Marnix J M van Agtmaal1,2, Alfons J H M Houben3,2, Vera de Wit3, Ronald M A Henry3,2,4, Nicolaas C Schaper3,2, Pieter C Dagnelie3,5,6, Carla J van der Kallen3,2, Annemarie Koster5,7, Simone J Sep5,8, Abraham A Kroon3,2, Jacobus F A Jansen9, Paul A Hofman9, Walter H Backes9,10, Miranda T Schram3,2,4, Coen D A Stehouwer3,2. 1. Department of Internal Medicine, Maastricht University Medical Center+, Maastricht, the Netherlands marnix.van.agtmaal@mumc.nl. 2. School for Cardiovascular Diseases (CARIM), Maastricht University Medical Center+, Maastricht, the Netherlands. 3. Department of Internal Medicine, Maastricht University Medical Center+, Maastricht, the Netherlands. 4. Heart and Vascular Center, Maastricht University Medical Center+, Maastricht, the Netherlands. 5. Care and Public Health Research Institute, Maastricht University Medical Center+, Maastricht, the Netherlands. 6. Department of Epidemiology, Maastricht University Medical Center+, Maastricht, the Netherlands. 7. Department of Social Medicine, Maastricht University Medical Center+, Maastricht, the Netherlands. 8. Department of Rehabilitation Medicine, Maastricht University Medical Center+, Maastricht, the Netherlands. 9. Department of Radiology and Nuclear Medicine, Maastricht University Medical Center+, Maastricht, the Netherlands. 10. School for Mental Health and Neuroscience, Maastricht University Medical Center+, Maastricht, the Netherlands.
Abstract
OBJECTIVE: Structural brain abnormalities are key risk factors for brain diseases, such as dementia, stroke, and depression, in type 2 diabetes. It is unknown whether structural brain abnormalities already occur in prediabetes. Therefore, we investigated whether both prediabetes and type 2 diabetes are associated with lacunar infarcts (LIs), white matter hyperintensities (WMHs), cerebral microbleeds (CMBs), and brain atrophy. RESEARCH DESIGN AND METHODS: We used data from 2,228 participants (1,373 with normal glucose metabolism [NGM], 347 with prediabetes, and 508 with type 2 diabetes (oversampled); mean age 59.2 ± 8.2 years; 48.3% women) of the Maastricht Study, a population-based cohort study. Diabetes status was determined with an oral glucose tolerance test. Brain imaging was performed with 3 Tesla MRI. Results were analyzed with multivariable logistic and linear regression analyses. RESULTS: Prediabetes and type 2 diabetes were associated with the presence of LIs (odds ratio 1.61 [95% CI 0.98-2.63] and 1.67 [1.04-2.68], respectively; P trend = 0.027), larger WMH (β 0.07 log10-transformed mL [log-mL] [95% CI 0.00-0.15] and 0.21 log-mL [0.14-0.28], respectively; P trend <0.001), and smaller white matter volumes (β -4.0 mL [-7.3 to -0.6] and -7.2 mL [-10.4 to -4.0], respectively; P trend <0.001) compared with NGM. Prediabetes was not associated with gray matter volumes or the presence of CMBs. CONCLUSIONS: Prediabetes is associated with structural brain abnormalities, with further deterioration in type 2 diabetes. These results indicate that, in middle-aged populations, structural brain abnormalities already occur in prediabetes, which may suggest that the treatment of early dysglycemia may contribute to the prevention of brain diseases.
OBJECTIVE:Structural brain abnormalities are key risk factors for brain diseases, such as dementia, stroke, and depression, in type 2 diabetes. It is unknown whether structural brain abnormalities already occur in prediabetes. Therefore, we investigated whether both prediabetes and type 2 diabetes are associated with lacunar infarcts (LIs), white matter hyperintensities (WMHs), cerebral microbleeds (CMBs), and brain atrophy. RESEARCH DESIGN AND METHODS: We used data from 2,228 participants (1,373 with normal glucose metabolism [NGM], 347 with prediabetes, and 508 with type 2 diabetes (oversampled); mean age 59.2 ± 8.2 years; 48.3% women) of the Maastricht Study, a population-based cohort study. Diabetes status was determined with an oral glucose tolerance test. Brain imaging was performed with 3 Tesla MRI. Results were analyzed with multivariable logistic and linear regression analyses. RESULTS:Prediabetes and type 2 diabetes were associated with the presence of LIs (odds ratio 1.61 [95% CI 0.98-2.63] and 1.67 [1.04-2.68], respectively; P trend = 0.027), larger WMH (β 0.07 log10-transformed mL [log-mL] [95% CI 0.00-0.15] and 0.21 log-mL [0.14-0.28], respectively; P trend <0.001), and smaller white matter volumes (β -4.0 mL [-7.3 to -0.6] and -7.2 mL [-10.4 to -4.0], respectively; P trend <0.001) compared with NGM. Prediabetes was not associated with gray matter volumes or the presence of CMBs. CONCLUSIONS:Prediabetes is associated with structural brain abnormalities, with further deterioration in type 2 diabetes. These results indicate that, in middle-aged populations, structural brain abnormalities already occur in prediabetes, which may suggest that the treatment of early dysglycemia may contribute to the prevention of brain diseases.
Authors: J David Spence; Catherine M Viscoli; Silvio E Inzucchi; Jennifer Dearborn-Tomazos; Gary A Ford; Mark Gorman; Karen L Furie; Anne M Lovejoy; Lawrence H Young; Walter N Kernan Journal: JAMA Neurol Date: 2019-05-01 Impact factor: 18.302
Authors: Rohith N Thota; Pratishtha Chatterjee; Steve Pedrini; Eugene Hone; Jessica J A Ferguson; Manohar L Garg; Ralph N Martins Journal: Front Endocrinol (Lausanne) Date: 2022-06-20 Impact factor: 6.055
Authors: Frank C T van der Heide; Yuri D Foreman; Iris W M Franken; Ronald M A Henry; Abraham A Kroon; Pieter C Dagnelie; Simone J P M Eussen; Tos T J M Berendschot; Jan S A G Schouten; Carroll A B Webers; Miranda T Schram; Carla J H van der Kallen; Marleen M J van Greevenbroek; Anke Wesselius; Casper G Schalkwijk; Nicolaas C Schaper; Martijn C G J Brouwers; Coen D A Stehouwer Journal: Sci Rep Date: 2022-10-22 Impact factor: 4.996
Authors: Francesco Vadini; Paola G Simeone; Andrea Boccatonda; Maria T Guagnano; Rossella Liani; Romina Tripaldi; Augusto Di Castelnuovo; Francesco Cipollone; Agostino Consoli; Francesca Santilli Journal: Int J Obes (Lond) Date: 2020-01-21 Impact factor: 5.095
Authors: Itziar Montalvo; Alexandre González-Rodríguez; Ángel Cabezas; Alfonso Gutiérrez-Zotes; Montse Solé; Maria José Algora; Laura Ortega; Lourdes Martorell; Vanessa Sánchez-Gistau; Elisabet Vilella; Javier Labad Journal: Front Psychiatry Date: 2020-05-25 Impact factor: 4.157