Associations of insulin resistance with cognition in individuals without diagnosed diabetes: Results from the Hispanic Community Health Study/Study of Latinos

Mitzi M. Gonzales, Ramon A. Durazo-Arvizu, Shruti Sachdeva, Terry G. Unterman, Matthew J. O'Brien, Linda C. Gallo, Gregory A. Talavera, Robert C. Kaplan, Jianwen Cai, Neil Schneiderman, Rebeca A. Espinoza Giacinto, Hector M. González, Martha L. Daviglus, Melissa Lamar

Research output: Contribution to journalArticle

Abstract

Aims: Insulin resistance (IR) adversely impacts memory and executive functioning in non-Hispanic whites without diabetes. Less is known in Hispanics/Latinos, despite the fact that Hispanics/Latinos have higher rates of insulin resistance than non-Hispanic whites. We investigated the association between IR and cognition and its variation by age. Methods: Data from 5987 participants 45–74 years old without diabetes from the Hispanic Community Health Study/Study of Latinos. IR was considered continuously using homeostasis model assessment for insulin resistance (HOMA-IR) and also dichotomized based on clinically relevant thresholds for hyperinsulinemia (fasting insulin > 84.73 pmol/L or HOMA-IR > 2.6) and sample-based norms (75th percentile of fasting insulin or HOMA-IR). Cognitive testing included the Brief Spanish English Verbal Learning Test (B-SEVLT), Verbal Fluency, and Digit Symbol Substitution. Results: There was 90% overlap in participant categorization comparing clinically relevant and sample-based thresholds. In separate fully-adjusted linear regression models, age modified the association between HOMA-IR and Digit Symbol Substitution (p = 0.02); advancing age combined with higher HOMA-IR levels resulted in higher scores. Age also modified the association between clinically relevant hyperinsulinemia and B-SEVLT recall (p = 0.03); with increasing age came worse performance for individuals with hyperinsulinemia. Conclusion: The relationship of IR with cognition in Hispanics/Latinos without diabetes may reflect an age- and test-dependent state.

Original languageEnglish (US)
Pages (from-to)38-47
Number of pages10
JournalDiabetes research and clinical practice
Volume150
DOIs
StatePublished - Apr 1 2019

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Hispanic Americans
Cognition
Insulin Resistance
Health
Homeostasis
Hyperinsulinism
Verbal Learning
Linear Models
Fasting
Insulin

Keywords

  • Aging
  • Cognition
  • Epidemiology
  • Hispanics
  • Insulin resistance
  • Latinos

ASJC Scopus subject areas

  • Internal Medicine
  • Endocrinology, Diabetes and Metabolism
  • Endocrinology

Cite this

Associations of insulin resistance with cognition in individuals without diagnosed diabetes : Results from the Hispanic Community Health Study/Study of Latinos. / Gonzales, Mitzi M.; Durazo-Arvizu, Ramon A.; Sachdeva, Shruti; Unterman, Terry G.; O'Brien, Matthew J.; Gallo, Linda C.; Talavera, Gregory A.; Kaplan, Robert C.; Cai, Jianwen; Schneiderman, Neil; Espinoza Giacinto, Rebeca A.; González, Hector M.; Daviglus, Martha L.; Lamar, Melissa.

In: Diabetes research and clinical practice, Vol. 150, 01.04.2019, p. 38-47.

Research output: Contribution to journalArticle

Gonzales, MM, Durazo-Arvizu, RA, Sachdeva, S, Unterman, TG, O'Brien, MJ, Gallo, LC, Talavera, GA, Kaplan, RC, Cai, J, Schneiderman, N, Espinoza Giacinto, RA, González, HM, Daviglus, ML & Lamar, M 2019, 'Associations of insulin resistance with cognition in individuals without diagnosed diabetes: Results from the Hispanic Community Health Study/Study of Latinos', Diabetes research and clinical practice, vol. 150, pp. 38-47. https://doi.org/10.1016/j.diabres.2019.01.030
Gonzales, Mitzi M. ; Durazo-Arvizu, Ramon A. ; Sachdeva, Shruti ; Unterman, Terry G. ; O'Brien, Matthew J. ; Gallo, Linda C. ; Talavera, Gregory A. ; Kaplan, Robert C. ; Cai, Jianwen ; Schneiderman, Neil ; Espinoza Giacinto, Rebeca A. ; González, Hector M. ; Daviglus, Martha L. ; Lamar, Melissa. / Associations of insulin resistance with cognition in individuals without diagnosed diabetes : Results from the Hispanic Community Health Study/Study of Latinos. In: Diabetes research and clinical practice. 2019 ; Vol. 150. pp. 38-47.
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abstract = "Aims: Insulin resistance (IR) adversely impacts memory and executive functioning in non-Hispanic whites without diabetes. Less is known in Hispanics/Latinos, despite the fact that Hispanics/Latinos have higher rates of insulin resistance than non-Hispanic whites. We investigated the association between IR and cognition and its variation by age. Methods: Data from 5987 participants 45–74 years old without diabetes from the Hispanic Community Health Study/Study of Latinos. IR was considered continuously using homeostasis model assessment for insulin resistance (HOMA-IR) and also dichotomized based on clinically relevant thresholds for hyperinsulinemia (fasting insulin > 84.73 pmol/L or HOMA-IR > 2.6) and sample-based norms (75th percentile of fasting insulin or HOMA-IR). Cognitive testing included the Brief Spanish English Verbal Learning Test (B-SEVLT), Verbal Fluency, and Digit Symbol Substitution. Results: There was 90{\%} overlap in participant categorization comparing clinically relevant and sample-based thresholds. In separate fully-adjusted linear regression models, age modified the association between HOMA-IR and Digit Symbol Substitution (p = 0.02); advancing age combined with higher HOMA-IR levels resulted in higher scores. Age also modified the association between clinically relevant hyperinsulinemia and B-SEVLT recall (p = 0.03); with increasing age came worse performance for individuals with hyperinsulinemia. Conclusion: The relationship of IR with cognition in Hispanics/Latinos without diabetes may reflect an age- and test-dependent state.",
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T1 - Associations of insulin resistance with cognition in individuals without diagnosed diabetes

T2 - Results from the Hispanic Community Health Study/Study of Latinos

AU - Gonzales, Mitzi M.

AU - Durazo-Arvizu, Ramon A.

AU - Sachdeva, Shruti

AU - Unterman, Terry G.

AU - O'Brien, Matthew J.

AU - Gallo, Linda C.

AU - Talavera, Gregory A.

AU - Kaplan, Robert C.

AU - Cai, Jianwen

AU - Schneiderman, Neil

AU - Espinoza Giacinto, Rebeca A.

AU - González, Hector M.

AU - Daviglus, Martha L.

AU - Lamar, Melissa

PY - 2019/4/1

Y1 - 2019/4/1

N2 - Aims: Insulin resistance (IR) adversely impacts memory and executive functioning in non-Hispanic whites without diabetes. Less is known in Hispanics/Latinos, despite the fact that Hispanics/Latinos have higher rates of insulin resistance than non-Hispanic whites. We investigated the association between IR and cognition and its variation by age. Methods: Data from 5987 participants 45–74 years old without diabetes from the Hispanic Community Health Study/Study of Latinos. IR was considered continuously using homeostasis model assessment for insulin resistance (HOMA-IR) and also dichotomized based on clinically relevant thresholds for hyperinsulinemia (fasting insulin > 84.73 pmol/L or HOMA-IR > 2.6) and sample-based norms (75th percentile of fasting insulin or HOMA-IR). Cognitive testing included the Brief Spanish English Verbal Learning Test (B-SEVLT), Verbal Fluency, and Digit Symbol Substitution. Results: There was 90% overlap in participant categorization comparing clinically relevant and sample-based thresholds. In separate fully-adjusted linear regression models, age modified the association between HOMA-IR and Digit Symbol Substitution (p = 0.02); advancing age combined with higher HOMA-IR levels resulted in higher scores. Age also modified the association between clinically relevant hyperinsulinemia and B-SEVLT recall (p = 0.03); with increasing age came worse performance for individuals with hyperinsulinemia. Conclusion: The relationship of IR with cognition in Hispanics/Latinos without diabetes may reflect an age- and test-dependent state.

AB - Aims: Insulin resistance (IR) adversely impacts memory and executive functioning in non-Hispanic whites without diabetes. Less is known in Hispanics/Latinos, despite the fact that Hispanics/Latinos have higher rates of insulin resistance than non-Hispanic whites. We investigated the association between IR and cognition and its variation by age. Methods: Data from 5987 participants 45–74 years old without diabetes from the Hispanic Community Health Study/Study of Latinos. IR was considered continuously using homeostasis model assessment for insulin resistance (HOMA-IR) and also dichotomized based on clinically relevant thresholds for hyperinsulinemia (fasting insulin > 84.73 pmol/L or HOMA-IR > 2.6) and sample-based norms (75th percentile of fasting insulin or HOMA-IR). Cognitive testing included the Brief Spanish English Verbal Learning Test (B-SEVLT), Verbal Fluency, and Digit Symbol Substitution. Results: There was 90% overlap in participant categorization comparing clinically relevant and sample-based thresholds. In separate fully-adjusted linear regression models, age modified the association between HOMA-IR and Digit Symbol Substitution (p = 0.02); advancing age combined with higher HOMA-IR levels resulted in higher scores. Age also modified the association between clinically relevant hyperinsulinemia and B-SEVLT recall (p = 0.03); with increasing age came worse performance for individuals with hyperinsulinemia. Conclusion: The relationship of IR with cognition in Hispanics/Latinos without diabetes may reflect an age- and test-dependent state.

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