Blood pressure and blood lipids reduction, but not glycemic changes, predict cognitive improvements after exercise training in people with type 2 diabetes: an exploratory analysis in a clinical trial

Abstract Background Identifying effective strategies to preserve cognitive health is a major concern of contemporary public health research. In this context, blood pressure, blood lipids, and glycemic parameters are well-established contributors to minor and major cardiovascular events, and emerging evidence suggests their association with cognitive impairment. However, the relationship between reductions in these parameters and potential cognitive improvements remains underexplored. Aim To observe whether exercise-induced improvements in blood pressure, blood lipids, and glycemic parameters are related to global cognitive improvement in people with type 2 diabetes mellitus (T2DM). Methods Sixteen participants (64 ± 8 years old) enrolled in a clinical trial (WHO International Clinical Trials Registry Platform, reference U1111-1202-6942) performed the 8-week exercise training program. A comprehensive cognitive test battery, blood pressure, and plasma samples were collected pre- and post-intervention. Results Changes in global cognitive functions were negatively associated with mean blood pressure ( r = −0.74), triglycerides ( r = −0.52), and total cholesterol reductions ( r = −0.51; p < 0.05 for all). In contrast, leptin concentrations showed a positive association ( r = 0.59). No significant associations were observed between changes in cognitive functions and low-density lipoprotein cholesterol (LDL), resistin, adiponectin, fructosamine, glucose, insulin, and Homeostatic Model Assessment (HOMA) indexes. Conclusion A potential link between longitudinal improvements in global cognitive functions and cardiovascular health indicators was observed, though no such relationship was observed with glycemic parameters.