Cognitive decline in elderly patients with type 2 diabetes is associated with glycated albumin, ratio of Glycated Albumin to glycated hemoglobin, and concentrations of inflammatory and oxidative stress markers

OBJECTIVE: To investigate the correlations of cognitive function with glycated albumin (GA), the ratio of GA to glycated hemoglobin (GA/HbA(1c)), and the concentrations of interleukin-6 (IL-6) and superoxide dismutase (SOD) in elderly patients with type 2 diabetes mellitus (T2DM). METHODS: A total of 44 elderly T2DM patients were evaluated for cognitive function using the mini-mental state examination (MMSE) and the Montreal cognitive assessment (MoCA). Patients were then divided into two groups based on the MMSE and MoCA scores: a cognitive dysfunction group and a normal cognitive function group. The correlations of the MMSE and MoCA scores with GA/HbA(1c), GA, IL-6, and SOD were analyzed. Logistic regression analysis was used to identify independent influential factors for cognitive dysfunction. The predictive value of GA and GA/HbA(1c) for cognitive dysfunction in elderly T2DM patients was evaluated by receiver operating characteristic (ROC) curve analysis. RESULTS: Among these patients, 28 had cognitive impairment. They had significantly higher GA/HbA(1c), increased GA and IL-6 levels, and lower SOD concentrations than the normal cognitive function group (all P < 0.05). GA/HbA(1c) was negatively correlated with the MMSE (r = −0.430, P = 0.007) and MoCA (r = −0.432, P = 0.007) scores. SOD was positively correlated with the MMSE (r = 0.585, P=0.014) and MoCA (r = 0.635, P=0.006) scores. IL-6 was negatively correlated with the MoCA score (r = −0.421, P=0.015). Age and GA/HbA(1c) were independent factors contributing to cognitive dysfunction. The areas under the ROC curves of GA and GA/HbA(1c) for the diagnosis of cognitive dysfunction were 0.712 and 0.720, respectively. CONCLUSIONS: GA and GA/HbA(1c) are related to cognitive dysfunction in elderly patients with T2DM.