T2DM: genotype common among African Americans is tied to cognitive decline

  • JAMA Netw Open

  • curated by Susan London
  • Clinical Essentials
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Takeaway

  • Among older African-American patients with type 2 diabetes (T2DM), those having the haptoglobin (HP) 1-1 genotype had poorer baseline cognitive function and more rapid decline over time.

Why this matters

  • Dementia risk is higher for blacks than for whites, but genetic contributors to this disparity are still being elucidated.

Key results

  • Genotype prevalences:
    • 29.4% for Hp 1-1.
    • 36.1% for Hp 2-1.
    • 10.9% for Hp 2-1m.
    • 23.6% for Hp 2-2.
  • Baseline Mini-Mental State Examination (MMSE) scores:
    • Differed across 4 genotype groups (P=.006).
    • Lowest with Hp 1-1 (mean, 25.68).
    • Highest with Hp 2-1m (mean, 27.15).
  • 40-month decline in MMSE score:
    • Significant for Hp 1-1 (mean, −0.41; P=.04).
    • Significant for Hp 2-2 (mean, −0.68; P=.001).
    • Not significantly different across 4 genotype groups.
  • Interaction of age with genotype on MMSE score:
    • Significant for Hp 1-1 genotype (mean annual decline, −0.87; P=.005).
    • Not significant for other genotypes.

Study design

  • Multicenter cohort study of 466 older African-American patients (mean age, 62.3 years) with T2DM from the ACCORD-MIND study.
  • Genotypes assessed from serum samples.
  • Main outcome: cognitive function (MMSE).
  • Funding: National Institute on Aging.

Limitations

  • Unclear generalizability.
  • Potential survivor bias.

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