Hsu Fang-Chi, Yuan Mingxia, Bowden Donald W, Xu Jianzhao, Smith S Carrie, Wagenknecht Lynne E, Langefeld Carl D, Divers Jasmin, Register Thomas C, Carr J Jeffrey, Williamson Jeff D, Sink Kaycee M, Maldjian Joseph A, Freedman Barry I
Division of Public Health Sciences, Department of Biostatistical Sciences, Wake Forest School of Medicine, Winston-Salem, NC, USA; Center for Public Health Genomics, Wake Forest School of Medicine, Winston-Salem, NC, USA.
Department of Internal Medicine, Section on Nephrology, Wake Forest School of Medicine, Winston-Salem, NC, USA; Department of Endocrinology, Beijing Tongren Hospital, Capital Medical University, Beijing, China.
J Diabetes Complications. 2016 Nov-Dec;30(8):1506-1512. doi: 10.1016/j.jdiacomp.2016.08.012. Epub 2016 Aug 19.
To assess associations between body mass index (BMI), waist circumference (WC), and computed tomography-determined volumes of pericardial, visceral, and subcutaneous adipose tissue with magnetic resonance imaging-(MRI) based cerebral structure and cognitive performance in individuals with type 2 diabetes (T2D).
This study was performed in 348 African Americans (AAs) and 256 European Americans (EAs) with T2D. Associations between adiposity measures with cerebral volumes of white matter (WMV), gray matter (GMV), white matter lesions, hippocampal GMV, and hippocampal WMV, cognitive performance and depression were examined using marginal models incorporating generalized estimating equations. All models were adjusted for age, sex, education, smoking, HbA1c, hypertension, statins, cardiovascular disease, MRI scanner (MRI outcomes only), and time between scans; some neuroimaging measures were additionally adjusted for intracranial volume.
Participants were 59.9% female with mean (SD) age 57.7(9.3)years, diabetes duration 9.6(6.8)years, and HbA1c 7.8(1.9)%. In AAs, inverse associations were detected between hippocampal GMV and both BMI (β [95% CI]-0.18 [-0.30, -0.07], P=0.0018) and WC (-0.23 [-0.35, -0.12], P=0.0001). In the full bi-ethnic sample, inverse associations were detected between hippocampal WMV and WC (P≤0.0001). Positive relationships were observed between BMI (P=0.0007) and WC (P<0.0001) with depression in EAs.
In patients with T2D, adiposity is inversely associated with hippocampal gray and white matter volumes.
评估2型糖尿病(T2D)患者的体重指数(BMI)、腰围(WC)以及计算机断层扫描测定的心包、内脏和皮下脂肪组织体积与基于磁共振成像(MRI)的脑结构和认知表现之间的关联。
本研究对348名非裔美国人(AA)和256名欧裔美国人(EA)的T2D患者进行。使用纳入广义估计方程的边际模型,研究肥胖指标与脑白质体积(WMV)、灰质体积(GMV)、白质病变、海马GMV和海马WMV、认知表现及抑郁之间的关联。所有模型均针对年龄、性别、教育程度、吸烟、糖化血红蛋白(HbA1c)、高血压、他汀类药物、心血管疾病、MRI扫描仪(仅针对MRI结果)以及扫描间隔时间进行了调整;部分神经影像测量指标还针对颅内体积进行了调整。
参与者中女性占59.9%,平均(标准差)年龄为57.7(9.3)岁,糖尿病病程为9.6(6.8)年,HbA1c为7.8(1.9)%。在非裔美国人中,海马GMV与BMI(β[95%置信区间]-0.18[-0.30,-0.07],P=0.0018)和WC(-0.23[-0.35,-0.12],P=0.0001)均呈负相关。在整个双种族样本中,海马WMV与WC呈负相关(P≤0.0001)。在欧裔美国人中,BMI(P=0.0007)和WC(P<0.0001)与抑郁呈正相关。
在T2D患者中,肥胖与海马灰质和白质体积呈负相关。