ArticleDiabetes care2020
The Prevalence and Determinants of Cognitive Deficits and Traditional Diabetic Complications in the Severely Obese.
Article in Diabetes care, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT07202000 (Double-blind, Prospective, Randomized, Placebo-controlled Trial to Assess if Activin Ligand-trap Biological Therapy Can Improve Exercise Capacity and Cognitive Function in Heart Failure With Preserved Ejection Fraction Compared to Placebo.), which is not on this map. Cited by 34 papers, 2 of them syntheses that pooled it.
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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.
Double-blind, Prospective, Randomized, Placebo-controlled Trial to Assess if Activin Ligand-trap Biological Therapy Can Improve Exercise Capacity and Cognitive Function in Heart Failure With Preserved Ejection Fraction Compared to Placebo.
Who cites it
34 citing papers in PubMed, 2 syntheses or guidelines pooled it, 52 citations in OpenAlex.
- Cognitive impairment and associated factors among patients with diabetes mellitus in Africa: a systematic review and meta-analysis.Frontiers in endocrinology · 2024Pooled it
- The prevalence of cardiac autonomic neuropathy in prediabetes: a systematic review.Diabetologia · 2021Pooled it
- Effects of Peripheral Neural Blocks in Laparoscopic Sleeve Gastrectomy: a Pilot Study on Cognitive Functions in Severe Obese Patients.Obesity surgery · 2023Trial
- Diabetes and the Metabolic Syndrome as Drivers of Neurodegeneration: Convergent Mechanisms Linking Peripheral Neuropathy and Dementia.Annals of neurology · 2026Review
- Neurological manifestations in metabolic dysfunction syndrome are associated with cumulative metabolic burden beyond hyperglycaemia: a translational study.Frontiers in endocrinology · 2026Article
- Glycaemic control, low levels of high-density lipoprotein, and high cardiovascular risk are associated with cardiovascular autonomic neuropathy.Diabetology & metabolic syndrome · 2025Article
- Metabolic syndrome and diabetic kidney disease: a consistent dose-response association validated in an independent clinical cohort.Frontiers in endocrinology · 2025Article
- Prevalence and Risk Factors of Distal Symmetric Polyneuropathy Among Predominantly Non-Hispanic Black, Low-Income Patients.Neurology · 2024Article
- Prevalence of Retinopathy in Prediabetic Populations: A Systematic Review and Meta-Analysis.Cureus · 2023Review
- Association between brain health outcomes and metabolic risk factors in persons with diabetes.Annals of clinical and translational neurology · 2023Article
- New perspectives in diabetic neuropathy.Neuron · 2023Review
- The effect of surgical weight loss on diabetes complications in individuals with class II/III obesity.Diabetologia · 2023Article
- Single-cell RNA sequencing identifies hippocampal microglial dysregulation in diet-induced obesity.iScience · 2023Article
- The Effect of Surgical Weight Loss on Cognition in Individuals with Class II/III Obesity.The journal of nutrition, health & aging · 2023Article
- Obesity-induced neuroinflammation and cognitive impairment in young adult versus middle-aged mice.Immunity & ageing : I & A · 2022Article
- Diabetes and dementia: Clinical perspective, innovation, knowledge gaps.Journal of diabetes and its complications · 2022Review
- Towards prevention of diabetic peripheral neuropathy: clinical presentation, pathogenesis, and new treatments.The Lancet. Neurology · 2022Review
- Serum lipidomic determinants of human diabetic neuropathy in type 2 diabetes.Annals of clinical and translational neurology · 2022Article
- Glial-neuron crosstalk in health and disease: A focus on metabolism, obesity, and cognitive impairment.Neurobiology of disease · 2022Review
- Anesthesia management in a post Covid-19 obstetric patient-What we need to know.Journal of anaesthesiology, clinical pharmacology · 2022Review
Corrections and comments
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Authors and funding
11 authors at 1 institution in 1 country.
Funding
Abstract
objectiveTo determine the prevalence of cognitive deficits and traditional diabetic complications and the association between metabolic factors and these outcomes. RESEARCH DESIGN AND
methodsWe performed a cross-sectional study in severely obese individuals before bariatric surgery. Lean control subjects were recruited from a research website. Cognitive deficits were defined by the National Institutes of Health (NIH) Toolbox (<5th percentile for lean control subjects). Cardiovascular autonomic neuropathy (CAN) was defined by an expiration-to-inspiration (E-to-I) ratio of <5th percentile for lean control subjects. Retinopathy was based on retinal photographs and nephropathy on the estimated glomerular filtration rate (<60 mg/dL) and/or the albumin-to-creatinine ratio (ACR) (≥30 mg/g). NIH Toolbox, E-to-I ratio, mean deviation on frequency doubling technology testing, and ACR were used as sensitive measures of these outcomes. We used multivariable linear regression to explore associations between metabolic factors and these outcomes.
resultsWe recruited 138 severely obese individuals and 46 lean control subjects. The prevalence of cognitive deficits, CAN, retinopathy, and nephropathy were 6.5%, 4.4%, 0%, and 6.5% in lean control subjects; 22.2%, 18.2%, 0%, and 6.1% in obese participants with normoglycemia; 17.7%, 21.4%, 1.9%, and 17.9% in obese participants with prediabetes; and 25.6%, 31.9%, 6.1%, and 16.3% in obese participants with diabetes. Waist circumference was significantly associated with cognitive function (-1.48; 95% CI -2.38, -0.57) and E-to-I ratio (-0.007; 95% CI -0.012, -0.002). Prediabetes was significantly associated with retinal function (-1.78; 95% CI -3.56, -0.002).
conclusionsObesity alone is likely sufficient to cause cognitive deficits but not retinopathy or nephropathy. Central obesity is the key metabolic risk factor.
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Registered trials
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.