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Relationships between glycemic status and (sub)cortical gray matter volumes in adults

Poster No:

2128 

Submission Type:

Abstract Submission 

Authors:

Eustace Hsu1, Ankush Shetty1, Elizabeth Haddad1, Neda Jahanshad1, Shan Luo1

Institutions:

1University of Southern California, Los Angeles, CA

First Author:

Eustace Hsu  
University of Southern California
Los Angeles, CA

Co-Author(s):

Ankush Shetty  
University of Southern California
Los Angeles, CA
Elizabeth Haddad  
University of Southern California
Los Angeles, CA
Neda Jahanshad  
University of Southern California
Los Angeles, CA
Shan Luo  
University of Southern California
Los Angeles, CA

Introduction:

Diabetes has been linked to structural brain abnormalities, including smaller cortical and subcortical gray matter volumes (GMV). But impact of different glycemic status on brain volumes is not clearly defined.

Methods:

This was a cross-sectional data obtained from the UK Biobank. Brain structure was evaluated by magnetic resonance imaging (MRI) and glycemic control was assessed with hemoglobin A1c (HbA1c). Diabetes mellitus (DM) status was based on either doctor's diagnosis or self-report, and further categorized into type 1 diabetes (T1D) and type 2 diabetes (T2D). Prediabetes status was determined by HbA1c 5.7 to 6.4%. Normoglycemia was defined as HbA1c <5.7%. Linear regressions were used to examine relationships between glycemic status [1) normoglycemia vs prediabetes vs diabetes; 2) normoglycemic vs T1D vs T2D] and total cortical and subcortical GMV; and follow-up analysis modeled glycemic status as a linear regressor. All models adjusted for sex, age, education, body mass index (BMI), handedness, intracranial volume (ICV), and 4 principal component variables accounting for MRI-related variance.

Results:

N=36,157 adults were included in the final sample [Age (Mean±SD): 64.4±7.7 yrs; 53% female; diabetes 4.8%, T1D 0.2%, T2D 2.0%; prediabetes 11.9%; HbA1c 5.35±0.45%). There was a significant main effect of glycemic status on total cortical GMV [F(2, 36143) = 383.3, P<0.001] and subcortical GMV [F(2, 36143) = 198.0, P<0.001]. Differences between all groups were significant in cortical GMV (DM vs normoglycemia: β (95% CI) = -14452.3 (-16624.9, -12279.7) mm3, P<0.001; DM vs prediabetes: β (95% CI) = -11566.2 (-14031.8, -9100.6) mm3, P<0.001; prediabetes vs normoglycemia: β (95% CI) = -2886.1 (-4307.0, -1465.1) mm3, P<0.001) and subcortical GMV (DM vs normoglycemia: β (95% CI) = -1060.7 (-1269.2, -852.3) mm3, P<0.001; DM vs prediabetes: β (95% CI) = -155.9 (-292.2, -19.5) mm3, P=0.020; prediabetes vs normoglycemia: β (95% CI) = -904.9 (-1141.4, -668.3) mm3, P<0.001). There was a progressively lower cortical and subcortical GMV among people with normoglycemia, prediabetes and diabetes (cortical GMV: standardized β (95% CI) = -0.053 (-0.061, -0.046), P<0.001; subcortical GMV: standardized β (95% CI) = -0.042 (-0.050, -0.034), P<0.001). There was a significant main effect of type of diabetes on total cortical GMV [F(2, 30834 = 75.6), P<0.001] and subcortical GMV [F(2, 30834 = 27.8), P<0.001]. Compared with normoglycemic participants, individuals with T2D had smaller GMV (β (95% CI) = -15896.4 (-19236.3, -12556.6) mm3, P<0.001) and smaller subcortical GMV (β (95% CI) = -1098 (-1453, -744) mm3, P<0.001); individuals with T1D had smaller subcortical GMV ( β (95% CI) = -1394.8 (-2698.3, -91.3) mm3, P=0.033) but not cortical GMV (β (95% CI) = -6728.6 (-20278.8, -6821.7) mm3, P=0.475). Furthermore, individuals with T1D did not significantly differ from individuals with T2D in cortical GMV [β (95% CI) = 9167.9 (-4773.3, 23109.1) mm3, P=0.272] and subcortical GMV [β (95% CI) = -284.6 (-1625.7, -1056.5) mm3, P=0.873)]. There was a progressive decline in cortical GMV among individuals with normoglycemia, T1D and T2D [standardized β (95% CI) = -0.043 (-0.050, -0.035), P<0.001] as well as in subcortical GMV among people with normoglycemia, T2D and T1D [standardized β (95% CI) = -0.034 (-0.042, -0.026, P<0.001).
Supporting Image: FigureUKBsMRIglycemia.jpeg
   ·Relationships between glycemic status and cortical and subcortical gray matter volumes
 

Conclusions:

There is a progressively lower global cortical and subcortical GMV among individuals at a higher glycemic status. People with T1D have the lowest total subcortical GMV, whereas individuals with T2D have the lowest total cortical GMV, suggesting T1D and T2D may have differential negative effects on cortical and subcortical GMV.

Neuroanatomy, Physiology, Metabolism and Neurotransmission:

Cortical Anatomy and Brain Mapping 2
Subcortical Structures

Physiology, Metabolism and Neurotransmission:

Physiology, Metabolism and Neurotransmission Other 1

Keywords:

ADULTS
STRUCTURAL MRI

1|2Indicates the priority used for review

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Structural MRI

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