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Original Article Metabolic Risk/Epidemiology Longitudinal Association of Changes in Metabolic Syndrome with Cognitive Function: 12-Year Follow-up of the Guangzhou Biobank Cohort Study
Yu Meng Tian1,2orcid , Wei Sen Zhang2,3orcid , Chao Qiang Jiang2,3, Feng Zhu3, Ya Li Jin3, Shiu Lun Au Yeung2,4, Jiao Wang1,2, Kar Keung Cheng5, Tai Hing Lam2,3,4, Lin Xu1,2,4,5orcid

DOI: https://doi.org/10.4093/dmj.2024.0117 [Epub ahead of print]
Published online: October 29, 2024
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1School of Public Health, Sun Yat-sen University, Guangzhou, China
2Greater Bay Area Public Health Research Collaboration, Guangzhou, China
3Occupational Disease Prevention and Treatment Centre, Guangzhou Twelfth People’s Hospital, Guangzhou, China
4School of Public Health, The University of Hong Kong, Hong Kong
5Institute of Applied Health Research, University of Birmingham, Birmingham, UK
Corresponding author:  Wei Sen Zhang,
Email: zwsgzcn@163.com
Lin Xu,
Email: xulin27@mail.sysu.edu.cn
Received: 8 March 2024   • Accepted: 13 May 2024

Background
The association of changes in metabolic syndrome (MetS) with cognitive function remains unclear. We explored this association using prospective and Mendelian randomization (MR) studies.
Methods
MetS components including high-density lipoprotein cholesterol (HDL-C), systolic blood pressure (SBP), waist circumference (WC), fasting plasma glucose (FPG), and triglycerides were measured at baseline and two follow-ups, constructing a MetS index. Immediate, delayed memory recall, and cognitive function along with its dimensions were assessed by immediate 10- word recall test (IWRT) and delayed 10-word recall test (DWRT), and mini-mental state examination (MMSE), respectively, at baseline and follow-ups. Linear mixed-effect model was used. Additionally, the genome-wide association study (GWAS) of MetS was conducted and one-sample MR was performed to assess the causality between MetS and cognitive function.
Results
Elevated MetS index was associated with decreasing annual change rates (decrease) in DWRT and MMSE scores, and with decreases in attention, calculation and recall dimensions. HDL-C was positively associated with an increase in DWRT scores, while SBP and FPG were negatively associated. HDL-C showed a positive association, whereas WC was negatively associated with increases in MMSE scores, including attention, calculation and recall dimensions. Interaction analysis indicated that the association of MetS index on cognitive decline was predominantly observed in low family income group. The GWAS of MetS identified some genetic variants. MR results showed a non-significant causality between MetS and decrease in DWRT, IWRT, nor MMSE scores.
Conclusion
Our study indicated a significant association of MetS and its components with declines in memory and cognitive function, especially in delayed memory recall.

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Tian YM, Zhang WS, Jiang CQ, Zhu F, Jin YL, Yeung SLA, Wang J, Cheng KK, Lam TH, Xu L. Longitudinal Association of Changes in Metabolic Syndrome with Cognitive Function: 12-Year Follow-up of the Guangzhou Biobank Cohort Study. Diabetes Metab J. 2024 Oct 29. doi: 10.4093/dmj.2024.0117. Epub ahead of print.
Received: Mar 08, 2024; Accepted: May 13, 2024
DOI: https://doi.org/10.4093/dmj.2024.0117.

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