Letter to the Editor from Brunerová et al: "Association of Cognitive Function and Retinal Neural and Vascular Structure in Type 1 Diabetes"

Kód výsledku v IS VaVaI

<a href="https://www.isvavai.cz/riv?ss=detail&h=RIV%2F00216208%3A11120%2F21%3A43921577" target="_blank" >RIV/00216208:11120/21:43921577 - isvavai.cz</a>

Nalezeny alternativní kódy

RIV/00216208:11210/21:10427722 RIV/00216208:11130/21:10427722 RIV/00064173:_____/21:N0000205

Výsledek na webu

<a href="https://doi.org/10.1210/clinem/dgab350" target="_blank" >https://doi.org/10.1210/clinem/dgab350</a>

DOI - Digital Object Identifier

<a href="http://dx.doi.org/10.1210/clinem/dgab350" target="_blank" >10.1210/clinem/dgab350</a>

Jazyk výsledku

angličtina

Název v původním jazyce

Letter to the Editor from Brunerová et al: "Association of Cognitive Function and Retinal Neural and Vascular Structure in Type 1 Diabetes"

Popis výsledku v původním jazyce

We read with much interest the paper written by W. Fickweiler et al (1) in the Journal of Clinical Endocrinology &amp; Metabolism on the association between optical coherence tomography (OCT)/OCT angiography and cognitive dysfunction in patients with type 1 diabetes mellitus (T1DM). The authors analyzed data of 129 patients with long-term history of T1DM who underwent OCT/OCTA and complete cognitive testing, and they concluded that some structural and vascular abnormalities of the retina, representing an extension of the central nervous system, significantly correlate with cognitive impairment. The authors should be congratulated for the excellent and unique data showing that noninvasive retinal imaging may assist in revealing cognitive dysfunction in T1DM, and if the results are confirmed by future studies (prospective, on T1DM with shorter diabetes duration etc.), OCT could become a feasible screening method for identification of T1DM at risk of cognitive decline. However, we would like to focus on 4 methodologic aspects. Firstly, mood disorders were not excluded in the participants. This fact could have biased the results since not only already established mood disorders but also depressive and anxiety symptoms have been found to influence cognitive performance (2, 3) in the general population. Secondly, the influence of neuropathy on cognitive functions in TDM1 has already been proven; therefore, in addition to motor dexterity, it would be appropriate to include the evaluation of the grip strength dynamometer (4). Thirdly, premorbid intellect or education were not evaluated as independent variables in the correlation of cognitive functions and OCT, although lower general intelligence may represent a risk factor for both, the onset of dementia and the rate of cognitive decline in aging through the mechanism of cerebral reserve. Lower premorbid IQ has been associated with diabetes in the general population (5). Fourthly, glycemia was not measured before the complex cognitive testing. Actual glycemia (both hypoglycemia (6) and hyperglycemia (7)) represents a significant confounder in cognitive performance. Furthermore, not only acute hypoglycemia or hyperglycemia but also high glycemic variability could play a role. The patients were followed since 2004 and at that period, continuous glucose monitoring had already been available but, of course, not as routinely as it is today. Still, it would be of great interest to analyze the data from glucometers. In the study of Chaytor et al (8), diabetes-related correlates of cognitive impairment were identified (as hypoglycemia unawareness, recent hypoglycemic episodes, and continuous glucose monitoring/CGM variables). Thus, with great respect, we suggest taking these comments into consideration if further analyses (on the same population) or novel studies are planned.

Název v anglickém jazyce

Letter to the Editor from Brunerová et al: "Association of Cognitive Function and Retinal Neural and Vascular Structure in Type 1 Diabetes"

Popis výsledku anglicky

We read with much interest the paper written by W. Fickweiler et al (1) in the Journal of Clinical Endocrinology &amp; Metabolism on the association between optical coherence tomography (OCT)/OCT angiography and cognitive dysfunction in patients with type 1 diabetes mellitus (T1DM). The authors analyzed data of 129 patients with long-term history of T1DM who underwent OCT/OCTA and complete cognitive testing, and they concluded that some structural and vascular abnormalities of the retina, representing an extension of the central nervous system, significantly correlate with cognitive impairment. The authors should be congratulated for the excellent and unique data showing that noninvasive retinal imaging may assist in revealing cognitive dysfunction in T1DM, and if the results are confirmed by future studies (prospective, on T1DM with shorter diabetes duration etc.), OCT could become a feasible screening method for identification of T1DM at risk of cognitive decline. However, we would like to focus on 4 methodologic aspects. Firstly, mood disorders were not excluded in the participants. This fact could have biased the results since not only already established mood disorders but also depressive and anxiety symptoms have been found to influence cognitive performance (2, 3) in the general population. Secondly, the influence of neuropathy on cognitive functions in TDM1 has already been proven; therefore, in addition to motor dexterity, it would be appropriate to include the evaluation of the grip strength dynamometer (4). Thirdly, premorbid intellect or education were not evaluated as independent variables in the correlation of cognitive functions and OCT, although lower general intelligence may represent a risk factor for both, the onset of dementia and the rate of cognitive decline in aging through the mechanism of cerebral reserve. Lower premorbid IQ has been associated with diabetes in the general population (5). Fourthly, glycemia was not measured before the complex cognitive testing. Actual glycemia (both hypoglycemia (6) and hyperglycemia (7)) represents a significant confounder in cognitive performance. Furthermore, not only acute hypoglycemia or hyperglycemia but also high glycemic variability could play a role. The patients were followed since 2004 and at that period, continuous glucose monitoring had already been available but, of course, not as routinely as it is today. Still, it would be of great interest to analyze the data from glucometers. In the study of Chaytor et al (8), diabetes-related correlates of cognitive impairment were identified (as hypoglycemia unawareness, recent hypoglycemic episodes, and continuous glucose monitoring/CGM variables). Thus, with great respect, we suggest taking these comments into consideration if further analyses (on the same population) or novel studies are planned.

Druh

J_imp - Článek v periodiku v databázi Web of Science

CEP obor

—

OECD FORD obor

30202 - Endocrinology and metabolism (including diabetes, hormones)

Projekt

—

Návaznosti

I - Institucionalni podpora na dlouhodoby koncepcni rozvoj vyzkumne organizace

Rok uplatnění

2021

Kód důvěrnosti údajů

S - Úplné a pravdivé údaje o projektu nepodléhají ochraně podle zvláštních právních předpisů

Název periodika

Journal of Clinical Endocrinology &amp; Metabolism

ISSN

0021-972X

e-ISSN

—

Svazek periodika

106

Číslo periodika v rámci svazku

8

Stát vydavatele periodika

US - Spojené státy americké

Počet stran výsledku

2

Strana od-do

"e3281"-"e3282"

Kód UT WoS článku

000753603800065

EID výsledku v databázi Scopus

2-s2.0-85111941025