TY - JOUR
T1 - Prediabetes Is Associated With Structural Brain Abnormalities
T2 - The Maastricht Study
AU - van Agtmaal, Marnix J. M.
AU - Houben, Alfons J. H. M.
AU - de Wit, Vera
AU - Henry, Ronald M. A.
AU - Schaper, Nicolaas C.
AU - Dagnelie, Pieter C.
AU - van der Kallen, Carla J.
AU - Koster, Annemarie
AU - Sep, Simone J.
AU - Kroon, Abraham A.
AU - Jansen, Jacobus F. A.
AU - Hofman, Paul A.
AU - Backes, Walter H.
AU - Schram, Miranda T.
AU - Stehouwer, Coen D. A.
PY - 2018/12/1
Y1 - 2018/12/1
N2 - OBJECTIVEStructural 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 METHODSWe 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.RESULTSPrediabetes 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 (beta 0.07 log10-transformed mL [log-mL] [95% CI 0.00-0.15] and 0.21 log-mL [0.14-0.28], respectively; P-trendCONCLUSIONSPrediabetes 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.
AB - OBJECTIVEStructural 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 METHODSWe 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.RESULTSPrediabetes 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 (beta 0.07 log10-transformed mL [log-mL] [95% CI 0.00-0.15] and 0.21 log-mL [0.14-0.28], respectively; P-trendCONCLUSIONSPrediabetes 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.
KW - SMALL VESSEL DISEASE
KW - WHITE-MATTER HYPERINTENSITIES
KW - TYPE-2 DIABETES-MELLITUS
KW - LATE-LIFE DEPRESSION
KW - ALZHEIMERS-DISEASE
KW - MICROVASCULAR DYSFUNCTION
KW - COGNITIVE DYSFUNCTION
KW - GLUCOSE-METABOLISM
KW - TISSUE SEGMENTATION
KW - VASCULAR DEPRESSION
U2 - 10.2337/dc18-1132
DO - 10.2337/dc18-1132
M3 - Article
SN - 0149-5992
VL - 41
SP - 2535
EP - 2543
JO - Diabetes Care
JF - Diabetes Care
IS - 12
ER -