Open Access2型糖尿病患者较高的细胞外水分/全身水分比值与认知功能下降有关
Author(s) -
Low Serena,
Ng Tze Pin,
Lim Chin Leong,
Ang Su Fen,
Moh Angela,
Wang Jiexun,
Yap Philip,
Cheong Chin Yee,
Goh Kiat Sern,
Ang Keven,
Tang Wern Ee,
Lim Ziliang,
Subramaniam Tavintharan,
Sum Chee Fang,
Lim Su Chi
Publication year - 2021
Publication title -
journal of diabetes
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.949
H-Index - 43
eISSN - 1753-0407
pISSN - 1753-0393
DOI - 10.1111/1753-0407.13104
Subject(s) - medicine , repeatable battery for the assessment of neuropsychological status , bioelectrical impedance analysis , diabetes mellitus , body water , type 2 diabetes , edema , cognition , endocrinology , body mass index , neuropsychology , psychiatry , body weight
Background Fluid imbalance is associated with various clinical conditions, but the association between elevated extracellular‐water to total‐body‐water (ECW/TBW) ratio, an indicator of fluid balance, and cognitive impairment is unknown. We aimed to investigate relationship between ECW/TBW ratio and cognitive function in type 2 diabetes mellitus. Methods This study was a cross‐sectional design, comparing 1233 patients aged 61.4 ± 8.0 years from the Singapore Study of Macro‐angiopathy and Micro‐vascular Reactivity in Type 2 Diabetes (SMART2D) cohort. ECW/TBW was measured using bioelectrical impedance method. Cognitive function was assessed with Repeatable Battery for the Assessment of Neuropsychological Status (RBANS). Multiple linear regression was used to examine association between ECW/TBW and RBANS scores, adjusting for demographics, education, clinical covariates, and apolipoprotein E allele. Results In unadjusted analyses, there was an inverse dose‐dependent association between ECW/TBW and RBANS total score. The associations persisted in fully adjusted model with β = −1.18 (95% confidence interval [CI] −2.19 to −0.17; P = 0.022) for slight edema and −2.33 (−3.99 to −0.67; P = 0.006) for edema. Slight edema and edema were significantly associated with reduced cognitive function in delayed memory and attention. There was significant association between edema but not slight edema, with reduced cognitive function in language. Pulse pressure accounted for 16.8% of association between ECW/TBW and RBANS total score. Conclusions Our novel finding of an independent association between higher ECW/TBW and poorer cognitive function highlights the potential importance of maintaining body fluid balance in the management of cognitive impairment.