TY - JOUR
T1 - Association of N-Terminal Pro-Brain Natriuretic Peptide with Cognitive Function and Depression in Elderly People with Type 2 Diabetes
AU - Edinburgh Type 2 Diabet Study Inve
AU - Feinkohl, Insa
AU - Sattar, Naveed
AU - Welsh, Paul
AU - Reynolds, Rebecca M.
AU - Deary, Ian
AU - Strachan, Mark W. J.
AU - Price, Jackie F.
PY - 2012/9/4
Y1 - 2012/9/4
N2 - Background: 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).Methodology and Principal Findings: 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 (beta -0.09, 95% CI -0.13 to -0.03, p = 0.004 and beta 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 (beta -0.02, 95% CI 20.07 to 0.03, p > 0.05 for 'g'; beta 0.03, 95% CI 20.02 to 0.07, p. 0.05 for depression scores).Conclusion: 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.
AB - Background: 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).Methodology and Principal Findings: 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 (beta -0.09, 95% CI -0.13 to -0.03, p = 0.004 and beta 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 (beta -0.02, 95% CI 20.07 to 0.03, p > 0.05 for 'g'; beta 0.03, 95% CI 20.02 to 0.07, p. 0.05 for depression scores).Conclusion: 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.
KW - OLDER-ADULTS
KW - RISK-FACTORS
KW - HOSPITAL ANXIETY
KW - CONGESTIVE-HEART-FAILURE
KW - ARTERY-DISEASE
KW - MINI-MENTAL-STATE
KW - C-REACTIVE PROTEIN
KW - CARDIOVASCULAR-DISEASE
KW - PLASMA-LEVELS
KW - LEFT-VENTRICULAR DYSFUNCTION
U2 - 10.1371/journal.pone.0044569
DO - 10.1371/journal.pone.0044569
M3 - Article
VL - 7
JO - PLoS ONE
JF - PLoS ONE
SN - 1932-6203
IS - 9
M1 - ARTN e44569
ER -