Association of N-Terminal Pro-Brain Natriuretic Peptide with Cognitive Function and Depression in Elderly People with Type 2 Diabetes

Type 2 diabetes mellitus is associated with risk of congestive heart failure (CHF), cognitive dysfunction and depression. CHF itself is linked both to poor cognition and depression. The ventricular N-terminal pro-brain natriuretic peptide (NT-proBNP) is a marker of CHF, suggesting potential as a mar...

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Veröffentlicht in:PloS one Jg. 7; H. 9; S. e44569
Hauptverfasser: Feinkohl, Insa, Sattar, Naveed, Welsh, Paul, Reynolds, Rebecca M., Deary, Ian J., Strachan, Mark W. J., Price, Jackie F.
Format: Journal Article
Sprache:Englisch
Veröffentlicht: United States Public Library of Science 04.09.2012
Public Library of Science (PLoS)
Schlagworte:
Aged
Analysis
Ankle
Anxiety
Atherosclerosis
Blood Pressure
Body Mass Index
Brain
Brain natriuretic peptide
Brain research
Cardiovascular disease
Cholesterol - blood
Cognition
Cognition & reasoning
Cognition - physiology
Cognitive ability
Cognitive disorders
Congestive heart failure
Cross-Sectional Studies
Dementia
Depression (Mood disorder)
Depression - complications
Depression - metabolism
Diabetes
Diabetes mellitus
Diabetes mellitus (non-insulin dependent)
Diabetes Mellitus, Type 2 - complications
Ethics
Female
Geriatrics
Health risks
Heart failure
Heart Failure - complications
Heart Failure - metabolism
Hospitals
Humans
Impairment
Intelligence
Male
Medicine
Memory
Mental depression
Middle Aged
Natriuretic Peptide, Brain - blood
Natriuretic peptides
Neuropsychological Tests
Older people
Peptide Fragments - blood
Peptides
Psychological aspects
Risk analysis
Risk factors
Statistical analysis
Systematic review
Type 2 diabetes
Ventricle
United Kingdom > UK
Scotland
Edinburgh Scotland
ISSN:1932-6203, 1932-6203
Online-Zugang:Volltext
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Zusammenfassung:Type 2 diabetes mellitus is associated with risk of congestive heart failure (CHF), cognitive dysfunction and depression. CHF itself is linked both to poor cognition and depression. The ventricular N-terminal pro-brain natriuretic peptide (NT-proBNP) is a marker of CHF, suggesting potential as a marker for cognitive impairment and/or depression. This was tested in the Edinburgh Type 2 Diabetes Study (ET2DS). Cross-sectional analysis of 1066 men and women aged 60-75 with type 2 diabetes. Results from seven neuropsychological tests were combined in a standardised general cognitive ability factor, 'g'. A vocabulary-based test estimated pre-morbid cognitive ability. The Hospital Anxiety and Depression Scale (HADS) assessed possible depression. After adjustment for age and sex, raised plasma NT-proBNP was weakly associated with lower 'g' and higher depression scores (ß -0.09, 95% CI -0.13 to -0.03, p = 0.004 and ß 0.08, 95% CI 0.04 to 0.12, p<0.001, respectively). Comparing extreme quintiles of NT-proBNP, subjects in the highest quintile were more likely to have reduced cognitive ability (within the lowest tertile of 'g') and 'possible' depression (HADS depression ≥8) (OR 1.80; 95% CI: 1.20, 2.70; p = 0.005 and OR 2.18; 95% CI: 1.28, 3.71; p = 0.004, respectively). Associations persisted when pre-morbid ability was adjusted for, but as expected were no longer statistically significant following the adjustment for diabetes-related and vascular co-variates (β -0.02, 95% CI -0.07 to 0.03, p>0.05 for 'g'; β 0.03, 95% CI -0.02 to 0.07, p>0.05 for depression scores). Raised plasma NT-proBNP was weakly but statistically significantly associated with poorer cognitive function and depression. The prospective phases of the ET2DS will help determine whether or not NT-proBNP can be considered a risk marker for subsequent cognitive impairment and incident depression and whether it provides additional information over and above traditional risk factors for these conditions.
Bibliographie:ObjectType-Article-1
SourceType-Scholarly Journals-1
ObjectType-Feature-2
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Competing Interests: The ET2DS is co-funded by Pfizer plc. This does not alter the authors' adherence to all the PLoS ONE policies on sharing data and materials.
Conceived and designed the experiments: JFP MWJS. Performed the experiments: IJD NS PW RMR. Analyzed the data: IF. Wrote the paper: IF NS PW RMR IJD MWJS JFP.
ISSN:1932-6203
1932-6203
DOI:10.1371/journal.pone.0044569