LAUSR

OBJECTIVE Although a reduction in brain-derived neurotrophic factor (BDNF) has been implicated as a cause of cognitive impairment in type 2 diabetes mellitus (T2DM), the role of sex in moderating this effect has not been explored. METHODS We compared the difference in serum BDNF and performance on the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) between 96 men and 134 women with T2DM. We compared this to the difference in serum BDNF and performance in the control group (104 men, 144 women). RESULTS Patients with T2DM performed worse on most RBANS indices (Eta=0.372; all p<0.05); within T2DM patients, men performed worse than women on the delayed memory score (74.1±12.1 vs. 79.9±11.5; p=0.002) and on the total score (71.4±11.5 vs. 76.5±10.8, p=0.025). Serum BDNF was lower in patients with T2DM vs. controls (7.5±2.7 ng/ml vs. 11.5±2.7 ng/ml: p<.001), and in males compared to females (6.9±2.4 vs. 7.9±2.8; p=0.024). Serum BDNF levels positively correlated with delayed memory score in patients with T2DM (β=0.19; p=0.007). However, this association was only observed in women, not in men (p interaction=0.04). Among healthy controls, no sex differences were noted in either RBANS or BDNF levels (Eta=0.04; Cohen's d<0.163; all p>0.05). CONCLUSIONS Our results show sex differences in poorer cognitive performance, lower BDNF concentration and their relationship in T2DM patients, suggesting that female sex may be a protective factor for cognitive decline in T2DM patients. However, the findings could only be regarded preliminary because of the cross-sectional design and chronicity of the diabetes.