{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,28]],"date-time":"2026-08-28T05:17:56Z","timestamp":1787894276329,"version":"build-2784847793"},"reference-count":60,"publisher":"MDPI AG","issue":"5","license":[{"start":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T00:00:00Z","timestamp":1787702400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Australian Government Research Training Program"},{"id":[{"id":"https:\/\/ror.org\/0314h5y94","id-type":"ROR","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000925","name":"National Health and Medical Research Council (NHMRC) of Australia","doi-asserted-by":"publisher","award":["1161871"],"award-info":[{"award-number":["1161871"]}],"id":[{"id":"10.13039\/501100000925","id-type":"DOI","asserted-by":"publisher"}]},{"award":["1161871"],"award-info":[{"award-number":["1161871"]}],"id":[{"id":"https:\/\/ror.org\/011kf5r70","id-type":"ROR","asserted-by":"publisher"}]},{"name":"CASS (Contributing to Australian Scholarship & Science) Foundation"},{"id":[{"id":"https:\/\/ror.org\/009ynjf67","id-type":"ROR","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001232","name":"Royal Australasian College of Physicians","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100001232","id-type":"DOI","asserted-by":"crossref"}]},{"id":[{"id":"https:\/\/ror.org\/047hk9367","id-type":"ROR","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Med. Sci.","Medical Sciences"],"abstract":"<jats:p>Background: Cardiometabolic risk factors are increasingly recognised as contributors to cognitive decline, yet their associations with domain-specific cognitive performance in adults with prediabetes or well-controlled type 2 diabetes (T2DM) remain poorly characterised. Methods: This cross-sectional study included 49 adults with prediabetes or well-controlled T2DM (managed by diet or metformin alone; HbA1c &lt; 8%). Cognitive function was assessed using the Cambridge Neuropsychological Test Automated Battery (CANTAB), Trail Making Tests (TMTs) parts A and B, Stroop, and Digit Symbol Substitution Test (DSST). Multivariable linear regression examined associations between cardiometabolic predictors (adiposity [DXA], glycaemic indices [OGTT], and serum lipids) and cognitive outcomes, adjusting for age, BMI, and education. Results: Higher HbA1c was independently associated with increased false alarms on the rapid visual processing task (RVPPFA; \u03b2 = 0.04 [95% CI 0.01, 0.07]; p = 0.015); fasting and 2 h glucose were not associated with any cognitive measure. Higher triglycerides were associated with lower sustained attention accuracy (RVPA; \u03b2 = \u22120.02 [95% CI \u22120.04, \u22120.004]; p = 0.016) and lower DSST scores (\u03b2 = \u22124.61 [95% CI \u22128.81, \u22120.40]; p = 0.033). Higher HDL cholesterol was independently associated with better sustained attention (RVPA; \u03b2 = 0.08 [95% CI 0.02, 0.15]; p = 0.017). No consistent associations were found between adiposity measures and any cognitive outcome, with no effect modification by sex or diabetes status (all Pinteraction &gt; 0.05). Conclusions: In cognitively healthy adults with prediabetes or well-controlled T2DM, higher HbA1c and triglycerides and lower HDL were associated with poorer domain-specific cognitive performance in the absence of overt cognitive impairment. Larger longitudinal studies are needed to establish whether these associations represent early cognitive changes and to determine whether reducing cardiometabolic risk can preserve cognitive function.<\/jats:p>","DOI":"10.3390\/medsci14050520","type":"journal-article","created":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T11:53:42Z","timestamp":1787745222000},"page":"520","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Cardiometabolic Risk Factors and Domain-Specific Cognitive Function in Prediabetes and Type 2 Diabetes"],"prefix":"10.3390","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4273-3205","authenticated-orcid":false,"given":"Rohit","family":"Hariharan","sequence":"first","affiliation":[{"name":"Monash Centre for Health Research and Implementation, Faculty of Medicine, Nursing and Health Sciences, Monash University, 43-51 Kanooka Grove, Clayton, VIC 3168, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2781-6478","authenticated-orcid":false,"given":"Simon M.","family":"Bell","sequence":"additional","affiliation":[{"name":"Sheffield Institute for Translational Neuroscience, School of Medicine and Population Health, University of Sheffield, 385a Glossop Rd., Broomhall, Sheffield S10 2HQ, UK"},{"name":"NIHR Sheffield Biomedical Research Centre, University of Sheffield and Sheffield Teaching Hospitals NHS Foundation Trust, Glossop Rd, Broomhall, Sheffield S10 2JF, UK"},{"name":"Neuroscience Institute, University of Sheffield, Firth Court, Sheffield S10 2TN, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1144-039X","authenticated-orcid":false,"given":"Arshad","family":"Majid","sequence":"additional","affiliation":[{"name":"Sheffield Institute for Translational Neuroscience, School of Medicine and Population Health, University of Sheffield, 385a Glossop Rd., Broomhall, Sheffield S10 2HQ, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jack","family":"Feehan","sequence":"additional","affiliation":[{"name":"School of Health and Biomedical Sciences, STEM College, RMIT University, 30 Janefield Drive, Bundoora, VIC 3083, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8760-2511","authenticated-orcid":false,"given":"Barbora","family":"de Courten","sequence":"additional","affiliation":[{"name":"School of Health and Biomedical Sciences, STEM College, RMIT University, 30 Janefield Drive, Bundoora, VIC 3083, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7356-4523","authenticated-orcid":false,"given":"Aya","family":"Mousa","sequence":"additional","affiliation":[{"name":"Monash Centre for Health Research and Implementation, Faculty of Medicine, Nursing and Health Sciences, Monash University, 43-51 Kanooka Grove, Clayton, VIC 3168, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,8,26]]},"reference":[{"key":"ref_1","unstructured":"United Nations, Department of Economic and Social Affairs, Population Division (2020). World Population Ageing 2020 Highlights: Living Arrangements of Older Persons, United Nations. ST\/ESA\/SER.A\/451."},{"key":"ref_2","unstructured":"World Health Organization (2026, August 14). Ageing and Health. Available online: https:\/\/www.who.int\/news-room\/fact-sheets\/detail\/ageing-and-health."},{"key":"ref_3","first-page":"470","article-title":"Type 2 Diabetes Mellitus, Hypertension, Dyslipidemia and Obesity: A Systematic Comparison of Their Impact on Cognition","volume":"1792","author":"Kloppenborg","year":"2009","journal-title":"Biochim. Biophys. Acta (BBA)-Mol. Basis Dis."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"591","DOI":"10.1038\/s41574-018-0048-7","article-title":"Cognitive decline and dementia in diabetes mellitus: Mechanisms and clinical implications","volume":"14","author":"Biessels","year":"2018","journal-title":"Nat. Rev. Endocrinol."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"413","DOI":"10.1016\/S0140-6736(20)30367-6","article-title":"Dementia prevention, intervention, and care: 2020 report of the Lancet Commission","volume":"396","author":"Livingston","year":"2020","journal-title":"Lancet"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"1056","DOI":"10.2174\/1567205013666160401114415","article-title":"Inflammation, Oxidation, Caloric Expenditure and Cognitive Impairment in Brazilian Elderly Assisted at Primary Care","volume":"13","author":"Nogueira","year":"2016","journal-title":"Curr. Alzheimer Res."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"225","DOI":"10.3233\/JAD-170257","article-title":"Decreased Glucose Metabolism in Medial Prefrontal Areas Is Associated with Nutritional Status in Patients with Prodromal and Early Alzheimer\u2019s Disease","volume":"60","author":"Sugimoto","year":"2017","journal-title":"J. Alzheimer\u2019s Dis."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"168","DOI":"10.1038\/nrneurol.2017.185","article-title":"Brain insulin resistance in type 2 diabetes and Alzheimer disease: Concepts and conundrums","volume":"14","author":"Arnold","year":"2018","journal-title":"Nat. Rev. Neurol."},{"key":"ref_9","doi-asserted-by":"crossref","unstructured":"American Diabetes Association (2014). Diagnosis and classification of diabetes mellitus. Diabetes Care, 37, S81\u2013S90.","DOI":"10.2337\/dc14-S081"},{"key":"ref_10","unstructured":"World Health Organization (2006). Definition and Diagnosis of Diabetes Mellitus and Intermediate Hyperglycaemia: Report of a WHO\/IDF Consultation, World Health Organization."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"296","DOI":"10.1038\/ijo.2012.37","article-title":"Body Mass Index Across Midlife and Cognitive Change in Late Life","volume":"37","author":"Dahl","year":"2012","journal-title":"Int. J. Obes."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"1812","DOI":"10.1002\/oby.23785","article-title":"BMI, Insulin Sensitivity, and Cognition in Early Type 2 Diabetes: The Glycemia Reduction Approaches in Diabetes: A Comparative Effectiveness Study","volume":"31","author":"Luchsinger","year":"2023","journal-title":"Obesity"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"785","DOI":"10.7326\/M14-0737","article-title":"Diabetes in midlife and cognitive change over 20 years: A cohort study","volume":"161","author":"Rawlings","year":"2014","journal-title":"Ann. Intern. Med."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"e12939","DOI":"10.1590\/1414-431x2023e12939","article-title":"Diabetes, Hemoglobin A1c, and Cognitive Performance in Older Adults: Is There Any Impact of Frailty? Evidence From the ELSI-Brazil Study","volume":"57","author":"Souza","year":"2024","journal-title":"Braz. J. Med. Biol. Res."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"e4260","DOI":"10.1210\/clinem\/dgab135","article-title":"Association Between Midlife Obesity and Its Metabolic Consequences, Cerebrovascular Disease, and Cognitive Decline","volume":"106","author":"Morys","year":"2021","journal-title":"J. Clin. Endocrinol. Metab."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1089\/met.2014.0049","article-title":"Type 2 Diabetes Mellitus, Metabolic Syndrome, and Mixed Dyslipidemia: How Similar, How Different, and How to Treat?","volume":"13","author":"Halcox","year":"2015","journal-title":"Metab. Syndr. Relat. Disord."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"61","DOI":"10.1007\/s42000-018-0014-8","article-title":"Diabetes and Lipid Metabolism","volume":"17","author":"Athyros","year":"2018","journal-title":"Hormones"},{"key":"ref_18","doi-asserted-by":"crossref","unstructured":"Duong, M.T., Nasrallah, I.M., Wolk, D.A., Chang, C.C., and Chang, T.Y. (2021). Cholesterol, Atherosclerosis, and APOE in Vascular Contributions to Cognitive Impairment and Dementia (VCID): Potential Mechanisms and Therapy. Front. Aging Neurosci., 13.","DOI":"10.3389\/fnagi.2021.647990"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"e017691","DOI":"10.1136\/bmjopen-2017-017691","article-title":"Does supplementation with carnosine improve cardiometabolic health and cognitive function in patients with pre-diabetes and type 2 diabetes? Study protocol for a randomised, double-blind, placebo-controlled trial","volume":"7","author":"Baye","year":"2017","journal-title":"BMJ Open"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"485","DOI":"10.1016\/j.numecd.2023.10.012","article-title":"Carnosine supplementation improves glucose control in adults with pre-diabetes and type 2 diabetes: A randomised controlled trial","volume":"34","author":"Hariharan","year":"2024","journal-title":"Nutr. Metab. Cardiovasc. Dis."},{"key":"ref_21","unstructured":"World Health Organization (2019). Classification of Diabetes Mellitus, World Health Organization."},{"key":"ref_22","unstructured":"National Health & Medical Research Council (2020). Australian Guidelines to Reduce Health Risks from Drinking Alcohol."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"200","DOI":"10.7326\/0003-4819-158-3-201302050-00583","article-title":"SPIRIT 2013 statement: Defining standard protocol items for clinical trials","volume":"158","author":"Chan","year":"2013","journal-title":"Ann. Intern. Med."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"1453","DOI":"10.1016\/S0140-6736(07)61602-X","article-title":"The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement: Guidelines for reporting observational studies","volume":"370","author":"Altman","year":"2007","journal-title":"Lancet"},{"key":"ref_25","doi-asserted-by":"crossref","unstructured":"World Medical Association (2013). World Medical Association Declaration of Helsinki: Ethical principles for medical research involving human subjects. JAMA, 310, 2191\u20132194.","DOI":"10.1001\/jama.2013.281053"},{"key":"ref_26","unstructured":"Cambridge Cognition (2021). CANTAB Connect Research: Admin Application User Guide, Cambridge Cognition Ltd."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"360","DOI":"10.1212\/01.wnl.0000285081.04409.bb","article-title":"Body mass index and cognitive decline in a biracial community population","volume":"70","author":"Sturman","year":"2008","journal-title":"Neurology"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"2446","DOI":"10.1007\/s00125-020-05264-8","article-title":"Higher BMI is associated with smaller regional brain volume in older adults with type 2 diabetes","volume":"63","author":"West","year":"2020","journal-title":"Diabetologia"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"e091659","DOI":"10.1002\/alz.091659","article-title":"Sex-specific differences in the association between regional adiposity, cognition, and brain pathology in older adults with Type II Diabetes","volume":"20","author":"Boccara","year":"2024","journal-title":"Alzheimer\u2019s Dement."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"e104389","DOI":"10.1002\/alz70860_104389","article-title":"Regional Adiposity, Cognition and Brain Volumes in Older Adults with Type 2 Diabetes: Sex-Specific Associations","volume":"21","author":"Boccara","year":"2025","journal-title":"Alzheimer\u2019s Dement."},{"key":"ref_31","doi-asserted-by":"crossref","unstructured":"Xing, Z., Long, C., Hu, X., and Chai, X. (2022). Obesity is associated with greater cognitive function in patients with type 2 diabetes mellitus. Front. Endocrinol., 13.","DOI":"10.3389\/fendo.2022.953826"},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"235","DOI":"10.1016\/j.bbr.2018.04.029","article-title":"Body mass index and its relation to neuropsychological functioning and brain volume in healthy older adults","volume":"348","author":"Gogniat","year":"2018","journal-title":"Behav. Brain Res."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"e098699","DOI":"10.1002\/alz70860_098699","article-title":"Association of Body Mass Index and Cognitive Performance in the Diabetes Prevention Program Outcomes Study","volume":"21","author":"Luchsinger","year":"2025","journal-title":"Alzheimer\u2019s Dement."},{"key":"ref_34","first-page":"5978","article-title":"Impact of Glycated Hemoglobin (HbA1c) on cognitive functions in Type 2 diabetic patients","volume":"25","author":"Maan","year":"2021","journal-title":"Eur. Rev. Med. Pharmacol. Sci."},{"key":"ref_35","doi-asserted-by":"crossref","unstructured":"Dybjer, E., Nilsson, P.M., Engstr\u00f6m, G., Helmer, C., and N\u00e4gga, K. (2018). Pre-diabetes and diabetes are independently associated with adverse cognitive test results: A cross-sectional, population-based study. BMC Endocr. Disord., 18.","DOI":"10.1186\/s12902-018-0318-3"},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"839","DOI":"10.1007\/s00125-017-4541-7","article-title":"HbA1c, diabetes and cognitive decline: The English Longitudinal Study of Ageing","volume":"61","author":"Zheng","year":"2018","journal-title":"Diabetologia"},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"108939","DOI":"10.1016\/j.diabres.2021.108939","article-title":"Cognitive function among older adults with diabetes and prediabetes, NHANES 2011\u20132014","volume":"178","author":"Casagrande","year":"2021","journal-title":"Diabetes Res. Clin. Pract."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"484","DOI":"10.1111\/j.1445-5994.2012.02758.x","article-title":"Diabetes as a Risk Factor for Dementia and Mild Cognitive Impairment: A Meta-analysis of Longitudinal Studies","volume":"42","author":"Cheng","year":"2012","journal-title":"Intern. Med. J."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"75","DOI":"10.1016\/S2213-8587(14)70148-2","article-title":"Glucose regulation, cognition, and brain MRI in type 2 diabetes: A systematic review","volume":"3","author":"Geijselaers","year":"2015","journal-title":"Lancet Diabetes Endocrinol."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"4580","DOI":"10.1038\/s41598-024-54996-9","article-title":"Investigating the effect of hypertension on vascular cognitive impairment by using the resting-state functional connectome","volume":"14","author":"Hung","year":"2024","journal-title":"Sci. Rep."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"37","DOI":"10.1016\/j.mehy.2018.01.010","article-title":"Mismatch between GLUTs and glucose levels causes neuronal damage during glucose fluctuations","volume":"112","author":"Xie","year":"2018","journal-title":"Med. Hypotheses"},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"63","DOI":"10.1007\/s11892-017-0891-2","article-title":"Dietary Advanced Glycation End Products and Cardiometabolic Risk","volume":"17","year":"2017","journal-title":"Curr. Diab Rep."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"384","DOI":"10.1177\/1559827617708991","article-title":"Advanced Glycation End Products and Risks for Chronic Diseases: Intervening Through Lifestyle Modification","volume":"13","author":"Prasad","year":"2019","journal-title":"Am. J. Lifestyle Med."},{"key":"ref_44","doi-asserted-by":"crossref","unstructured":"Gorska-Ciebiada, M., Saryusz-Wolska, M., Borkowska, A., Ciebiada, M., and Loba, J. (2015). C-Reactive Protein, Advanced Glycation End Products, and Their Receptor in Type 2 Diabetic, Elderly Patients with Mild Cognitive Impairment. Front. Aging Neurosci., 7.","DOI":"10.3389\/fnagi.2015.00209"},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"e2033012","DOI":"10.1001\/jamanetworkopen.2020.33012","article-title":"Assessment of Advanced Glycation End Products and Receptors and the Risk of Dementia","volume":"4","author":"Chen","year":"2021","journal-title":"JAMA Netw. Open"},{"key":"ref_46","doi-asserted-by":"crossref","unstructured":"Chen, X., Huang, Y., and Xiong, X. (2025). Mechanisms underlying cognitive impairment and management strategies in type 2 diabetes. Front. Endocrinol., 16.","DOI":"10.3389\/fendo.2025.1655768"},{"key":"ref_47","doi-asserted-by":"crossref","unstructured":"Spinelli, M., Fusco, S., and Grassi, C. (2019). Brain Insulin Resistance and Hippocampal Plasticity: Mechanisms and Biomarkers of Cognitive Decline. Front. Neurosci., 13.","DOI":"10.3389\/fnins.2019.00788"},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"107","DOI":"10.1016\/S0006-8993(00)03023-7","article-title":"Hyperglycemic but not normoglycemic global ischemia induces marked early intraneuronal expression of \u03b2-amyloid precursor protein","volume":"888","author":"Lin","year":"2001","journal-title":"Brain Res."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"682","DOI":"10.1037\/neu0000335","article-title":"Triglycerides are negatively correlated with cognitive function in nondemented aging adults","volume":"31","author":"Parthasarathy","year":"2017","journal-title":"Neuropsychology"},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"961","DOI":"10.1017\/S1355617714000885","article-title":"Higher HDL Cholesterol Is Associated with Better Cognitive Function: The Maine-Syracuse Study","volume":"20","author":"Crichton","year":"2014","journal-title":"J. Int. Neuropsychol. Soc."},{"key":"ref_51","doi-asserted-by":"crossref","unstructured":"Cai, R., Han, J., Sun, J., Huang, R., Tian, S., Shen, Y., and Wang, S. (2017). Effects of ABCA1 R219K Polymorphism and Serum Lipid Profiles on Mild Cognitive Impairment in Type 2 Diabetes Mellitus. Front. Aging Neurosci., 9.","DOI":"10.3389\/fnagi.2017.00257"},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/s40001-023-01574-w","article-title":"The association between blood lipids and cognitive impairment in type 2 diabetes mellitus","volume":"29","author":"Ma","year":"2024","journal-title":"Eur. J. Med. Res."},{"key":"ref_53","doi-asserted-by":"crossref","unstructured":"Chakraborty, A., Hegde, S., Praharaj, S.K., Prabhu, K., Patole, C., Shetty, A.K., Mayya, S.S., Acharya, R.V., Hande, H.M., and Prabhu, M.M. (2021). Age Related Prevalence of Mild Cognitive Impairment in Type 2 Diabetes Mellitus Patients in the Indian Population and Association of Serum Lipids with Cognitive Dysfunction. Front. Endocrinol., 12.","DOI":"10.3389\/fendo.2021.798652"},{"key":"ref_54","first-page":"e72227","article-title":"Association of Hyperlipidemia and Hyperglycemia with Cognitive Function in Type 2 Diabetes: A Cross-Sectional Analysis","volume":"16","author":"Ansari","year":"2024","journal-title":"Cureus"},{"key":"ref_55","doi-asserted-by":"crossref","unstructured":"Dimache, A.M., \u0218alaru, D.L., Sasc\u0103u, R., and St\u0103tescu, C. (2021). The Role of High Triglycerides Level in Predicting Cognitive Impairment: A Review of Current Evidence. Nutrients, 13.","DOI":"10.3390\/nu13062118"},{"key":"ref_56","doi-asserted-by":"crossref","unstructured":"Denimal, D. (2024). Antioxidant and Anti-Inflammatory Functions of High-Density Lipoprotein in Type 1 and Type 2 Diabetes. Antioxidants, 13.","DOI":"10.3390\/antiox13010057"},{"key":"ref_57","doi-asserted-by":"crossref","unstructured":"Raji\u010d Bumber, J., Ra\u010dki, V., Me\u017enari\u0107, S., Pel\u010di\u0107, G., and Mr\u0161i\u0107-Pel\u010di\u0107, J. (2025). Clinical Significance of APOE4 Genotyping: Potential for Personalized Therapy and Early Diagnosis of Alzheimer\u2019s Disease. J. Clin. Med., 14.","DOI":"10.3390\/jcm14176047"},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"141","DOI":"10.1186\/s13195-020-00712-4","article-title":"APOE4 is associated with cognitive and pathological heterogeneity in patients with Alzheimer\u2019s disease: A systematic review","volume":"12","author":"Emrani","year":"2020","journal-title":"Alzheimer\u2019s Res. Ther."},{"key":"ref_59","doi-asserted-by":"crossref","unstructured":"Saadati, S., Cameron, J., Menon, K., Hodge, A., Lu, Z.X., de Courten, M., Feehan, J., and de Courten, B. (2023). Carnosine Did Not Affect Vascular and Metabolic Outcomes in Patients with Prediabetes and Type 2 Diabetes: A 14-Week Randomized Controlled Trial. Nutrients, 15.","DOI":"10.3390\/nu15224835"},{"key":"ref_60","doi-asserted-by":"crossref","first-page":"e71514","DOI":"10.1002\/fsn3.71514","article-title":"The Effect of Carnosine Supplementation on Depressive Symptoms and Health-Related Quality of Life in Individuals with Prediabetes and Well-Controlled Type 2 Diabetes: A Randomized Controlled Trial","volume":"14","author":"Kabthymer","year":"2026","journal-title":"Food Sci. Nutr."}],"container-title":["Medical Sciences"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2076-3271\/14\/5\/520\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,28]],"date-time":"2026-08-28T04:28:02Z","timestamp":1787891282000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2076-3271\/14\/5\/520"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,8,26]]},"references-count":60,"journal-issue":{"issue":"5","published-online":{"date-parts":[[2026,9]]}},"alternative-id":["medsci14050520"],"URL":"https:\/\/doi.org\/10.3390\/medsci14050520","relation":{},"ISSN":["2076-3271"],"issn-type":[{"value":"2076-3271","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,8,26]]}}}