Plasma homocysteine and cerebral small vessel disease as possible mediators between kidney and cognitive functions in patients with diabetes mellitus

Abstract Cognitive impairment is more prevalent in those with decreased kidney function. We tested a hypothesis that an increased homocysteine and/or cerebral small vessel diseases (SVDs) mediate the link between kidney and cognitive functions in a cross-sectional study in 143 type 2 diabetes patien...

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Autores principales:	Mika Sonoda, Tetsuo Shoji, Yukinobu Kuwamura, Yujiro Okute, Toshihide Naganuma, Hideaki Shima, Koka Motoyama, Tomoaki Morioka, Katsuhito Mori, Shinya Fukumoto, Atsushi Shioi, Taro Shimono, Hisako Fujii, Daijiro Kabata, Ayumi Shintani, Masanori Emoto, Masaaki Inaba
Formato:	article
Lenguaje:	EN
Publicado:	Nature Portfolio 2017
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/bbf0cdebe86b41b69e1df0f3e709c31b
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spelling	oai:doaj.org-article:bbf0cdebe86b41b69e1df0f3e709c31b2021-12-02T16:06:49ZPlasma homocysteine and cerebral small vessel disease as possible mediators between kidney and cognitive functions in patients with diabetes mellitus10.1038/s41598-017-04515-w2045-2322https://doaj.org/article/bbf0cdebe86b41b69e1df0f3e709c31b2017-06-01T00:00:00Zhttps://doi.org/10.1038/s41598-017-04515-whttps://doaj.org/toc/2045-2322Abstract Cognitive impairment is more prevalent in those with decreased kidney function. We tested a hypothesis that an increased homocysteine and/or cerebral small vessel diseases (SVDs) mediate the link between kidney and cognitive functions in a cross-sectional study in 143 type 2 diabetes patients without diagnosis of dementia or prior stroke. The exposure and outcome variables were estimated glomerular filtration rate (eGFR) and cognitive performance evaluated with Modified Mini-Mental State (3 MS) examination, respectively. The candidate mediators were plasma homocysteine concentration, and SVDs including silent cerebral infarction, cerebral microbleed, periventricular hyperintensity, and deep and subcortical white matter hyperintensity by magnetic resonance imaging. In multiple regression models adjusted for 12 potential confounders, eGFR was positively associated with 3 MS score, inversely with homocysteine, but not significantly with the presence of any type of SVD. The association of eGFR with 3 MS remained significant when each of the SVDs was added to the model, whereas it disappeared when homocysteine was included in place of SVD. Mediation analysis indicated nearly significant mediation of homocysteine (P = 0.062) but no meaningful mediations of SVDs (P = 0.842–0.930). Thus, homocysteine, not SVDs, was shown to be the possible mediator between kidney and cognitive functions in patients with type 2 diabetes mellitus.Mika SonodaTetsuo ShojiYukinobu KuwamuraYujiro OkuteToshihide NaganumaHideaki ShimaKoka MotoyamaTomoaki MoriokaKatsuhito MoriShinya FukumotoAtsushi ShioiTaro ShimonoHisako FujiiDaijiro KabataAyumi ShintaniMasanori EmotoMasaaki InabaNature PortfolioarticleMedicineRScienceQENScientific Reports, Vol 7, Iss 1, Pp 1-11 (2017)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Mika Sonoda Tetsuo Shoji Yukinobu Kuwamura Yujiro Okute Toshihide Naganuma Hideaki Shima Koka Motoyama Tomoaki Morioka Katsuhito Mori Shinya Fukumoto Atsushi Shioi Taro Shimono Hisako Fujii Daijiro Kabata Ayumi Shintani Masanori Emoto Masaaki Inaba Plasma homocysteine and cerebral small vessel disease as possible mediators between kidney and cognitive functions in patients with diabetes mellitus
description	Abstract Cognitive impairment is more prevalent in those with decreased kidney function. We tested a hypothesis that an increased homocysteine and/or cerebral small vessel diseases (SVDs) mediate the link between kidney and cognitive functions in a cross-sectional study in 143 type 2 diabetes patients without diagnosis of dementia or prior stroke. The exposure and outcome variables were estimated glomerular filtration rate (eGFR) and cognitive performance evaluated with Modified Mini-Mental State (3 MS) examination, respectively. The candidate mediators were plasma homocysteine concentration, and SVDs including silent cerebral infarction, cerebral microbleed, periventricular hyperintensity, and deep and subcortical white matter hyperintensity by magnetic resonance imaging. In multiple regression models adjusted for 12 potential confounders, eGFR was positively associated with 3 MS score, inversely with homocysteine, but not significantly with the presence of any type of SVD. The association of eGFR with 3 MS remained significant when each of the SVDs was added to the model, whereas it disappeared when homocysteine was included in place of SVD. Mediation analysis indicated nearly significant mediation of homocysteine (P = 0.062) but no meaningful mediations of SVDs (P = 0.842–0.930). Thus, homocysteine, not SVDs, was shown to be the possible mediator between kidney and cognitive functions in patients with type 2 diabetes mellitus.
format	article
author	Mika Sonoda Tetsuo Shoji Yukinobu Kuwamura Yujiro Okute Toshihide Naganuma Hideaki Shima Koka Motoyama Tomoaki Morioka Katsuhito Mori Shinya Fukumoto Atsushi Shioi Taro Shimono Hisako Fujii Daijiro Kabata Ayumi Shintani Masanori Emoto Masaaki Inaba
author_facet	Mika Sonoda Tetsuo Shoji Yukinobu Kuwamura Yujiro Okute Toshihide Naganuma Hideaki Shima Koka Motoyama Tomoaki Morioka Katsuhito Mori Shinya Fukumoto Atsushi Shioi Taro Shimono Hisako Fujii Daijiro Kabata Ayumi Shintani Masanori Emoto Masaaki Inaba
author_sort	Mika Sonoda
title	Plasma homocysteine and cerebral small vessel disease as possible mediators between kidney and cognitive functions in patients with diabetes mellitus
title_short	Plasma homocysteine and cerebral small vessel disease as possible mediators between kidney and cognitive functions in patients with diabetes mellitus
title_full	Plasma homocysteine and cerebral small vessel disease as possible mediators between kidney and cognitive functions in patients with diabetes mellitus
title_fullStr	Plasma homocysteine and cerebral small vessel disease as possible mediators between kidney and cognitive functions in patients with diabetes mellitus
title_full_unstemmed	Plasma homocysteine and cerebral small vessel disease as possible mediators between kidney and cognitive functions in patients with diabetes mellitus
title_sort	plasma homocysteine and cerebral small vessel disease as possible mediators between kidney and cognitive functions in patients with diabetes mellitus
publisher	Nature Portfolio
publishDate	2017
url	https://doaj.org/article/bbf0cdebe86b41b69e1df0f3e709c31b
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Plasma homocysteine and cerebral small vessel disease as possible mediators between kidney and cognitive functions in patients with diabetes mellitus

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