Blood pressure, aortic stiffness, hemodynamics and cognition in twin pairs discordant for type 2 diabetes

C Karayiannis, C Moran, J E Sharman, R Beare, S J Quinn, T G Phan, Amanda Wood, A G Thrift, W C Wang, V Srikanth

Research output: Contribution to journalArticle

Abstract

Background: Type 2 diabetes (T2D) is associated with an increased risk of cognitive impairment and dementia with poorly understood underlying mechanisms. Objective: We examined the role of blood pressure (BP), aortic stiffness, and hemodynamics in this association. Methods: Cross-sectional sample of late middle-aged twins discordant for T2D from the Australian Twin Registry. Measurements included neuropsychological battery and brain MRI including arterial spin labelling (ASL) to measure cerebral perfusion. Mobil-o-Graph devices were used to non-invasively obtain 24-hour BP, aortic stiffness, and hemodynamic measures. Using mixed modelling, we studied associations of T2D with cognition, MRI measures, BP, aortic stiffness, and hemodynamics. Results: There were 23 twin pairs with mean age 63.7 (SD = 6.1) years. T2D (β=-0.45, p < 0.001) and age (β=-0.05, p = 0.022) were independently associated with poorer attention but not with memory or perceptual speed. T2D was associated with reduced nocturnal central systolic BP dipping (β=-3.79, p = 0.027), but not with BP, aortic stiffness, cerebral perfusion, or other hemodynamic measures. There was a statistically significant interaction between T2D and central systolic BP dipping in predicting attention scores (both p < 0.05 for the interaction term) whereby there was a positive association between BP dipping and attention scores in those with T2D, but not in those without T2D. Conclusion: We found an association between T2D and reduced nocturnal central systolic dipping, but not with any other measures of BP, stiffness or hemodynamic measures. Further study of the role of nocturnal central BP dipping in the association between T2D and cognitive impairment may help identify potential mechanisms.

Original languageEnglish
Pages (from-to)763-773
Number of pages11
JournalJournal of Alzheimer's disease
Volume71
Issue number3
Early online date16 Aug 2019
DOIs
Publication statusE-pub ahead of print - 16 Aug 2019

Fingerprint

Vascular Stiffness
Type 2 Diabetes Mellitus
Cognition
Hemodynamics
Blood Pressure
Perfusion
Dementia
Registries

Bibliographical note

Copyright ©2019 IOS Press. Journal of Alzheimer's Disease, vol. Pre-press, no. Pre-press, pp. 1-11, 2019

Keywords

  • Blood pressure
  • cerebrovascular circulation
  • cognitive dysfunction
  • dementia
  • hemodynamics
  • type 2 diabetes mellitus
  • vascular stiffness

Cite this

Karayiannis, C., Moran, C., Sharman, J. E., Beare, R., Quinn, S. J., Phan, T. G., ... Srikanth, V. (2019). Blood pressure, aortic stiffness, hemodynamics and cognition in twin pairs discordant for type 2 diabetes. Journal of Alzheimer's disease, 71(3), 763-773. https://doi.org/10.3233/JAD-190319
Karayiannis, C ; Moran, C ; Sharman, J E ; Beare, R ; Quinn, S J ; Phan, T G ; Wood, Amanda ; Thrift, A G ; Wang, W C ; Srikanth, V. / Blood pressure, aortic stiffness, hemodynamics and cognition in twin pairs discordant for type 2 diabetes. In: Journal of Alzheimer's disease. 2019 ; Vol. 71, No. 3. pp. 763-773.
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Karayiannis, C, Moran, C, Sharman, JE, Beare, R, Quinn, SJ, Phan, TG, Wood, A, Thrift, AG, Wang, WC & Srikanth, V 2019, 'Blood pressure, aortic stiffness, hemodynamics and cognition in twin pairs discordant for type 2 diabetes', Journal of Alzheimer's disease, vol. 71, no. 3, pp. 763-773. https://doi.org/10.3233/JAD-190319

Blood pressure, aortic stiffness, hemodynamics and cognition in twin pairs discordant for type 2 diabetes. / Karayiannis, C; Moran, C; Sharman, J E; Beare, R; Quinn, S J; Phan, T G; Wood, Amanda; Thrift, A G; Wang, W C; Srikanth, V.

In: Journal of Alzheimer's disease, Vol. 71, No. 3, 16.08.2019, p. 763-773.

Research output: Contribution to journalArticle

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T1 - Blood pressure, aortic stiffness, hemodynamics and cognition in twin pairs discordant for type 2 diabetes

AU - Karayiannis, C

AU - Moran, C

AU - Sharman, J E

AU - Beare, R

AU - Quinn, S J

AU - Phan, T G

AU - Wood, Amanda

AU - Thrift, A G

AU - Wang, W C

AU - Srikanth, V

N1 - Copyright ©2019 IOS Press. Journal of Alzheimer's Disease, vol. Pre-press, no. Pre-press, pp. 1-11, 2019

PY - 2019/8/16

Y1 - 2019/8/16

N2 - Background: Type 2 diabetes (T2D) is associated with an increased risk of cognitive impairment and dementia with poorly understood underlying mechanisms. Objective: We examined the role of blood pressure (BP), aortic stiffness, and hemodynamics in this association. Methods: Cross-sectional sample of late middle-aged twins discordant for T2D from the Australian Twin Registry. Measurements included neuropsychological battery and brain MRI including arterial spin labelling (ASL) to measure cerebral perfusion. Mobil-o-Graph devices were used to non-invasively obtain 24-hour BP, aortic stiffness, and hemodynamic measures. Using mixed modelling, we studied associations of T2D with cognition, MRI measures, BP, aortic stiffness, and hemodynamics. Results: There were 23 twin pairs with mean age 63.7 (SD = 6.1) years. T2D (β=-0.45, p < 0.001) and age (β=-0.05, p = 0.022) were independently associated with poorer attention but not with memory or perceptual speed. T2D was associated with reduced nocturnal central systolic BP dipping (β=-3.79, p = 0.027), but not with BP, aortic stiffness, cerebral perfusion, or other hemodynamic measures. There was a statistically significant interaction between T2D and central systolic BP dipping in predicting attention scores (both p < 0.05 for the interaction term) whereby there was a positive association between BP dipping and attention scores in those with T2D, but not in those without T2D. Conclusion: We found an association between T2D and reduced nocturnal central systolic dipping, but not with any other measures of BP, stiffness or hemodynamic measures. Further study of the role of nocturnal central BP dipping in the association between T2D and cognitive impairment may help identify potential mechanisms.

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KW - cerebrovascular circulation

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