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Diabetes, Prediabetes, and Brain Volumes and Subclinical Cerebrovascular Disease on MRI: The Atherosclerosis Risk in Communities Neurocognitive Study (ARIC-NCS).

TitleDiabetes, Prediabetes, and Brain Volumes and Subclinical Cerebrovascular Disease on MRI: The Atherosclerosis Risk in Communities Neurocognitive Study (ARIC-NCS).
Publication TypeJournal Article
Year of Publication2017
AuthorsSchneider ALC, Selvin E, Sharrett ARichey, Griswold M, Coresh JJ, Jack CR, Knopman D, Mosley T
Secondary AuthorsGottesman RF
JournalDiabetes Care
Volume40
Issue11
Pagination1514-1521
Date Published2017 11
ISSN1935-5548
KeywordsAtherosclerosis, Biomarkers, Brain, Cerebrovascular Disorders, Cross-Sectional Studies, Diabetes Mellitus, Female, Follow-Up Studies, Glycated Hemoglobin A, Humans, Magnetic Resonance Imaging, Male, Middle Aged, Neurocognitive Disorders, Organ Size, Prediabetic State, Prospective Studies, Risk Factors
Abstract

OBJECTIVE: To examine the associations of prediabetes, diabetes, and diabetes severity (as assessed by HbA and diabetes duration) with brain volumes and vascular pathology on brain MRI and to assess whether the associations of diabetes with brain volumes are mediated by brain vascular pathology.

RESEARCH DESIGN AND METHODS: Cross-sectional study of 1,713 participants in the Atherosclerosis Risk in Communities Neurocognitive Study (ARIC-NCS) (mean age 75 years, 60% female, 27% black, 30% prediabetes, and 35% diabetes) who underwent 3T brain MRI scans in 2011-2013. Participants were categorized by diabetes-HbA status as without diabetes (

RESULTS: In adjusted analyses, compared with participants without diabetes and HbA 0.05), but those with diabetes and HbA ≥7.0% had smaller total brain volume (β -0.20 SDs, 95% CI -0.31, -0.09), smaller regional brain volumes (including frontal, temporal, occipital, and parietal lobes; deep gray matter; Alzheimer disease signature region; and hippocampus [all 0.05).

CONCLUSIONS: More-severe diabetes (defined by higher HbA and longer disease duration) but not prediabetes or less-severe diabetes was associated with smaller brain volumes and an increased burden of brain vascular pathology. No evidence was found that associations of diabetes with smaller brain volumes are mediated by brain vascular pathology, suggesting that other mechanisms may be responsible for these associations.

DOI10.2337/dc17-1185
Alternate JournalDiabetes Care
PubMed ID28916531
PubMed Central IDPMC5652590
Grant ListU01 HL096812 / HL / NHLBI NIH HHS / United States
U01 HL096917 / HL / NHLBI NIH HHS / United States
R01 DK089174 / DK / NIDDK NIH HHS / United States
U01 HL096902 / HL / NHLBI NIH HHS / United States
R25 NS065729 / NS / NINDS NIH HHS / United States
K24 DK106414 / DK / NIDDK NIH HHS / United States
U01 HL096814 / HL / NHLBI NIH HHS / United States
U01 HL096899 / HL / NHLBI NIH HHS / United States
K24 AG052573 / AG / NIA NIH HHS / United States