The following is a summary of “Orthostatic Hypotension Promotes the Progression From Mild Cognitive Impairment to Dementia in Type 2 Diabetes Mellitus,” published in the June 2024 issue of Endocrinology by Xiong, et al.

For a study, researchers sought to elucidate the role of Alzheimer’s disease (AD) biomarkers and complement proteins in mediating the association between orthostatic hypotension (OH) and cognitive impairment in patients with type 2 diabetes mellitus (T2DM). Additionally, they sought to investigate whether OH contributes to the accelerated progression from mild cognitive impairment (MCI) to dementia in individuals with T2DM.

Patients diagnosed with T2DM and MCI were enrolled, and relevant clinical information and blood samples were collected. They focused on isolating complement proteins from astrocyte-derived exosomes and quantifying AD biomarkers from neuronal cell-derived exosomes using enzyme-linked immunosorbent assay (ELISA). Cognitive assessments were conducted at baseline and during follow-up visits.

Mediation analysis revealed that baseline levels of AD biomarkers partially mediated the impact of OH on cognitive function in patients with T2DM and complement proteins. Furthermore, Cox proportional-hazards regression analysis demonstrated that individuals in the OH group had a significantly higher risk of progressing to dementia compared to those without OH in the T2DM cohort.

The study highlighted the role of AD biomarkers and complement proteins in mediating the relationship between OH and cognitive impairment in patients with T2DM and MCI. Moreover, OH appeared to be a potential risk factor for the accelerated progression from MCI to dementia in individuals with T2DM. The findings underscored the importance of further research into the mechanisms underlying these associations and the potential implications for clinical management strategies.

Reference: academic.oup.com/jcem/article/109/6/1454/7505036