Association of N-terminal pro-brain natriuretic peptide with cognitive function and depression in elderly people with type 2 diabetes.
<h4>Background</h4>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...
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| Format: | Article |
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Public Library of Science (PLoS)
2012-01-01
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| Series: | PLoS ONE |
| Online Access: | https://doi.org/10.1371/journal.pone.0044569 |
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| author | Insa Feinkohl Naveed Sattar Paul Welsh Rebecca M Reynolds Ian J Deary Mark W J Strachan Jackie F Price Edinburgh Type 2 Diabetes Study-ET2DS Investigators |
| author_facet | Insa Feinkohl Naveed Sattar Paul Welsh Rebecca M Reynolds Ian J Deary Mark W J Strachan Jackie F Price Edinburgh Type 2 Diabetes Study-ET2DS Investigators |
| author_sort | Insa Feinkohl |
| collection | DOAJ |
| description | <h4>Background</h4>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).<h4>Methodology and principal findings</h4>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).<h4>Conclusion</h4>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. |
| format | Article |
| id | doaj-art-2fc0d8defeaa4fc0b6ffae49c9cd869b |
| institution | Kabale University |
| issn | 1932-6203 |
| language | English |
| publishDate | 2012-01-01 |
| publisher | Public Library of Science (PLoS) |
| record_format | Article |
| series | PLoS ONE |
| spelling | doaj-art-2fc0d8defeaa4fc0b6ffae49c9cd869b2025-01-24T05:31:14ZengPublic Library of Science (PLoS)PLoS ONE1932-62032012-01-0179e4456910.1371/journal.pone.0044569Association of N-terminal pro-brain natriuretic peptide with cognitive function and depression in elderly people with type 2 diabetes.Insa FeinkohlNaveed SattarPaul WelshRebecca M ReynoldsIan J DearyMark W J StrachanJackie F PriceEdinburgh Type 2 Diabetes Study-ET2DS Investigators<h4>Background</h4>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).<h4>Methodology and principal findings</h4>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).<h4>Conclusion</h4>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.https://doi.org/10.1371/journal.pone.0044569 |
| spellingShingle | Insa Feinkohl Naveed Sattar Paul Welsh Rebecca M Reynolds Ian J Deary Mark W J Strachan Jackie F Price Edinburgh Type 2 Diabetes Study-ET2DS Investigators Association of N-terminal pro-brain natriuretic peptide with cognitive function and depression in elderly people with type 2 diabetes. PLoS ONE |
| title | Association of N-terminal pro-brain natriuretic peptide with cognitive function and depression in elderly people with type 2 diabetes. |
| title_full | Association of N-terminal pro-brain natriuretic peptide with cognitive function and depression in elderly people with type 2 diabetes. |
| title_fullStr | Association of N-terminal pro-brain natriuretic peptide with cognitive function and depression in elderly people with type 2 diabetes. |
| title_full_unstemmed | Association of N-terminal pro-brain natriuretic peptide with cognitive function and depression in elderly people with type 2 diabetes. |
| title_short | Association of N-terminal pro-brain natriuretic peptide with cognitive function and depression in elderly people with type 2 diabetes. |
| title_sort | association of n terminal pro brain natriuretic peptide with cognitive function and depression in elderly people with type 2 diabetes |
| url | https://doi.org/10.1371/journal.pone.0044569 |
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