Inflammatory markers in type 2 diabetes with vs. without cognitive impairment; a systematic review and meta-analysis

置信区间 内科学 医学 痴呆 荟萃分析 2型糖尿病 糖尿病 严格标准化平均差 胃肠病学 2型糖尿病 C反应蛋白 认知障碍 炎症 疾病 内分泌学
作者
Natasha Z. Anita,Julia Zebarth,Brian Chan,Che‐Yuan Wu,Taha Syed,Dinie Shahrul,Michelle Nguyen,Maureen Pakosh,Nathan Herrmann,Krista L. Lanctôt,Walter Swardfager
出处
期刊:Brain Behavior and Immunity [Elsevier BV]
卷期号:100: 55-69 被引量:38
标识
DOI:10.1016/j.bbi.2021.11.005
摘要

People with type 2 diabetes mellitus (T2DM) are at increased risk of mild cognitive impairment and dementia. Systemic inflammation has been proposed as a common risk factor. This study aimed to summarize the clinical data pertaining to peripheral blood inflammatory markers. We identified original peer-reviewed articles reporting blood inflammatory marker concentrations in groups of people with a T2DM diagnosis who have cognitive impairment (CI; including mild cognitive impairment, Alzheimer’s disease, vascular cognitive impairment) vs. normal cognition (NC). Between-group standardized mean differences (SMD) were summarized in random effects meta-analyses. From 2108 records, data were combined quantitatively from 40 studies. Concentrations of interleukin-6 (IL-6; NCI/NNC = 934/3154, SMD 0.74 95% confidence interval [0.07, 1.42], Z5 = 2.15, p = 0.03; I2 = 98.08%), C-reactive protein (CRP; NCI/NNC = 1610/4363, SMD 0.80 [0.50, 1.11], Z14 = 5.25, p < 0.01; I2 = 94.59%), soluble vascular cell adhesion molecule-1 (sVCAM-1; NCI/NNC = 104/1063, SMD 1.64 95% confidence interval [0.21, 3.07], Z2 = 2.25, p = 0.02; I2 = 95.19%), and advanced glycation end products (AGEs; NCI/NNC = 227/317, SMD 0.84 95% confidence interval [0.41, 1.27], Z2 = 3.82, p < 0.01; I2 = 81.07%) were higher among CI groups compared to NC. Brain derived neurotropic factor (BDNF) concentrations were significantly lower in CI compared to NC (NCI/NNC = 848/2063, SMD −0.67 95% confidence interval [-0.99, −0.35], Z3 = -4.09, p < 0.01; I2 = 89.20%). Cognitive impairment among people with T2DM was associated with systemic inflammation and lower BDNF concentrations. These inflammatory characteristics support an increased inflammatory-vascular interaction associated with cognitive impairment in T2DM. PROSPERO (CRD42020188625).
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