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<p>This study aims to investigate the clinical baseline characteristics and HbA1c variability in elderly patients with mild cognitive impairment (MCI) associated with type 2 diabetes mellitus (T2DM), as well as the synergistic relationship between these factors and dementia progression.&#xa0;A total of 186 elderly patients with T2DM with MCI were enrolled and stratified into 94 with normolipidemia and 92 with dyslipidemia. The patients’ demographics, baseline characteristics, lipid levels, baseline HbA1c, and Montreal cognitive assessment scale scores were recorded. Patients were followed up for at least 36 months, with a maximum follow-up period of 48 months.&#xa0;Patients in the dyslipidemia group had a longer duration of DM and had significantly higher total cholesterol, triglycerides, and low-density lipoprotein cholesterol than those in the normolipidemia group. Thirty-five patients progressed to dementia, with 25% (23/92) in the dyslipidemia group compared to 12.77% (12/94) in the normolipidemia group. Patients in the dyslipidemia group had significantly higher HbA1c variability than those in the normolipidemia group. Furthermore, the group progressing to dementia exhibited advanced age, prolonged DM duration, shorter years of education, and abnormal lipid levels, as well as greater HbA1c variability. Dyslipidemia under the association with the glycemic variability profile (HbA1c variability ≥ 10.49%) was also strongly associated with the degree of MCI in patients with dementia. Multivariable logistic regression confirmed that both dyslipidemia (OR = 2.05, <i>P</i> = 0.015) and high HbA1c variability (OR = 3.56, <i>P</i> = 0.010) were independent risk factors, with a significant interaction between them (OR = 3.15, <i>P</i> = 0.046).&#xa0;Dyslipidemia and glycemic variability are not only correlates of cognitive decline in patients with T2DM, but may also act synergistically to accelerate the process of MCI to dementia. The stratification by lipid status effectively identifies patient subgroups at differential risk, highlighting the combined impact of these metabolic factors.</p>

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Clinical value of dyslipidemia and glycemic variability for progression to dementia in type 2 diabetes mellitus-associated mild cognitive impairment

  • 期刊论文

  • 发表日期：

    2025年11月7日

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  • GuiTing Liu,
  • SiOu Li,
  • XiaoXuan Qi,
  • XinPing Wang,
  • MengXian Wang,
  • Qi Li,
  • LingJia Cui,
  • HuiYing Yue,
  • Feng Liu,
  • Ying Lin

摘要

This study aims to investigate the clinical baseline characteristics and HbA1c variability in elderly patients with mild cognitive impairment (MCI) associated with type 2 diabetes mellitus (T2DM), as well as the synergistic relationship between these factors and dementia progression. A total of 186 elderly patients with T2DM with MCI were enrolled and stratified into 94 with normolipidemia and 92 with dyslipidemia. The patients’ demographics, baseline characteristics, lipid levels, baseline HbA1c, and Montreal cognitive assessment scale scores were recorded. Patients were followed up for at least 36 months, with a maximum follow-up period of 48 months. Patients in the dyslipidemia group had a longer duration of DM and had significantly higher total cholesterol, triglycerides, and low-density lipoprotein cholesterol than those in the normolipidemia group. Thirty-five patients progressed to dementia, with 25% (23/92) in the dyslipidemia group compared to 12.77% (12/94) in the normolipidemia group. Patients in the dyslipidemia group had significantly higher HbA1c variability than those in the normolipidemia group. Furthermore, the group progressing to dementia exhibited advanced age, prolonged DM duration, shorter years of education, and abnormal lipid levels, as well as greater HbA1c variability. Dyslipidemia under the association with the glycemic variability profile (HbA1c variability ≥ 10.49%) was also strongly associated with the degree of MCI in patients with dementia. Multivariable logistic regression confirmed that both dyslipidemia (OR = 2.05, P = 0.015) and high HbA1c variability (OR = 3.56, P = 0.010) were independent risk factors, with a significant interaction between them (OR = 3.15, P = 0.046). Dyslipidemia and glycemic variability are not only correlates of cognitive decline in patients with T2DM, but may also act synergistically to accelerate the process of MCI to dementia. The stratification by lipid status effectively identifies patient subgroups at differential risk, highlighting the combined impact of these metabolic factors.