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Diabetes is Not Associated with Alzheimer’s Disease Neuropathology

2017; IOS Press; Volume: 60; Issue: 3 Linguagem: Inglês

10.3233/jad-170179

1875-8908

Maria Niures Pimentel dos Santos Matioli, Cláudia Kimie Suemoto, Roberta Diehl Rodriguez, Daniela Souza Farias, Magnólia Moreira da Silva, Renata Elaine Paraízo Leite, Renata Eloah de Lucena Ferretti‐Rebustini, José M. Farfel, Carlos Augusto Pasqualucci, Wilson Jacob Filho, Zoe Arvanitakis, Michel Satya Naslavsky, Mayana Zatz, Lea T. Grinberg, Ricardo Nitríni,

Dementia and Cognitive Impairment Research

Previous evidence linking diabetes to Alzheimer's disease (AD) neuropathology is mixed and scant data are available from low- and middle-income countries.To investigate the association between diabetes and AD neuropathology in a large autopsy study of older Brazilian adults.In this cross-sectional study, diabetes was defined by diagnosis during life or use of antidiabetic medication. A standardized neuropathological examination was performed using immunohistochemistry. The associations of diabetes with Consortium to Establish and Registry for Alzheimer Disease (CERAD) scores for neuritic plaques and Braak-Braak (BB) scores for neurofibrillary tangles were investigated using multivariable ordinal logistic regression. We investigated effect modification of education, race, and APOE on these associations.Among 1,037 subjects (mean age = 74.4±11.5 y; mean education = 4.0±3.7 y; 48% male, 61% White), diabetes was present in 279 subjects. Diabetes was not associated with BB (OR = 1.12, 95% CI = 0.81-1.54, p = 0.48) or with CERAD (OR = 0.97, 95% CI = 0.68-1.38, p = 0.86) scores on analyses adjusted for sociodemographic and clinical variables. We observed effect modification by the APOE allele ɛ4 on the association between diabetes mellitus and BB scores.No evidence of an association between diabetes and AD neuropathology was found in a large sample of Brazilians; however, certain subgroups, such as APOE allele ɛ4 carriers, had higher odds of accumulation of neurofibrillary tangles.