Alterations in white matter volume and integrity in obesity and type 2 diabetes

Metabolic Brain Disease - Tập 31 - Trang 621-629 - 2016
Liselotte van Bloemendaal1, Richard G. Ijzerman1, Jennifer S. ten Kulve1, Frederik Barkhof2, Michaela Diamant1, Dick J. Veltman3, Eelco van Duinkerken1,4,5
1Diabetes Center, Department of Internal Medicine, VU University Medical Center, Amsterdam, The Netherlands
2Department of Radiology & Nuclear Medicine, VU University Medical Center, Amsterdam, The Netherlands
3Department of Psychiatry, VU University Medical Center, Amsterdam, The Netherlands
4Department of Medical Psychology, VU University Medical Center, Amsterdam, The Netherlands
5Department of Psychology, Pontifícia Universidade Católica (PUC-Rio), Rio de Janeiro, Brazil

Tóm tắt

Type 2 diabetes mellitus (T2DM) is characterized by obesity, hyperglycemia and insulin resistance. Both T2DM and obesity are associated with cerebral complications, including an increased risk of cognitive impairment and dementia, however the underlying mechanisms are largely unknown. In the current study, we aimed to determine the relative contributions of obesity and the presence of T2DM to altered white matter structure. We used diffusion tensor imaging (DTI) and voxel-based morphometry (VBM) to measure white matter integrity and volume in obese T2DM patients without micro- or macrovascular complications, age- gender- and BMI-matched normoglycemic obese subjects and age- and gender-matched normoglycemic lean subjects. We found that obese T2DM patients compared with lean subjects had lower axial diffusivity (in the right corticospinal tract, right inferior fronto-occipital tract, right superior longitudinal fasciculus and right forceps major) and reduced white matter volume (in the right inferior parietal lobe and the left external capsule region). In normoglycemic obese compared with lean subjects axial diffusivity as well as white matter volume tended to be reduced, whereas there were no significant differences between normoglycemic obese subjects and T2DM patients. Decreased white matter integrity and volume were univariately related to higher age, being male, higher BMI, HbA1C and fasting glucose and insulin levels. However, multivariate analyses demonstrated that only BMI was independently related to white matter integrity, and age, gender and BMI to white matter volume loss. Our data indicate that obese T2DM patients have reduced white matter integrity and volume, but that this is largely explained by BMI, rather than T2DM per se.

Tài liệu tham khảo

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