Tsiknia Amaryllis A, Tennant Victoria R, Lee Noelle, Hall Brandon J, Vintimilla Raul, Hazra Nalini, Kothapalli Deydeep, Toga Arthur W, O'Bryant Sid E, Nandy Rajesh R, Clark Alexandra L, Petersen Melissa, Yaffe Kristine, Braskie Meredith N
Mark and Mary Stevens Neuroimaging and Informatics Institute University of Southern California Los Angeles California USA.
Institute for Translational Research University of North Texas Health Science Center Fort Worth Texas USA.
Alzheimers Dement (Amst). 2025 May 9;17(2):e70088. doi: 10.1002/dad2.70088. eCollection 2025 Apr-Jun.
Mechanisms linking type 2 diabetes mellitus (T2DM) with dementia are poorly understood. We examined T2DM associations with cortical thickness and hippocampal volume in ethnoracially diverse, cognitively unimpaired older adults.
In 2171 cognitively unimpaired older adults, we examined (1) how T2DM related to cortical thickness and hippocampal volume, (2) whether associations were independent of socioeconomic factors and comorbidities, (3) whether associations were driven by hyperglycemia or hyperinsulinemia, and (4) how associations varied by self-reported race/ethnicity.
T2DM was correlated with thinner cortex independent of socioeconomic factors and comorbidities, and this was driven by higher hemoglobin A1c (HbA1c). Higher HbA1c levels were correlated with thinner cortex in diabetics and non-diabetics. T2DM-cortical thickness associations were strong and widespread in Hispanic participants, modest and limited to temporal regions in non-Hispanic White participants, and not present in non-Hispanic Black adults.
T2DM is associated with a thinner cortex, and this is driven by poor glycemic control.
T2DM is associated with a thinner cortex.The T2DM-cortical thickness relationship is likely driven by poor glucose control.Higher HbA1c levels correlated with thinner cortex in diabetics and non-diabetics.The T2DM-cortical thickness association varied by self-reported ethnicity/race.
2型糖尿病（T2DM）与痴呆症之间的关联机制尚不清楚。我们在种族多样化、认知未受损的老年人中研究了T2DM与皮质厚度和海马体积的关联。
在2171名认知未受损的老年人中，我们研究了（1）T2DM如何与皮质厚度和海马体积相关，（2）这些关联是否独立于社会经济因素和合并症，（3）这些关联是否由高血糖或高胰岛素血症驱动，以及（4）这些关联如何因自我报告的种族/族裔而有所不同。
T2DM与较薄的皮质相关，独立于社会经济因素和合并症，这是由较高的糖化血红蛋白（HbA1c）驱动的。较高的HbA1c水平与糖尿病患者和非糖尿病患者较薄的皮质相关。T2DM与皮质厚度的关联在西班牙裔参与者中强烈且广泛，在非西班牙裔白人参与者中中等且仅限于颞叶区域，在非西班牙裔黑人成年人中不存在。
T2DM与较薄的皮质相关，这是由血糖控制不佳驱动的。
T2DM与较薄的皮质相关。T2DM与皮质厚度的关系可能由血糖控制不佳驱动。较高的HbA1c水平与糖尿病患者和非糖尿病患者较薄的皮质相关。T2DM与皮质厚度的关联因自我报告的种族/族裔而异。
