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Diabetologia. 2015 Nov;58(11):2545-53. doi: 10.1007/s00125-015-3715-4. Epub 2015 Aug 15.

Insulin resistance is associated with poorer verbal fluency performance in women.

Author information

1
Turku PET Centre, University of Turku and Turku University Hospital, P.O. Box 52, 20521, Turku, Finland. llekbl@utu.fi.
2
Turku Health Care Centre, Turku, Finland. llekbl@utu.fi.
3
Turku PET Centre, University of Turku and Turku University Hospital, P.O. Box 52, 20521, Turku, Finland.
4
Division of Clinical Neurosciences, Turku University Hospital, Turku, Finland.
5
National Institute for Health and Welfare (THL), Turku, Finland.
6
Turku City Hospital, University of Turku, Turku, Finland.
7
Department of Medicine, University of Turku, Turku, Finland.
8
University of Eastern Finland, Kuopio, Finland.
9
Clinical Geriatrics, Karolinska Institutet, Karolinska University Hospital, Huddinge, Sweden.

Abstract

AIMS/HYPOTHESIS:

Type 2 diabetes is an independent risk factor for cognitive decline. Insulin resistance occurring during midlife may increase the risk of cognitive decline later in life. We hypothesised that insulin resistance is associated with poorer cognitive performance and that sex and APOE*E4 might modulate this association.

METHODS:

The association of insulin resistance and APOE*E4 genotype on cognitive function was evaluated in a nationwide Finnish population-based study (n = 5,935, mean age 52.5 years, range 30-97 years). HOMA-IR was used to measure insulin resistance. Cognitive function was tested by word-list learning, word-list delayed-recall, categorical verbal fluency and simple and visual-choice reaction-time tests. Linear regression analysis was used to determine the association between HOMA-IR and the results of the cognitive tests.

RESULTS:

Higher HOMA-IR was associated with poorer verbal fluency in women (p < 0.0001) but not in men (p = 0.56). Higher HOMA-IR was also associated with poorer verbal fluency in APOE*E4 -negative individuals (p = 0.0003), but not in APOE*E4 carriers (p = 0.28). Furthermore, higher HOMA-IR was associated with a slower simple reaction time in the whole study group (p = 0.02).

CONCLUSIONS/INTERPRETATION:

To our knowledge, this is the first comprehensive, population-based study, including both young and middle-aged adults, to report that female sex impacts the association of HOMA-IR with verbal fluency. Our study was cross-sectional, so causal effects of HOMA-IR on cognition could not be evaluated. However, our results suggest that HOMA-IR could be an early marker for an increased risk of cognitive decline in women.

KEYWORDS:

APOE*E4 genotype; Alzheimer’s disease; Categorical verbal fluency; Cognition; HOMA-IR; Insulin resistance; Sex difference

PMID:
26276262
DOI:
10.1007/s00125-015-3715-4
[Indexed for MEDLINE]

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