Reduced Gray Matter Volume in Patients with Type 2 Diabetes Mellitus

Aims/hypothesis: Diabetes mellitus (DM) is associated with comorbid brain disorders. Neuroimaging studies in DM revealed neuronal degeneration in several cortical and subcortical brain regions. Previous studies indicate more pronounced brain alterations in type 2 diabetes mellitus (T2DM) than in type 1 diabetes mellitus (T1DM). However, a comparison of both types of DM in a single analysis has not been done so far. The aim of this meta-analysis was to conduct an unbiased objective investigation of neuroanatomical differences in DM by combining voxel-based morphometry (VBM) studies of T1DM and T2DM using dual disorder anatomical likelihood estimation (ALE) quantification.Methods: PubMed, Web of Science and Medline were systematically searched for publications until June 15, 2020. VBM studies comparing gray matter volume (GMV) differences between DM patients and controls at the whole-brain level were included. Study coordinates were entered into the ALE meta-analysis to investigate the extent to which T1DM, T2DM, or both conditions contribute to gray matter volume differences compared to controls.Results: Twenty studies (comprising of 1,175 patients matched with 1,013 controls) were included, with seven studies on GMV alterations in T1DM and 13 studies on GMV alterations in T2DM. ALE analysis revealed seven clusters of significantly lower GMV in T1DM and T2DM patients relative to controls across studies. Both DM subtypes showed GMV reductions in the left caudate, right superior temporal lobe, and left cuneus. Conversely, GMV reductions associated exclusively with T2DM (>99% contribution) were found in the left cingulate, right posterior lobe, right caudate and left occipital lobe. Meta-regression revealed no significant influence of study size, disease duration, and HbA1c values.Conclusions/interpretation: Our findings suggest a more pronounced gray matter atrophy in T2DM compared to T1DM. The increased risk of microvascular or macrovascular complications, as well as the disease-specific pathology of T2DM may contribute to observed GMV reductions.Systematic Review Registration: [PROSPERO], identifier [CRD42020142525].

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The Association of Type 2 Diabetes Mellitus with Cerebral Gray Matter Volume Is Independent of Retinal Vascular Architecture and Retinopathy

Journal of Diabetes Research ◽

10.1155/2016/6328953 ◽

2016 ◽

Vol 2016 ◽

pp. 1-9 ◽

Cited By ~ 11

Author(s):

C. Moran ◽

R. J. Tapp ◽

A. D. Hughes ◽

C. G. Magnussen ◽

L. Blizzard ◽

...

Keyword(s):

Diabetes Mellitus ◽

Type 2 Diabetes ◽

Gray Matter ◽

Small Vessel Disease ◽

Gray Matter Volume ◽

Brain Volumes ◽

Vascular Architecture ◽

Vessel Disease ◽

Matter Volume

It is uncertain whether small vessel disease underlies the relationship between Type 2 Diabetes Mellitus (T2DM) and brain atrophy. We aimed to study whether retinal vascular architecture, as a proxy for cerebral small vessel disease, may modify or mediate the associations of T2DM with brain volumes. In this cross-sectional study using Magnetic Resonance Imaging (MRI) scans and retinal photographs in 451 people with and without T2DM, we measured brain volumes, geometric measures of retinal vascular architecture, clinical retinopathy, and MRI cerebrovascular lesions. There were 270 people with (mean age 67.3 years) and 181 without T2DM (mean age 72.9 years). T2DM was associated with lower gray matter volume (p=0.008). T2DM was associated with greater arteriolar diameter (p=0.03) and optimality ratio (p=0.04), but these associations were attenuated by adjustments for age and sex. Only optimality ratio was associated with lower gray matter volume (p=0.03). The inclusion of retinal measures in regression models did not attenuate the association of T2DM with gray matter volume. The association of T2DM with lower gray matter volume was independent of retinal vascular architecture and clinical retinopathy. Retinal vascular measures or retinopathy may not be sufficiently sensitive to confirm a microvascular basis for T2DM-related brain atrophy.

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Irregular structural networks of gray matter in patients with type 2 diabetes mellitus

Brain Imaging and Behavior ◽

10.1007/s11682-019-00070-2 ◽

2019 ◽

Vol 14 (5) ◽

pp. 1477-1486 ◽

Cited By ~ 1

Author(s):

Chuanlong Cao ◽

Wanqing Liu ◽

Qing Zhang ◽

Jian-lin Wu ◽

Yumei Sun ◽

...

Keyword(s):

Diabetes Mellitus ◽

Type 2 Diabetes ◽

Type 2 Diabetes Mellitus ◽

Gray Matter ◽

Structural Networks

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Brain gray matter volume differences in obese youth with type 2 diabetes: a pilot study

Journal of Pediatric Endocrinology and Metabolism ◽

10.1515/jpem-2017-0349 ◽

2018 ◽

Vol 31 (3) ◽

pp. 261-268 ◽

Cited By ~ 1

Author(s):

Jacob M. Redel ◽

Mark DiFrancesco ◽

Jennifer Vannest ◽

Mekibib Altaye ◽

Dean Beebe ◽

...

Keyword(s):

Type 2 Diabetes ◽

Pilot Study ◽

Gray Matter ◽

Gray Matter Volume ◽

Brain Magnetic Resonance Imaging ◽

Direct Result ◽

Intracranial Volume ◽

Matter Volume ◽

Obese Youth

AbstractBackground:Adults with type 2 diabetes (T2D) have significantly lower gray matter volume (GMV) compared to healthy peers. Whether GMV differences exist in youth with T2D remains unclear. Thus, we compared global and regional GMV between obese youth with T2D with age, race and sex similar healthy controls.Methods:In a cross-sectional study, 20 obese youth with T2D underwent T1-weighted brain magnetic resonance imaging (MRI). Comparisons were made to 20 age, race and sex similar controls. Differences in global and regional GMV between groups were identified using voxel-based morphometry (VBM).Results:Youth with T2D had a significantly lower global GMV-to-intracranial volume ratio (0.51±0.02 in T2D vs. 0.53±0.02 in controls, p=0.02, Cohen’sd=0.85). There were 14 regions where GMV was significantly lower in the T2D group, and nine of these were found in either the temporal or occipital lobes. There were six regions with increased GMV in T2D. All regional differences were significant at p<0.05 after adjusting for multiple comparisons.Conclusions:Results from this pilot study show obese youth with T2D have significantly lower global GMV and regional GMV differences, when compared to their age, race and sex similar peers. Future work is needed to determine whether these brain findings are a direct result of adolescent-onset T2D.

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