High Glycemic Load Is Associated with Cognitive Decline in Apolipoprotein E ε4 Allele Carriers
Abstract
:1. Introduction
2. Materials and Methods
2.1. Study Sample
2.2. Dietary Data
2.3. Neuropsychological Evaluation and Dementia Diagnosis
2.4. Covariates
2.5. Statistical Analyses
2.5.1. Main Analyses
2.5.2. Sensitivity Analyses
2.5.3. Imputation of Missing Values
3. Results
3.1. Population Characteristics
3.2. Main Analyses
3.2.1. Association between GL and Cognitive Changes in APOE4 Non-Carriers (12-Year Follow-up)
3.2.2. Association between Glycemic Load and Cognitive Changes in APOE4 Carriers (12-Year Follow-up)
3.3. Sensitivity Analyses
4. Discussion
Supplementary Materials
Author Contributions
Funding
Acknowledgments
Conflicts of Interest
References
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Characteristics Mean (SD) or n (%) | Daily Glycemic Load Tertiles | |||
---|---|---|---|---|
Low (<93) n = 846 | Middle (93 to <119) n = 845 | High (≥119) n = 848 | p Value 1 | |
Montpellier center | 342 (40.4) | 390 (46.2) | 527 (62.1) | <0.0001 |
Age (years) | 75.9 (4.8) | 75.5 (4.8) | 76.4 (4.9) | 0.038 |
Women | 572 (67.6) | 512 (60.6) | 515 (60.7) | 0.003 |
Education level | 0.19 | |||
No school | 231 (27.3) | 216 (25.6) | 208 (24.5) | |
Primary school | 237 (28) | 265 (31.4) | 224 (26.4) | |
High school | 192 (22.7) | 183 (21.7) | 210 (24.8) | |
Graduated | 185 (21.9) | 178 (21.1) | 204 (24.1) | |
MMSE (IQR) | 28 (27-29) | 28 (27-29) | 28 (27–29) | 0.805 |
APOE4 carriers | 142 (16.8) | 156 (18.5) | 144 (17) | 0.539 |
BMI (kg/m2) | 26.1 (4.1) | 25.6 (3.9) | 24.8 (3.4) | <0.0001 |
Hypertension | 521 (61.6) | 487 (57.6) | 465 (54.8) | 0.017 |
Cardiovascular history | 90 (10.6) | 82 (9.7) | 77 (9.1) | 0.555 |
Stroke history | 37 (4.4) | 25 (3) | 39 (4.6) | 0.173 |
Hypercholesterolemia | 464 (54.8) | 475 (56.2) | 452 (53.3) | 0.486 |
Depressive symptomatology 2 | 74 (8.7) | 56 (6.6) | 70 (8.3) | 0.238 |
Tobacco use (current or past) | 337 (39.8) | 310 (36.7) | 300 (35.4) | 0.15 |
Mediterranean-like diet | 4.3 (1.6) | 5 (1.6) | 5.5 (1.5) | <0.0001 |
Physical activity | 251 (29.7) | 274 (32.4) | 317 (37.4) | 0.002 |
Energy intake (kJ/day) | 3553.2 (698.8) | 4694.5 (656.2) | 6379.4 (1476.5) | <0.0001 |
Glycemic Load | IST n = 1815 | BVRT n = 1794 | log(TMTA) n = 1612 | log(TMTB) n = 1593 | FIRS n = 1351 | FDRS n = 1348 | MMSE n = 1831 |
---|---|---|---|---|---|---|---|
β (SE) | β (SE) | β (SE) | β (SE) | β (SE) | β (SE) | β (SE) | |
Daily | |||||||
Middle | −0.159 (0.654) | −0.1 (0.12) | 0.003 (0.026) | 0.01 (0.029) | 0.649 (0.654) | 0.304 (0.285) | −0.096 (0.119) |
High | −0.103 (0.82) | −0.129 (0.146) | 0.023 (0.032) | −0.004 (0.035) | 0.944 (0.757) | 0.411 (0.326) | 0.03 (0.147) |
Middle × time | 0.102 (0.056) | 0.008 (0.012) | −0.006 * (0.003) | −0.003 (0.003) | 0.015 (0.075) | 0.003 (0.034) | 0.022 (0.024) |
High × time | 0.086 (0.055) | 0.01 (0.012) | −0.004 (0.003) | −0.001 (0.003) | 0.045 (0.073) | 0.007 (0.033) | −0.015 (0.024) |
Breakfast | |||||||
Middle | 0.608 (0.579) | 0.073 (0.109) | -0.033 (0.024) | −0.031 (0.026) | −0.965 (0.604) | 0.136 (0.267) | 0.058 (0.105) |
High | 0.136 (0.67) | 0.033 (0.122) | 0.015 (0.027) | −0.036 (0.029) | −0.31 (0.644) | 0.026 (0.28) | 0.07 (0.121) |
Middle × time | 0.031 (0.057) | −0.005 (0.012) | 0 (0.003) | 0.002 (0.003) | 0.136 (0.076) | −0.014 (0.035) | 0.023 (0.024) |
High × time | 0.08 (0.054) | 0.015 (0.012) | −0.003 (0.003) | 0 (0.003) | 0.09 (0.071) | 0.01 (0.032) | 0.023 (0.023) |
Lunch | |||||||
Middle | −1.312 * (0.6) | −0.07 (0.114) | 0.027 (0.025) | 0.067 (0.027) | 0.292 (0.627) | −0.279 (0.274) | 0.017 (0.11) |
High | −1.904 ** (0.732) | −0.324 * (0.133) | 0.074 * (0.029) | 0.066 (0.032) | 0.124 (0.687) | −0.1 (0.297) | −0.054 (0.132) |
Middle × time | 0.021 (0.057) | −0.008 (0.012) | −0.001 (0.003) | −0.008 ** (0.003) | −0.055 (0.077) | 0.026 (0.035) | −0.021 (0.024) |
High × time | 0.102 (0.054) | 0.011 (0.012) | −0.006 * (0.003) | −0.006 * (0.003) | 0.064 (0.072) | 0.025 (0.033) | −0.012 (0.023) |
Afternoon snack | |||||||
Middle | −2.125 (5.936) | −0.552 (0.964) | −0.003 (0.216) | −0.07 (0.225) | −2.922 (4.169) | −0.029 (1.732) | −0.328 (1.035) |
High | −2.924 (5.978) | −0.61 (0.972) | 0.019 (0.217) | −0.047 (0.227) | −3.165 (4.205) | 0.16 (1.747) | −0.44 (1.043) |
Middle × time | −0.054 (0.054) | −0.006 (0.012) | −0.002 (0.003) | −0.002 (0.003) | 0.026 (0.072) | −0.016 (0.033) | −0.016 (0.023) |
High × time | 0.038 (0.056) | −0.006 (0.012) | −0.002 (0.003) | 0.001 (0.003) | 0.106 (0.074) | 0.001 (0.034) | −0.035 (0.024) |
Dinner | |||||||
Middle | 0.565 (0.601) | −0.065 (0.113) | 0.033 (0.025) | 0.054 (0.027) | −0.056 (0.616) | −0.19 (0.269) | −0.178 (0.109) |
High | 0.194 (0.778) | −0.204 (0.138) | 0.064 * (0.03) | 0.072 * (0.033) | 0.212 (0.71) | −0.03 (0.305) | −0.066 (0.139) |
Middle × time | 0.027 (0.056) | 0.017 (0.012) | 0.002 (0.003) | 0.002 (0.003) | 0.046 (0.075) | 0.039 (0.034) | 0.045 (0.024) |
High × time | −0.015 (0.053) | 0.019 (0.012) | −0.003 (0.003) | −0.001 (0.003) | −0.02 (0.071) | 0.015 (0.032) | 0.001 (0.023) |
Glycemic Load | IST n = 401 | BVRT n = 401 | log(TMTA) n = 348 | log(TMTB) n = 348 | FIRS n = 278 | FDRS n = 275 | MMSE n = 409 |
---|---|---|---|---|---|---|---|
β (SE) | β (SE) | β (SE) | β (SE) | β (SE) | β (SE) | β (SE) | |
Daily | |||||||
Middle | −0.719 (1.402) | −0.049 (0.259) | 0.04 (0.059) | −0.024 (0.065) | −0.018 (1.58) | −0.037 (0.706) | 0.183 (0.266) |
High | −1.476 (1.741) | 0.115 (0.316) | 0.034 (0.071) | −0.034 (0.077) | 0.428 (1.811) | 0.747 (0.799) | 0.141 (0.332) |
Middle × time | 0.086 (0.134) | −0.009 (0.033) | 0.002 (0.006) | −0.002 (0.007) | −0.033 (0.2) | 0.03 (0.093) | −0.013 (0.062) |
High × time | 0.042 (0.131) | −0.031 (0.032) | 0.007 (0.006) | 0.001 (0.006) | −0.167 (0.196) | −0.103 (0.09) | −0.028 (0.062) |
Breakfast | |||||||
Middle | −1.571 (1.237) | −0.055 (0.234) | 0.037 (0.054) | −0.022 (0.058) | −0.771 (1.475) | −0.649 (0.654) | 0.088 (0.238) |
High | −1.647 (1.444) | −0.201 (0.267) | 0.065 (0.059) | −0.06 (0.064) | 0.192 (1.534) | −0.133 (0.677) | 0.165 (0.279) |
Middle × time | −0.11 (0.134) | −0.041 (0.034) | 0.003 (0.007) | 0.002 (0.007) | −0.095 (0.2) | −0.007 (0.092) | −0.143 * (0.061) |
High × time | 0.018 (0.126) | −0.053 (0.031) | 0.002 (0.006) | 0.004 (0.006) | −0.269 (0.18) | −0.076 (0.083) | −0.051 (0.057) |
Lunch | |||||||
Middle | −0.772 (1.27) | 0.006 (0.242) | 0.114 * (0.055) | −0.005 (0.06) | 1.738 (1.521) | 0.325 (0.683) | 0.032 (0.246) |
High | −0.202 (1.58) | 0.219 (0.293) | 0.085 (0.065) | −0.066 (0.07) | 0.545 (1.674) | −0.452 (0.76) | −0.162 (0.302) |
Middle × time | 0.038 (0.132) | 0.021 (0.033) | −0.01 (0.006) | −0.001 (0.006) | −0.09 (0.195) | −0.007 (0.089) | 0.039 (0.06) |
High × time | 0.011 (0.131) | −0.024 (0.032) | −0.006 (0.006) | 0.002 (0.006) | −0.082 (0.188) | −0.055 (0.087) | −0.024 (0.06) |
Afternoon snack | |||||||
Middle | 15.27 (8.8) | 0.896 (1.499) | −0.032 (0.322) | 0.082 (0.345) | −0.888 (6.569) | −1.579 (2.938) | −2.218 (1.747) |
High | 14.429 (8.908) | 0.421 (1.524) | 0.071 (0.326) | 0.277 (0.349) | 0.386 (6.723) | −1.213 (3.01) | −2.522 (1.77) |
Middle × time | −0.069 (0.133) | −0.071 * (0.033) | 0.004 (0.006) | 0.005 (0.007) | 0.081 (0.198) | −0.005 (0.091) | −0.04 (0.06) |
High × time | −0.183 (0.129) | −0.04 (0.032) | 0.011 (0.006) | 0.002 (0.006) | −0.343 (0.188) | −0.175 * (0.087) | −0.158 ** (0.059) |
Dinner | |||||||
Middle | 0.962 (1.343) | −0.012 (0.255) | −0.026 (0.058) | −0.051 (0.063) | 1.418 (1.589) | 0.351 (0.711) | −0.002 (0.255) |
High | 2.361 (1.765) | 0.281 (0.31) | −0.011 (0.071) | −0.058 (0.077) | 0.943 (1.81) | −0.116 (0.805) | −0.184 (0.32) |
Middle × time | −0.067 (0.139) | −0.031 (0.035) | 0.006 (0.007) | 0.006 (0.007) | −0.141 (0.204) | −0.054 (0.094) | −0.034 (0.063) |
High × time | 0.029 (0.128) | −0.02 (0.032) | 0.005 (0.006) | −0.004 (0.006) | −0.129 (0.193) | −0.033 (0.087) | 0.012 (0.058) |
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Gentreau, M.; Raymond, M.; Chuy, V.; Samieri, C.; Féart, C.; Berticat, C.; Artero, S. High Glycemic Load Is Associated with Cognitive Decline in Apolipoprotein E ε4 Allele Carriers. Nutrients 2020, 12, 3619. https://doi.org/10.3390/nu12123619
Gentreau M, Raymond M, Chuy V, Samieri C, Féart C, Berticat C, Artero S. High Glycemic Load Is Associated with Cognitive Decline in Apolipoprotein E ε4 Allele Carriers. Nutrients. 2020; 12(12):3619. https://doi.org/10.3390/nu12123619
Chicago/Turabian StyleGentreau, Mélissa, Michel Raymond, Virginie Chuy, Cécilia Samieri, Catherine Féart, Claire Berticat, and Sylvaine Artero. 2020. "High Glycemic Load Is Associated with Cognitive Decline in Apolipoprotein E ε4 Allele Carriers" Nutrients 12, no. 12: 3619. https://doi.org/10.3390/nu12123619