title: Impaired glucose regulation is associated with poorer performance on the Stroop Task.
abstract: BACKGROUND
  Type 2 diabetes is a risk factor for development of cognitive dysfunction. Impairments in glucose regulation have been associated with poorer performance on tests of executive function and information processing speed.
  
  
  METHODS
  We administered the Stroop Color Word Task, where higher interference scores are indicative of decreased selective attention, to 98 non-diabetic volunteers (64 m; %fat=37 ± 12; age=36 ± 9 yrs, race=41 NA/30 C/13 H/14 AA) on our inpatient unit. After 3d on a weight maintaining diet, % body fat was measured by DXA and a 75 g oral glucose tolerance test (OGTT) was administered. Impaired glucose regulation (IGR) was defined as: fasting plasma glucose ≥ 100 and ≤ 125 mg/dL and/or 2h plasma glucose between ≥ 140 and ≤ 199 mg/dL (IGR; n=48; NGR; n=50). Total and incremental area under the curve (AUC) for insulin and glucose were calculated.
  
  
  RESULTS
  Stroop interference scores were not significantly associated with any measure of adiposity or insulin concentrations. Individuals with IGR had significantly higher interference scores than those with normal glucose regulation (NGR; p=0.003). Higher interference scores were significantly correlated with fasting plasma glucose concentrations (r=0.26, p=0.007) and total glucose AUC (r=0.30, p=0.02) and only trending so for iAUC and 2h plasma glucose (r=0.18, p=0.08; r=0.17, p=0.09 respectively). In separate multivariate linear models, fasting plasma glucose (p=0.002) and total glucose AUC (p=0.0005) remained significant predictors of Stroop interference scores, even after adjustment for age, sex, race, education and %fat.
  
  
  CONCLUSIONS
  Individuals with IGR had decreased performance on a test of selective attention. Fasting plasma glucose was more strongly associated with lower performance scores than 2h plasma glucose. Our results indicate that even mild hyperglycemia in the non-diabetic range is associated with attentional processing difficulties in a sample of younger adults. Whether these impairments precede or are induced by impaired glucose regulation is not clear.
authors.affiliation: Obesity and Diabetes Clinical Research Section, Phoenix Epidemiology and Clinical Research Branch, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Phoenix, AZ, United States. Electronic address: gmarci@niddk.nih.gov.
authors.forename: Marci E
authors.initials: ME
authors.lastname: Gluck
authors.forename: Cindy
authors.initials: C
authors.lastname: Ziker
authors.forename: Matthew
authors.initials: M
authors.lastname: Schwegler
authors.forename: Marie
authors.initials: M
authors.lastname: Thearle
authors.forename: Susanne B
authors.initials: SB
authors.lastname: Votruba
authors.forename: Jonathan
authors.initials: J
authors.lastname: Krakoff
mesh_terms: D000293:Adolescent; D000328:Adult; D001288:Attention / Q000502:physiology*; D001786:Blood Glucose / Q000378:metabolism*; D015992:Body Mass Index; D005260:Female; D018149:Glucose Intolerance / Q000097:blood / Q000523:psychology*; D005951:Glucose Tolerance Test; D006801:Humans; D007328:Insulin / Q000097:blood*; D008297:Male; D008875:Middle Aged; D057190:Stroop Test
chemical_list: D001786:Blood Glucose; D007328:Insulin
keywords: Cognitive performance; Executive function; Insulin; Interference; Obesity; Processing speed
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