Evidence map›Paper›PMID 29997193›Full record

ArticleNeurology2018

Low fasting serum insulin and dementia in nondiabetic women followed for 34 years.

Kirsten Mehlig, Leif Lapidus, Dag S Thelle, Margda Waern, Henrik Zetterberg, Cecilia Björkelund, Ingmar Skoog, Lauren Lissner

Open access · hybridAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Neurology, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
16citing papers in PubMed, 2 pooled it
1.0field-weighted citation impact, top 25% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

16 citing papers in PubMed, 2 syntheses or guidelines pooled it, 19 citations in OpenAlex.

  1. Pooled it
  2. Pooled it
  3. Article
  4. Review
  5. Article
  6. Review
  7. Article
  8. Review
  9. Article
  10. Article
  11. Article
  12. Article
  13. Review
  14. Article
  15. Article
  16. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors at 1 institution in 3 countries.

Kirsten MehligFrom the Institutes of Medicine (K.M., L.L., D.S.T., C.B., L.L.) and Neuroscience and Physiology (M.W., H.Z., I.S.), University of Gothenburg, Sweden; Institute of Basic Medical Sciences (D.S.T.), University of Oslo, Norway; UCL Institute of Neurology (H.Z.), Queen Square; UK Dementia Research Institute (H.Z.), London; and Clinical Neurochemistry Laboratory (H.Z.), Sahlgrenska University Hospital, Mölndal, Sweden. kirsten.mehlig@gu.se.
Leif LapidusFrom the Institutes of Medicine (K.M., L.L., D.S.T., C.B., L.L.) and Neuroscience and Physiology (M.W., H.Z., I.S.), University of Gothenburg, Sweden; Institute of Basic Medical Sciences (D.S.T.), University of Oslo, Norway; UCL Institute of Neurology (H.Z.), Queen Square; UK Dementia Research Institute (H.Z.), London; and Clinical Neurochemistry Laboratory (H.Z.), Sahlgrenska University Hospital, Mölndal, Sweden.
Dag S ThelleFrom the Institutes of Medicine (K.M., L.L., D.S.T., C.B., L.L.) and Neuroscience and Physiology (M.W., H.Z., I.S.), University of Gothenburg, Sweden; Institute of Basic Medical Sciences (D.S.T.), University of Oslo, Norway; UCL Institute of Neurology (H.Z.), Queen Square; UK Dementia Research Institute (H.Z.), London; and Clinical Neurochemistry Laboratory (H.Z.), Sahlgrenska University Hospital, Mölndal, Sweden.
Margda WaernFrom the Institutes of Medicine (K.M., L.L., D.S.T., C.B., L.L.) and Neuroscience and Physiology (M.W., H.Z., I.S.), University of Gothenburg, Sweden; Institute of Basic Medical Sciences (D.S.T.), University of Oslo, Norway; UCL Institute of Neurology (H.Z.), Queen Square; UK Dementia Research Institute (H.Z.), London; and Clinical Neurochemistry Laboratory (H.Z.), Sahlgrenska University Hospital, Mölndal, Sweden.
Henrik ZetterbergFrom the Institutes of Medicine (K.M., L.L., D.S.T., C.B., L.L.) and Neuroscience and Physiology (M.W., H.Z., I.S.), University of Gothenburg, Sweden; Institute of Basic Medical Sciences (D.S.T.), University of Oslo, Norway; UCL Institute of Neurology (H.Z.), Queen Square; UK Dementia Research Institute (H.Z.), London; and Clinical Neurochemistry Laboratory (H.Z.), Sahlgrenska University Hospital, Mölndal, Sweden.
Cecilia BjörkelundFrom the Institutes of Medicine (K.M., L.L., D.S.T., C.B., L.L.) and Neuroscience and Physiology (M.W., H.Z., I.S.), University of Gothenburg, Sweden; Institute of Basic Medical Sciences (D.S.T.), University of Oslo, Norway; UCL Institute of Neurology (H.Z.), Queen Square; UK Dementia Research Institute (H.Z.), London; and Clinical Neurochemistry Laboratory (H.Z.), Sahlgrenska University Hospital, Mölndal, Sweden.
Ingmar SkoogFrom the Institutes of Medicine (K.M., L.L., D.S.T., C.B., L.L.) and Neuroscience and Physiology (M.W., H.Z., I.S.), University of Gothenburg, Sweden; Institute of Basic Medical Sciences (D.S.T.), University of Oslo, Norway; UCL Institute of Neurology (H.Z.), Queen Square; UK Dementia Research Institute (H.Z.), London; and Clinical Neurochemistry Laboratory (H.Z.), Sahlgrenska University Hospital, Mölndal, Sweden.
Lauren LissnerFrom the Institutes of Medicine (K.M., L.L., D.S.T., C.B., L.L.) and Neuroscience and Physiology (M.W., H.Z., I.S.), University of Gothenburg, Sweden; Institute of Basic Medical Sciences (D.S.T.), University of Oslo, Norway; UCL Institute of Neurology (H.Z.), Queen Square; UK Dementia Research Institute (H.Z.), London; and Clinical Neurochemistry Laboratory (H.Z.), Sahlgrenska University Hospital, Mölndal, Sweden.
University of Oslo · NO

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveIn a representative population of women followed over 34 years, we investigated the prospective association between fasting serum insulin and dementia, taking into account the incidence of diabetes mellitus.

methodsFasting values for serum insulin and blood glucose were obtained in 1,212 nondiabetic women 38 to 60 years of age at the 1968 baseline. Risk of dementia was assessed by Cox proportional hazard regression with adjustment for insulin, glucose, and other covariates and, in a second model, after censoring for incident cases of diabetes mellitus. Incident diabetes mellitus was considered as a third endpoint for comparison with dementia.

resultsOver 34 years, we observed 142 incident cases of dementia. The low tertile of insulin displayed excess risk for dementia (hazard ratio [HR] 2.34, 95% confidence interval [CI] 1.52-3.58) compared to the medium tertile, but the high tertile of insulin did not (HR 1.28, 95% CI 0.81-2.03). These associations were also seen for dementia without diabetes comorbidity. In contrast, high but not low insulin predicted incident diabetes mellitus (115 cases) (HR 1.70, 95% CI 1.08-2.68 and HR 0.76, 95% CI 0.43-1.37, respectively).

conclusionA previous study reported a U-shaped association between fasting insulin and dementia in a 5-year follow-up of elderly men. Our results confirmed a nonlinear association in a female population, with high risk at low insulin values that was not attributable to preclinical dementia or impaired insulin secretion. This condition suggests a new pathway to dementia, which differs from the metabolic pathway involving diabetes mellitus.

Indexed as

AdultBiomarkersDementiaDiabetes MellitusFastingFemaleFollow-Up StudiesHumansInsulinMiddle AgedProspective StudiesTime FactorsBiomarkersInsulin

Identifiers

PMID29997193
PMCPMC6093770
OpenAlexW2868307382

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.