The Maastricht Study: an extensive phenotyping study on determinants of type 2 diabetes, its complications and its comorbidities

Schram, Miranda T.; Sep, Simone J. S.; Kallen, Carla; Dagnelie, Pieter C.; Koster, Annemarie; Schaper, Nicolaas C.; Henry, Ronald M.A.; Stehouwer, Coen D. A.

doi:10.1007/s10654-014-9889-0

Cited by 338 publications

(614 citation statements)

References 58 publications

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“…The rationale and methodology have been described previously (21). In brief, the study focuses on the etiology, pathophysiology, complications, and comorbidities of type 2 diabetes and is characterized by an extensive phenotyping approach.…”

Section: Study Population and Designmentioning

confidence: 99%

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Functional Brain Networks Are Altered in Type 2 Diabetes and Prediabetes: Signs for Compensation of Cognitive Decrements? The Maastricht Study

et al. 2016

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Type 2 diabetes is associated with cognitive decrements, accelerated cognitive decline, and increased risk for dementia. Patients with the metabolic syndrome, a major risk factor for diabetes, may display comparable cognitive decrements as seen in type 2 diabetes. Currently, the impact of diabetes and prediabetes on cognition and the underlying organization of functional brain networks still remain to be elucidated. This study investigated whether functional brain networks are affected in type 2 diabetes and prediabetes. Forty-seven participants with diabetes, 47 participants with prediabetes, and 45 control participants underwent detailed cognitive testing and 3-Tesla resting state functional MRI. Graph theoretical network analysis was performed to investigate alterations in functional cerebral networks. Participants with diabetes displayed altered network measures, characterized by a higher normalized cluster coefficient and higher local efficiency, compared with control participants. The network measures of the participants with prediabetes fell between those with diabetes and control participants. Lower processing speed was associated with shorter path length and higher global efficiency. Participants with type 2 diabetes have altered functional brain networks. This alteration is already apparent in the prediabetic stage to a somewhat lower level, hinting at functional reorganization of the cerebral networks as a compensatory mechanism for cognitive decrements.The worldwide prevalence of diabetes is increasing rapidly, with the majority of patients having type 2 diabetes (1). Along with cardiovascular risk factors, type 2 diabetes is associated with cognitive decrements, accelerated cognitive decline, and an increased risk for dementia and Alzheimer disease (2,3). A broad range of cognitive domains are affected in type 2 diabetes, and one of the most commonly affected is processing speed (4,5). However, the underlying pathological mechanism is not yet clear.The progression of normal glucose metabolism to type 2 diabetes is a gradual process in which insulin resistance plays a crucial role. Before the clinical presentation of type 2 diabetes, insulin resistance often is accompanied by other metabolic and vascular abnormalities. The cluster of these cardiovascular risk factors is referred to as the metabolic syndrome and is considered a major risk factor for diabetes (6). Patients with the metabolic syndrome have a high likelihood for diabetes and may display comparable cognitive decrements as seen in patients with type 2 diabetes (5). Furthermore, the cardiovascular risk factors are associated with an increased risk of late-life dementia (7).

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Section: Study Population and Designmentioning

confidence: 99%

“…A fourth measurement was performed when the difference between measurements two and three exceeded .10 mmHg. Here, we used the averaged blood pressure values over all the available measurements (21).…”

Section: Covariatesmentioning

confidence: 99%

Functional Brain Networks Are Altered in Type 2 Diabetes and Prediabetes: Signs for Compensation of Cognitive Decrements? The Maastricht Study

et al. 2016

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“…The rationale and methodology have been described previously (16). In brief, the study focuses on the etiology, pathophysiology, complications, and comorbidities of type 2 diabetes and is characterized by an extensive phenotyping approach.…”

Section: Study Population and Designmentioning

confidence: 99%

“…To determine glucose metabolism, all participants (except those who use insulin) underwent a standardized 7-point oral glucose tolerance test after an overnight fast as previously described (16). Glucose metabolism was defined according to the World Health Organization 2006 criteria into normal glucose tolerance (NGT), impaired fasting glucose (IFG), impaired glucose tolerance (IGT), and type 2 diabetes (17).…”

Section: Glucose Metabolism Statusmentioning

confidence: 99%

“…Glucose metabolism was defined according to the World Health Organization 2006 criteria into normal glucose tolerance (NGT), impaired fasting glucose (IFG), impaired glucose tolerance (IGT), and type 2 diabetes (17). Additionally, individuals without type 1 diabetes and on diabetes medication were considered as having type 2 diabetes (16). For this study, we defined having either IFG or IGT as impaired glucose metabolism (IGM).…”

Section: Glucose Metabolism Statusmentioning

confidence: 99%

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Both Low and High 24-Hour Diastolic Blood Pressure Are Associated With Worse Cognitive Performance in Type 2 Diabetes: The Maastricht Study

et al. 2015

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OBJECTIVEHypertension and diabetes are both risk factors for cognitive decline, and individuals with both might have an especially high risk. We therefore examined linear and nonlinear (quadratic) associations of 24-h blood pressure (BP) with cognitive performance in participants with and without type 2 diabetes. We also tested the association of nocturnal dipping status with cognitive performance. RESEARCH DESIGN AND METHODSThis study was performed as part of the Maastricht Study, an ongoing populationbased cohort study. Cross-sectional associations of 24-h BP (n = 713, of whom 201 had type 2 diabetes) and nocturnal dipping status (n = 686, of whom 196 had type 2 diabetes) with performance on tests for global cognitive functioning, information processing speed, verbal memory (immediate and delayed word recall), and response inhibition were tested using linear regression analysis and adjusted for demographics, vascular risk factors, cardiovascular disease, depression, and lipidmodifying and antihypertensive medication use. RESULTSAfter full adjustment, we found quadratic (inverted U-shaped) associations of 24-h diastolic blood pressure (DBP) with information processing speed (b for quadratic term = 20.0267, P < 0.01) and memory (immediate word recall: b = 20.0180, P < 0.05; delayed word recall: b = 20.0076, P < 0.01) in participants with diabetes, but not in those without. No clear pattern was found for dipping status. CONCLUSIONSThis study shows that both low and high 24-h DBP are associated with poorer performance on tests of information processing speed and memory in individuals with type 2 diabetes.Type 2 diabetes is associated with cognitive decline and dementia (1,2), but the pathological mechanisms underlying these associations are not yet clear. Proposed mechanisms include the role of vascular risk factors, such as hypertension. Some studies have shown an association of hypertension with cognitive dysfunction and Alzheimer disease in individuals with diabetes (3,4). In addition, diabetes and hypertension seem to interact in their effect on cognitive decline (5) and dementia (6),

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Association of Retinal Nerve Fiber Layer Thickness, an Index of Neurodegeneration, With Depressive Symptoms Over Time

et al. 2021

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Key Points Question Is neurodegeneration associated with the early pathobiology of late-life depression? Findings This population-based cohort study of 4934 participants found that lower retinal nerve fiber layer thickness, an index of neurodegeneration, was significantly associated with higher incidence of clinically relevant depressive symptoms and more depressive symptoms over time, after adjustment for demographic, lifestyle, and cardiovascular risk factors. Meaning These findings suggest that neurodegeneration may be associated with the early pathobiology of late-life depression.

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The Maastricht Study: an extensive phenotyping study on determinants of type 2 diabetes, its complications and its comorbidities

Cited by 338 publications

References 58 publications

Functional Brain Networks Are Altered in Type 2 Diabetes and Prediabetes: Signs for Compensation of Cognitive Decrements? The Maastricht Study

Functional Brain Networks Are Altered in Type 2 Diabetes and Prediabetes: Signs for Compensation of Cognitive Decrements? The Maastricht Study

Both Low and High 24-Hour Diastolic Blood Pressure Are Associated With Worse Cognitive Performance in Type 2 Diabetes: The Maastricht Study

Association of Retinal Nerve Fiber Layer Thickness, an Index of Neurodegeneration, With Depressive Symptoms Over Time

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