Author information
1
Betty and Guy Beatty Center for Integrated Research, Inova Health System, Falls Church, VA; Center for the Study of Chronic Illness and Disability, George Mason University, Fairfax, VA.
2
Betty and Guy Beatty Center for Integrated Research, Inova Health System, Falls Church, VA.
3
Center for the Study of Chronic Illness and Disability, George Mason University, Fairfax, VA; Center for Liver Disease, Department of Medicine, Inova Fairfax Hospital, Falls Church, VA.
4
Betty and Guy Beatty Center for Integrated Research, Inova Health System, Falls Church, VA; Center for Liver Disease, Department of Medicine, Inova Fairfax Hospital, Falls Church, VA. Electronic address: Zobair.Younossi@inova.org.
Abstract
BACKGROUND:
Individuals with nonalcoholic fatty liver disease (NAFLD) share some common pathophysiological features with individuals with type 2 diabetes mellitus (T2DM). There is a well-established association between T2DM and cognitive decline, but no corollary data of people with NAFLD and without T2DM or whether combination of the 2 disorders is associated with additive deficits in cognitive performance. The purpose of this investigation is to compare measures of cognitive performance for individuals with NAFLD, individuals with T2DM, individuals with both or neither.
METHODS:
Using NHANES data from 2011-2014, 1102 individuals were identified who had completed cognitive assessments. Cognitive performance was assessed by a series of well-established tasks. Presence of T2DM was defined as the use of diabetes medication and/or a fasting glucose measure of >126 mg/dL. Presence of NAFLD was defined as fatty liver index ≥ 60 in the absence of other chronic liver diseases.
RESULTS:
After controlling for demographics, comorbidities, and metabolic components, individuals with both NAFLD and T2DM scored significantly lower statistically on a task that combines processing speed, sustained attention, and working memory (Beta = -3.44, 95% CI: -6.75 to -0.12) than individuals with neither. Individuals with T2DM without NAFLD scored significantly lower statistically on verbal fluency (Beta = -1.47, 95% CI: -2.7 to -0.23) than individuals with neither.
CONCLUSIONS:
Data from this study suggests that individuals with T2DM and individuals with both NAFLD and T2DM have lower cognitive performance on various tasks. These data support an approach that aims to apply preventive strategies to optimize management of T2DM in patients with NAFLD.