Endocrine Abstracts

Background: T2DM is a metabolic disorder characterized by high blood glucose in the context of insulin resistance and relative insulin deficiency with disturbances of carbohydrate, fat, and protein metabolism.T2DM is a risk factor for Alzheimer’s disease and mild cognitive impairment. The etiology of cognitive impairment in people with T2DM is uncertain, but it is most likely multi factorial. Chronic hyperglycemia, cerebral micro vascular disease, severe hypoglycemia, and increased prevalence of macro vascular disease are implicated.

Aim of the work: To determine the serum levels of soluble vascular adhesion molecule (sVCAM-1) and highly sensitive C-reactive protein (hs-CRP) in elderly type 2 diabetics with mild cognitive impairment (MCI).

Patient and methods: Our study was conducted on 90 elderly subjects (aged 60 years old or more). They were divided into Group I, 30 patients with T2DM and mild cognitive impairment, group II, 30 patients with T2DM without cognitive impairment and group III, 30 healthy subjects as a control group. All participants were subjected to history taking, full clinical examination, anthropometric measurement, the Addenbrooke’s Cognitive Examination III (ACE–-III 2012) and laboratory investigations including Fasting plasma glucose, 2 hours plasma glucose, HbA1c, serum cholesterol, triglycerides, LDL-c, HDL-c, protein/creatinine ratio, serum sVCAM-1 and hs-CRP.

Results: Serum levels of sVCAM-1 in diabetic elderly patients with MCI were significantly higher (946.7±162.01 ng/ml) than diabetic elderly patients without cognitive impairment (479.06±65.27 ng/ml) and control (263.7±72.05 ng/ml) with (F=0.652 and P=0.002). Serum levels of Hs-CRP in diabetic elderly patients with MCI were significantly higher (7.9±1.09 ng/ml) as compared to diabetic elderly patients without cognitive impairment (4.3±0.96 ng/ml) and control (2±0.74 ng/ml) with (F=1.033 and P=0.005).

Conclusion: Elderly diabetic patients with mild cognitive impairment, have higher levels of soluble adhesion molecules and markers of low-grade systemic inflammation than other groups. Inflammatory mediators play a role in the development of mild cognitive impairment in diabetic elderly patients.

Keywords: Diabetes Mellitus, Highly sensitive C-reactive protein, soluble vascular adhesion molecule, Mild Cognitive Impairment, Elderly