Inflammatory Status Modifies the Association Between Glycemic Traits and Cognitive Impairment in Patients With Coronary Artery Disease.

BACKGROUND

The evidence regarding the modifying role of inflammation in the association between glycemic traits and cognitive impairment remains insufficient. This study aimed to explore the association between glycemic traits and mild cognitive impairment (MCI) in patients with coronary artery disease (CAD), with particular emphasis on whether this association is influenced by varying levels of inflammation.

METHODS

This cross-sectional study included 1437 patients with CAD who underwent cognitive function assessment during hospitalization. Cognitive function was assessed using the Mini-Mental State Examination and the Montreal Cognitive Assessment to identify patients with MCI. The hsCRP (high-sensitivity C-reactive protein) level>3 mg/L was defined as high inflammatory risk. Multivariable logistic regression models were employed to estimate the associations of glycemic traits and inflammatory risk status with cognitive impairment.

RESULTS

Elevated fasting plasma glucose, glycosylated hemoglobin, and diabetes were positively associated with an increased risk of MCI in patients with CAD, with odds ratios ranging from 1.18 (95% CI, 1.10-1.26) to 1.55 (95% CI, 1.09-2.20). A significant interaction was observed between glycosylated hemoglobin and high inflammatory status on the risk of MCI (P for multiplicative interaction <0.001), with the effects of glycosylated hemoglobin on the risk of MCI being significant only in the group with high hsCRP. Additionally, there was evidence of significant additive interaction between high inflammatory risk and diabetes on the MCI risk in patients with CAD (P for additive interaction <0.05).

CONCLUSIONS

Inflammatory status modifies the association between glycemic traits and the risk of cognitive impairment. This finding highlights the importance of incorporating inflammation into the management of blood glucose levels in patients with CAD.