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Tang X, Cao J, Cai J, Mo X, Wei Y, He K, Ye Z, Liang YJ, Zhao L, Qin L, Li Y, Qin J, Zhang Z. Effect of Interaction of ATG7 and Plasma Metal Concentrations on Cognitive Impairment in Rural China. J Mol Neurosci 2025; 75:27. [PMID: 39988622 DOI: 10.1007/s12031-025-02322-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2024] [Accepted: 02/11/2025] [Indexed: 02/25/2025]
Abstract
The objective of this study is to explore the association of plasma metal concentrations with impaired cognitive function in different genotypes of ATG7 using multiple models. A cross-sectional survey was conducted in rural China among 994 individuals aged 30 years or older. Cognitive function was assessed using the Mini-Mental State Examination (MMSE). Genetic analysis focused on two single-nucleotide polymorphisms (SNPs) in the autophagy-related gene ATG7 (rs2606757 and rs8154). Plasma concentrations of metals were quantified using inductively coupled plasma mass spectrometry. Restricted cubic splines were used to explore the association between serum metal concentration and the occurrence of mild cognitive impairment in individuals with various genotypes. Bayesian Kernel Machine Regression (BKMR) models were used to explore the interactions between individual metals. In a restricted cubic spline model, there is a nonlinear relationship between plasma concentration of Cd and the occurrence of cognitive impairment in individuals carrying the AA (P of Nonlinear = 0.008) and AT (P of Nonlinear = 0.007) genotypes at the rs2606757. However, in people carrying the TT genotype at the rs2606757 locus, the concentration of metals in plasma was not significantly associated with cognitive impairment (P of Nonlinear = 0.534). The results of the BKMR model are consistent with those of the restricted cubic spline model. The TT genotype at rs2606757 in ATG7 appears to confer greater cognitive resilience against Cd-induced cognitive damage. These findings highlight the importance of considering gene-environment interactions in the context of cognitive impairment and suggest potential avenues for preventing cognitive decline in individuals exposed to Cd. Further research is needed to elucidate the precise mechanisms underlying these interactions.
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Affiliation(s)
- Xu Tang
- Department of Environmental and Occupational Health, Guangxi Medical University, Nanning, 530021, China
- Affiliated Hospital of Guilin Medical University, 15 Lequn Road, Guangxi Zhuang Autonomous Region, Guilin, China
| | - Jiejing Cao
- Department of Environmental and Occupational Health, Guangxi Medical University, Nanning, 530021, China
- Liuzhou People's Hospital, Guangxi Zhuang Autonomous Region, Liuzhou, China
| | - Jiansheng Cai
- Department of Environmental and Occupational Health, Guangxi Medical University, Nanning, 530021, China
| | - Xiaoting Mo
- Department of Environmental and Occupational Health, Guangxi Medical University, Nanning, 530021, China
| | - Yanfei Wei
- Department of Environmental and Occupational Health, Guangxi Medical University, Nanning, 530021, China
| | - Kailian He
- School of Public Health, Guilin Medical University, 1 Zhiyuan Road, Guangxi Zhuang Autonomous Region, Guilin, China
| | - Zeyan Ye
- School of Public Health, Guilin Medical University, 1 Zhiyuan Road, Guangxi Zhuang Autonomous Region, Guilin, China
| | - Yu Jian Liang
- Department of Environmental and Occupational Health, Guangxi Medical University, Nanning, 530021, China
| | - Linhai Zhao
- Department of Environmental and Occupational Health, Guangxi Medical University, Nanning, 530021, China
| | - Lidong Qin
- Department of Environmental and Occupational Health, Guangxi Medical University, Nanning, 530021, China
| | - You Li
- School of Public Health, Guilin Medical University, 1 Zhiyuan Road, Guangxi Zhuang Autonomous Region, Guilin, China
| | - Jian Qin
- Department of Environmental and Occupational Health, Guangxi Medical University, Nanning, 530021, China
| | - Zhiyong Zhang
- Department of Environmental and Occupational Health, Guangxi Medical University, Nanning, 530021, China.
- School of Public Health, Guilin Medical University, 1 Zhiyuan Road, Guangxi Zhuang Autonomous Region, Guilin, China.
- Guangxi Health Commission Key Laboratory of Entire Lifecycle Health and Care, Guangxi Zhuang Autonomous Region, Guilin, China.
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Zhai L, Yang Y, Zhang J, Hou W, Yang Y, Ding D, Li C, Zhu Y. Association between cognitive dysfunction and diabetes in patients over 65 years old: a cross-sectional study using propensity score matching. J Rehabil Med 2024; 56:jrm18372. [PMID: 38380813 PMCID: PMC10896218 DOI: 10.2340/jrm.v56.18372] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2023] [Accepted: 01/15/2024] [Indexed: 02/22/2024] Open
Abstract
OBJECTIVES To investigate the association between diabetes and cognitive dysfunction in the elderly population, and examine the impact of cognitive dysfunction on level of activities of daily living (ADL) in patients with diabetes. METHODS Data analysis was conducted on 2,951 individuals aged over 65 years from the Chinese Longitudinal Healthy Longevity Survey cohort. Propensity score matching was utilized to mitigate selection bias. Multivariate binary logistic regression was performed to analyse the association between diabetes and cognitive dysfunction in the study subjects. In addition, the relationship between ADL and cognitive function in patients with diabetes was analysed using the Wilcoxon rank-sum test. RESULTS A significant association (p = 0.017) was found between diabetes and the occurrence of cognitive dysfunction in older adults. Subgroup analyses revealed that diabetes patients with cognitive dysfunction exhibited a worse ADL dependence compared with those without cognitive dysfunction (p < 0.001). CONCLUSION These findings indicate that diabetes is associated with cognitive dysfunction in older adults. Meanwhile, there is an association between cognitive impairment and ADL level in subjects with diabetes. As such, healthcare professionals should pay close attention to the occurrence of cognitive dysfunction and ADL decline during diagnosis and treatment, and proactive prevention and intervention strategies should be implemented.
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Affiliation(s)
- Liwen Zhai
- The Fifth Affiliated Hospital of Zhengzhou University, Zhengzhou University, Zhengzhou, Henan, China; Academy of Medical Sciences, Zhengzhou University, Zhengzhou, Henan, China
| | - Yao Yang
- The Fifth Affiliated Hospital of Zhengzhou University, Zhengzhou University, Zhengzhou, Henan, China; Academy of Medical Sciences, Zhengzhou University, Zhengzhou, Henan, China
| | - Jun Zhang
- Department of Rehabilitation Medicine, Hainan Cancer Hospital, Haikou, Hainan, China
| | - Weiqian Hou
- The Fifth Affiliated Hospital of Zhengzhou University, Zhengzhou University, Zhengzhou, Henan, China; Academy of Medical Sciences, Zhengzhou University, Zhengzhou, Henan, China
| | - Yujie Yang
- School of Rehabilitation Sciences and Engineering, University of Health and Rehabilitation Sciences, Qingdao, Shandong, China
| | - Dongfang Ding
- The Fifth Affiliated Hospital of Zhengzhou University, Zhengzhou University, Zhengzhou, Henan, China; Academy of Medical Sciences, Zhengzhou University, Zhengzhou, Henan, China
| | - Conghui Li
- The Fifth Affiliated Hospital of Zhengzhou University, Zhengzhou University, Zhengzhou, Henan, China; Academy of Medical Sciences, Zhengzhou University, Zhengzhou, Henan, China
| | - Yi Zhu
- The Fifth Affiliated Hospital of Zhengzhou University, Zhengzhou University, Zhengzhou, Henan, China.
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Liabeuf S, Pešić V, Spasovski G, Maciulaitis R, Bobot M, Farinha A, Wagner CA, Unwin RJ, Capasso G, Bumblyte IA, Hafez G. Drugs with a negative impact on cognitive function (Part 1): chronic kidney disease as a risk factor. Clin Kidney J 2023; 16:2365-2377. [PMID: 38045996 PMCID: PMC10689135 DOI: 10.1093/ckj/sfad241] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2023] [Indexed: 12/05/2023] Open
Abstract
People living with chronic kidney disease (CKD) frequently suffer from mild cognitive impairment and/or other neurocognitive disorders. This review in two parts will focus on adverse drug reactions resulting in cognitive impairment as a potentially modifiable risk factor in CKD patients. Many patients with CKD have a substantial burden of comorbidities leading to polypharmacy. A recent study found that patients seen by nephrologists were the most complex to treat because of their high number of comorbidities and medications. Due to polypharmacy, these patients may experience a wide range of adverse drug reactions. Along with CKD progression, the accumulation of uremic toxins may lead to blood-brain barrier (BBB) disruption and pharmacokinetic alterations, increasing the risk of adverse reactions affecting the central nervous system (CNS). In patients on dialysis, the excretion of drugs that depend on kidney function is severely reduced such that adverse and toxic levels of a drug or its metabolites may be reached at relatively low doses, unless dosing is adjusted. This first review will discuss how CKD represents a risk factor for adverse drug reactions affecting the CNS via (i) BBB disruption associated with CKD and (ii) the impact of reduced kidney function and dialysis itself on drug pharmacokinetics.
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Affiliation(s)
- Sophie Liabeuf
- Pharmacoepidemiology Unit, Department of Clinical Pharmacology, Amiens University Medical Center, Amiens, France
- MP3CV Laboratory, EA7517, Jules Verne University of Picardie, Amiens, France
| | - Vesna Pešić
- Faculty of Pharmacy, University of Belgrade, Belgrade, Serbia
| | - Goce Spasovski
- Department of Nephrology, Clinical Centre “Mother Theresa”, Saints Cyril and Methodius University, Skopje, North Macedonia
| | - Romaldas Maciulaitis
- Department of Nephrology, Lithuanian University of Health Sciences, Kaunas, Lithuania
- Institute of Physiology and Pharmacology, Faculty of Medicines, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Mickaël Bobot
- Aix-Marseille University, Department of Nephrology, AP-HM, La Conception Hospital, Marseille, France; C2VN Laboratory, Inserm 1263, INRAE 1260, Aix-Marseille University, Marseille, France
| | - Ana Farinha
- Department of Nephrology, Hospital de Vila Franca de Xira, Lisbon, Portugal
| | - Carsten A Wagner
- Institute of Physiology, University of Zürich, Zurich, Switzerland
| | - Robert J Unwin
- Department of Renal Medicine, Royal Free Hospital, University College London, London, UK
| | - Giovambattista Capasso
- Department of Translantional Medical Sciences, University of Campania Luigi Vanvitelli , Naples, Italy
- Biogem Research Institute , Ariano Irpino, Italy
| | - Inga Arune Bumblyte
- Department of Nephrology, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Gaye Hafez
- Department of Pharmacology, Faculty of Pharmacy, Altinbas University, Istanbul, Turkey
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Wang Y, Shi M, Li X. Effects of weight loss on cognitive function in patients with diabetes: a systematic review and meta-analysis. Diabetes Res Clin Pract 2023; 200:110687. [PMID: 37105400 DOI: 10.1016/j.diabres.2023.110687] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/24/2023] [Revised: 04/08/2023] [Accepted: 04/20/2023] [Indexed: 04/29/2023]
Abstract
AIMS Normalization of body weight is a treatment objective for diabetes. Therefore, anti-diabetic drugs that cause weight loss are widely used in clinics, with the aim of reducing the risk of chronic complications. However, the effect of weight loss on cognition in patients with diabetes is unclear. METHODS Embase, the Cochrane Library, PubMed, and the Web of Science were searched systematically, without study type restrictions, from inception to December 18, 2022. Weight loss was defined as a statistically significant decrease in body mass index (BMI) following an observation or intervention. We conducted an analysis of pooled data using a random-effects model. RESULTS A total of 619 participants in five studies were included. Weight loss was not associated with cognitive changes in patients with diabetes (standardized mean difference 0.50, 95% confidence interval -0.09 to 1.08). Subgroup analyses showed that this was not significantly affected by the duration of intervention or observation, or the size of the reduction in BMI. However, it was challenging to draw definitive conclusions regarding the effects of interventions and baseline BMI, because only one study was included. CONCLUSIONS Weight loss may be neutral to cognitive function in diabetes, but further studies are required to draw more definitive conclusions.
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Affiliation(s)
- Yaqi Wang
- National Clinical Research Center for Metabolic Diseases, Key Laboratory of Diabetes Immunology (Central South University), Ministry of Education, and Department of Metabolism and Endocrinology, The Second Xiangya Hospital of Central South University, Changsha, 410011, Hunan, China
| | - Mei Shi
- National Clinical Research Center for Metabolic Diseases, Key Laboratory of Diabetes Immunology (Central South University), Ministry of Education, and Department of Metabolism and Endocrinology, The Second Xiangya Hospital of Central South University, Changsha, 410011, Hunan, China
| | - Xia Li
- National Clinical Research Center for Metabolic Diseases, Key Laboratory of Diabetes Immunology (Central South University), Ministry of Education, and Department of Metabolism and Endocrinology, The Second Xiangya Hospital of Central South University, Changsha, 410011, Hunan, China.
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