Incretin hormones, insulin, glucagon and advanced glycation end products in relation to cognitive function in older people with and without diabetes, a population-based study.

AIM: The aim of this observational study was to investigate relationships between physiological levels of glucometabolic biomarkers and cognitive test results in a population-based setting. METHODS: Cross-sectional data were obtained from the Swedish population-based Malmö Diet and Cancer Study Re-examination 2007-2012 comprising 3001 older people (mean age 72 years). Through oral glucose tolerance testing (OGTT), fasting and post-load levels of serum insulin, plasma glucagon, serum glucose-dependent insulinotropic peptide (GIP) and plasma glucagon-like peptide-1 (GLP-1) were measured. Insulin resistance and insulin sensitivity levels were calculated. In 454 participants, advanced glycation end products (AGEs) were estimated through skin autofluorescence. Associations between biomarkers and two cognitive tests, the Mini-Mental State Examination (MMSE) and A Quick Test of Cognitive Speed (AQT) respectively, were explored in multiple regression analyses. RESULTS: Positive associations following adjustments for known prognostic factors were found between MMSE scores and insulin sensitivity (B = 0.822, P = 0.004), 2-h plasma glucagon (B = 0.596, P = 0.026), 2-h serum GIP (B = 0.581, P = 0.040) and 2-h plasma GLP-1 (B = 0.585, P = 0.038), whereas negative associations were found between MMSE scores and insulin resistance (B = -0.734, P = 0.006), fasting plasma GLP-1 (B = -0.544, P = 0.033) and AGEs (B = -1.459, P = 0.030) were found. CONCLUSIONS: Higher levels of insulin sensitivity, GIP and GLP-1 were associated with better cognitive outcomes, but AGEs were associated with worse outcomes, supporting evidence from preclinical studies. Glucagon was linked to better outcomes, which could possibly reflect neuroprotective properties similar to the related biomarker GLP-1 which has similar intracellular properties. Longitudinal and interventional studies are needed to further evaluate neuromodulating effects of these biomarkers. Abstract presented at the European Association for the Study of Diabetes (EASD) 2019, Barcelona, Spain.

Civil unrest linked to intrauterine growth restriction in western Kenya.

Risk factors associated with intrauterine growth restriction (IUGR) have previously been identified, but few studies have described the relationship between IUGR and maternal stress caused by exposure to civil unrest. Here, we investigate this relationship during the Mount Elgon crisis in western Kenya between 2006 and 2008, following a period of violence. Birth weight data were compared between three hospitals in an exposed area, Mount Elgon (n=570), and one hospital in a control area, Kimilili (n=530). In a sub-analysis, the most stress exposed hospital, Bungoma West (n=211), was compared with the control hospital in Kimilili. Adjustments were made for offspring sex, gestational age and parity. The difference in mean birth weight between the most stress-exposed hospital (Bungoma West) and the control hospital (Kimilili) was 91 g after full adjustment (P=0.041). In conclusion, epidemiological data suggest a significant relationship between exposure to civil unrest and IUGR causing lower birth weight.