating factor. Elevated levels of inflammatory markers, including interleukin-6 (IL-6), tumor necrosis factor-alpha (TNF-α), and C-reactive protein (CRP), have been implicated in both diabetes-related metabolic dysfunction and neurodegenerative processes. This study aims to evaluate the association between inflammatory markers and cognitive decline in individuals with type 2 diabetes mellitus (T2DM). Objective: To assess the prevalence of cognitive impairment among individuals with T2DM and investigate its relationship with inflammatory markers such as IL-6, TNF-α, and CRP. Methods: A cross-sectional study was conducted at MGM Hospital, Warangal, Telangana, India, over a one-year period from January 2023 to December 2023. A total of 500 participants aged 50 years and above were enrolled, including 350 patients with T2DM and 150 non-diabetic controls. Cognitive function was assessed using the Mini-Mental State Examination (MMSE) and Montreal Cognitive Assessment (MoCA). Blood samples were collected to measure levels of IL-6, TNF-α, and CRP using enzyme-linked immunosorbent assay (ELISA). Anthropometric and clinical data, including HbA1c, fasting glucose, and lipid profiles, were also recorded. Statistical analysis included logistic regression to identify predictors of cognitive decline and correlation analysis to assess the relationship between inflammatory markers and cognitive scores. Results: The prevalence of cognitive decline was significantly higher in the diabetic group (48%) compared to non-diabetic controls (18%, p < 0.001). Among the diabetic group, elevated levels of IL-6 (mean ± SD: 8.5 ± 3.2 pg/mL), TNF-α (12.1 ± 4.5 pg/mL), and CRP (6.8 ± 2.3 mg/L) were observed compared to controls (IL-6: 4.2 ± 1.8 pg/mL; TNF-α: 6.3 ± 2.7 pg/mL; CRP: 3.1 ± 1.4 mg/L, all p < 0.001). Cognitive decline in T2DM patients was significantly associated with higher IL-6 (OR: 2.45, 95% CI: 1.73–3.47, p < 0.001), TNF-α (OR: 2.18, 95% CI: 1.54–3.10, p < 0.001), and CRP (OR: 1.92, 95% CI: 1.39–2.66, p < 0.001). HbA1c levels were also significantly higher in participants with cognitive decline (8.6 ± 1.2%) compared to those without (7.4 ± 0.9%, p < 0.001). Correlation analysis showed a strong negative association between inflammatory marker levels and cognitive scores (IL-6: r = -0.42, p < 0.001; TNF-α: r = -0.39, p < 0.001; CRP: r = -0.35, p < 0.001). Additionally, dyslipidemia and longer diabetes duration (>10 years) were found to exacerbate cognitive impairment. Conclusion: This study highlights a significant association between elevated inflammatory markers and cognitive decline in patients with T2DM. The findings emphasize the importance of monitoring inflammatory markers in diabetic individuals as potential predictors of cognitive impairment. Future research should explore targeted anti-inflammatory interventions to mitigate cognitive decline in this population.
Abstract (English)
Background: Cognitive decline is a significant complication observed in patients with diabetes mellitus, with increasing evidence pointing to the role of chronic systemic inflammation as a mediating factor. Elevated levels of inflammatory markers, including interleukin-6 (IL-6), tumor necrosis factor-alpha (TNF-α), and C-reactive protein (CRP), have been implicated in both diabetes-related metabolic dysfunction and neurodegenerative processes. This study aims to evaluate the association between inflammatory markers and cognitive decline in individuals with type 2 diabetes mellitus (T2DM). Objective: To assess the prevalence of cognitive impairment among individuals with T2DM and investigate its relationship with inflammatory markers such as IL-6, TNF-α, and CRP. Methods: A cross-sectional study was conducted at MGM Hospital, Warangal, Telangana, India, over a one-year period from January 2023 to December 2023. A total of 500 participants aged 50 years and above were enrolled, including 350 patients with T2DM and 150 non-diabetic controls. Cognitive function was assessed using the Mini-Mental State Examination (MMSE) and Montreal Cognitive Assessment (MoCA). Blood samples were collected to measure levels of IL-6, TNF-α, and CRP using enzyme-linked immunosorbent assay (ELISA). Anthropometric and clinical data, including HbA1c, fasting glucose, and lipid profiles, were also recorded. Statistical analysis included logistic regression to identify predictors of cognitive decline and correlation analysis to assess the relationship between inflammatory markers and cognitive scores. Results: The prevalence of cognitive decline was significantly higher in the diabetic group (48%) compared to non-diabetic controls (18%, p < 0.001). Among the diabetic group, elevated levels of IL-6 (mean ± SD: 8.5 ± 3.2 pg/mL), TNF-α (12.1 ± 4.5 pg/mL), and CRP (6.8 ± 2.3 mg/L) were observed compared to controls (IL-6: 4.2 ± 1.8 pg/mL; TNF-α: 6.3 ± 2.7 pg/mL; CRP: 3.1 ± 1.4 mg/L, all p < 0.001). Cognitive decline in T2DM patients was significantly associated with higher IL-6 (OR: 2.45, 95% CI: 1.73–3.47, p < 0.001), TNF-α (OR: 2.18, 95% CI: 1.54–3.10, p < 0.001), and CRP (OR: 1.92, 95% CI: 1.39–2.66, p < 0.001). HbA1c levels were also significantly higher in participants with cognitive decline (8.6 ± 1.2%) compared to those without (7.4 ± 0.9%, p < 0.001). Correlation analysis showed a strong negative association between inflammatory marker levels and cognitive scores (IL-6: r = -0.42, p < 0.001; TNF-α: r = -0.39, p < 0.001; CRP: r = -0.35, p < 0.001). Additionally, dyslipidemia and longer diabetes duration (>10 years) were found to exacerbate cognitive impairment. Conclusion: This study highlights a significant association between elevated inflammatory markers and cognitive decline in patients with T2DM. The findings emphasize the importance of monitoring inflammatory markers in diabetic individuals as potential predictors of cognitive impairment. Future research should explore targeted anti-inflammatory interventions to mitigate cognitive decline in this population.
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Additional details
Dates
- Accepted
-
2024-07-23
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References
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