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August 09, 2016; 87 (6) Article

Type 2 diabetes mellitus is associated with brain atrophy and hypometabolism in the ADNI cohort

Wei Li, Shannon L. Risacher, Edgar Huang, Andrew J. Saykin, For the Alzheimer's Disease Neuroimaging Initiative
First published July 6, 2016, DOI: https://doi.org/10.1212/WNL.0000000000002950
Wei Li
From Master of Physician Assistant Studies, School of Health and Rehabilitation Sciences (W.L.), and School of Informatics and Computing (E.H.), Indiana University Purdue University Indianapolis; and Center for Neuroimaging (S.L.R., A.J.S.), Department of Radiology and Imaging Sciences, and Indiana Alzheimer Disease Center, Indiana University School of Medicine, Indianapolis, IN.
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Shannon L. Risacher
From Master of Physician Assistant Studies, School of Health and Rehabilitation Sciences (W.L.), and School of Informatics and Computing (E.H.), Indiana University Purdue University Indianapolis; and Center for Neuroimaging (S.L.R., A.J.S.), Department of Radiology and Imaging Sciences, and Indiana Alzheimer Disease Center, Indiana University School of Medicine, Indianapolis, IN.
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Edgar Huang
From Master of Physician Assistant Studies, School of Health and Rehabilitation Sciences (W.L.), and School of Informatics and Computing (E.H.), Indiana University Purdue University Indianapolis; and Center for Neuroimaging (S.L.R., A.J.S.), Department of Radiology and Imaging Sciences, and Indiana Alzheimer Disease Center, Indiana University School of Medicine, Indianapolis, IN.
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Andrew J. Saykin
From Master of Physician Assistant Studies, School of Health and Rehabilitation Sciences (W.L.), and School of Informatics and Computing (E.H.), Indiana University Purdue University Indianapolis; and Center for Neuroimaging (S.L.R., A.J.S.), Department of Radiology and Imaging Sciences, and Indiana Alzheimer Disease Center, Indiana University School of Medicine, Indianapolis, IN.
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From Master of Physician Assistant Studies, School of Health and Rehabilitation Sciences (W.L.), and School of Informatics and Computing (E.H.), Indiana University Purdue University Indianapolis; and Center for Neuroimaging (S.L.R., A.J.S.), Department of Radiology and Imaging Sciences, and Indiana Alzheimer Disease Center, Indiana University School of Medicine, Indianapolis, IN.
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Type 2 diabetes mellitus is associated with brain atrophy and hypometabolism in the ADNI cohort
Wei Li, Shannon L. Risacher, Edgar Huang, Andrew J. Saykin, For the Alzheimer's Disease Neuroimaging Initiative
Neurology Aug 2016, 87 (6) 595-600; DOI: 10.1212/WNL.0000000000002950

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Abstract

Objective: We investigated type 2 diabetes mellitus (T2DM) as a risk factor for brain atrophy and glucose hypometabolism in older adults with or at risk of cognitive impairment.

Methods: Participants with the T2DM were identified from the Alzheimer's Disease Neuroimaging Initiative (ADNI-1/GO/2 cohorts). Analysis of covariance models were used to compare participants with and without T2DM, controlling for potential confounding factors.

Results: Whole brain volume and whole brain [18F]-fluorodeoxyglucose (FDG) uptake were significantly different as a function of T2DM status, independent of baseline clinical diagnosis. On post hoc analysis, a lower whole brain volume was seen in participants with both mild cognitive impairment (MCI) and T2DM (n = 76) compared with participants who had MCI but not T2DM (n = 747; p = 0.009). Similarly, mean FDG uptake in gray matter and white matter was lower in participants with both MCI and T2DM (n = 72) than in participants with MCI without T2DM (n = 719; p = 0.04). Subsequent regional analysis revealed that the decreased FDG uptake in participants with both MCI and T2DM was mainly manifested in 3 brain regions: frontal lobe, sensory motor cortex, and striatum.

Conclusions: T2DM may accelerate cognition deterioration in patients with MCI by affecting glucose metabolism and brain volume.

GLOSSARY

AD=
Alzheimer disease;
ADNI=
Alzheimer's Disease Neuroimaging Initiative;
CI=
confidence interval;
FDG=
[18F]-fluorodeoxyglucose;
HC=
healthy control;
MCI=
mild cognitive impairment;
SUVR=
standardized uptake value ratio;
SVD=
small vessel disease;
T2DM=
type 2 diabetes mellitus

Footnotes

  • Data used in preparation of this article were obtained from the Alzheimer's Disease Neuroimaging Initiative (ADNI) database. The ADNI investigators contributed to the design and implementation of ADNI and/or provided data. The ADNI list is available on the Neurology® Web site at Neurology.org.

  • Go to Neurology.org for full disclosures. Funding information and disclosures deemed relevant by the authors, if any, are provided at the end of the article.

  • Supplemental data at Neurology.org

  • Received December 20, 2015.
  • Accepted in final form April 22, 2016.
  • © 2016 American Academy of Neurology
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