Relationship Between Markers of Insulin Resistance, Markers of Adiposity, HbA1c, and Cognitive Functions in a Middle-Aged Population–Based Sample: the MONA LISA study

Adiposity and cognitive functions

  1. Sandrine Andrieu, PHD1,3,6
  1. 1UMR-1027, INSERM, University of Toulouse III, Toulouse, France
  2. 2Department of Diabetology, Metabolic Diseases, and Nutrition, Toulouse University Hospital, Toulouse, France
  3. 3Department of Epidemiology and Public Health, Toulouse University Hospital, Toulouse, France
  4. 4Cognition, Langues, Langage, Ergonomie, UMR-5263 CNRS-EPHE, University of Toulouse II, Toulouse, France
  5. 5Department of Cardiology B, Toulouse University Hospital, Toulouse, France
  6. 6Gerontopole, Department of Geriatric Medicine, Toulouse University Hospital, Toulouse, France
  1. Corresponding author: Jean-Bernard Ruidavets, jean-bernard.ruidavets{at}


OBJECTIVE To determine the relationship between markers of insulin resistance (fasting insulin and homeostasis model assessment of insulin resistance), markers of adiposity (BMI, waist circumference, and body fat), HbA1c, and cognitive performances in a middle-aged population–based sample free of diabetes.

RESEARCH DESIGN AND METHODS Our study sample consisted of 1,172 people aged 35–64 years (49% women), free of diabetes, and recruited between 2005 and 2007 in the MONA-LISA survey. Cognitive functions (memory, attention, and processing speed) were evaluated by neuropsychological tests: word-list learning test, digit symbol substitution test (DSST), word fluency test, and Stroop Test. Multiple logistic regressions were used to estimate the relationship between cognitive performance and metabolic markers. We serially adjusted for age, sex, education, and occupational status (model A), additionally for income, smoking, alcohol consumption, sedentarity, and psychotropic substance use (model B), and finally, included variables linked to the metabolic syndrome (hypertension, dyslipidemia, vascular disease, and C-reactive protein) and depression (model C).

RESULTS Elevated markers of adiposity were associated with poor cognitive performance in tests evaluating processing speed. The probability of being in the lowest quartile of each test was nearly doubled for participants in the upper quartile of BMI, compared with those in the lowest one [BMI, adjusted odds ratio (OR) 2.18, P = 0.003 (DSST), and OR 2.09, P = 0.005 (Stroop Test)]. High HbA1c was associated with poor cognitive performance in DSST (adjusted OR 1.75, P = 0.037). Waist circumference was linked to poor cognitive performance in men but not in women.

CONCLUSIONS Poor cognitive performance is associated with adiposity and hyperglycemia in healthy middle-aged people.

  • Received May 28, 2012.
  • Accepted November 5, 2012.

Readers may use this article as long as the work is properly cited, the use is educational and not for profit, and the work is not altered. See for details.

This Article

  1. Diabetes Care
  1. All Versions of this Article:
    1. dc12-1017v1
    2. 36/6/1512 most recent