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Association of prediabetes with reduced brain volume in a general elderly Japanese population

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Abstract

Objectives

Diabetes frequently results in cognitive impairment, but it is less clear if brain health is adversely affected during the prediabetic stage. Our aim is to identify possible changes in brain volume as measured by magnetic resonance imaging (MRI) in a large elderly population stratified according to level of “dysglycemia.”

Methods

This is a cross-sectional study of 2144 participants (median age 69 years, 60.9% female) who underwent 3-T brain MRI. Participants were divided into 4 dysglycemia groups based on HbA1c levels (%): normal glucose metabolism (NGM) (< 5.7%), prediabetes (5.7 to < 6.5%), undiagnosed diabetes (6.5% or higher), and known diabetes (defined by self-report).

Results

Of the 2144 participants, 982 had NGM, 845 prediabetes, 61 undiagnosed diabetes, and 256 known diabetes. After adjustment for age, sex, education, body weight, cognitive status, smoking, drinking, and disease history, total gray matter volume was significantly lower among participants with prediabetes (0.41% lower, standardized β =  − 0.0021 [95% CI − 0.0039, − 0.00039], p = 0.016), undiagnosed diabetes (1.4% lower, standardized β =  − 0.0069 [95% CI − 0.012, − 0.002], p = 0.005), and known diabetes (1.1% lower, standardized β =  − 0.0055 [95% CI − 0.0081, − 0.0029], p < 0.001) compared to the NGM group. After adjustment, total white matter volume and hippocampal volume did not differ significantly between the NGM group and either the prediabetes group or the diabetes group.

Conclusion

Sustained hyperglycemia may have deleterious effects on gray matter integrity even prior to the onset of clinical diabetes.

Key Points

• Sustained hyperglycemia has deleterious effects on gray matter integrity even prior to the onset of clinical diabetes.

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Abbreviations

AD:

Alzheimer’s disease

GMV:

Gray matter volume

HV:

Hippocampal volume

ICV:

Intracranial volume

NGM:

Normal glucose metabolism

WMV:

White matter volume

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Acknowledgements

The authors thank all the investigators and participants of this study.

Funding

This study has received funding by AMED (Japan Agency for Medical Research and Development) under Grant Number JP16dk0207025.

Author information

Authors and Affiliations

  1. Department of Radiology, Hirosaki University Graduate School of Medicine, Hirosaki, Japan

    Soichiro Tatsuo, Fumiyasu Tsushima, Sayuri Tatsuo & Shingo Kakeda

  2. Open Innovation Institute, Kyoto University, Kyoto, Japan

    Keita Watanabe

  3. Department of Radiology, University of Occupational and Environmental Health, School of Medicine, Kitakyushu, Japan

    Satoru Ide

  4. Department of Medical Informatics and Clinical Research Support Center, Hirosaki University Hospital, Hirosaki, Japan

    Masashi Matsuzaka

  5. Department of Endocrinology and Metabolism, Hirosaki University Graduate School of Medicine, Hirosaki, Japan

    Hiroshi Murakami & Makoto Daimon

  6. Hirosaki University COI Research Initiative Organization, Hirosaki University, Hirosaki, Japan

    Mizuri Ishida, Takuro Iwane & Shigeyuki Nakaji

  7. Department of Radiology, Narumi Hospital, Hirosaki, Japan

    Hiraku Yodono

Authors
  1. Soichiro Tatsuo
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  2. Keita Watanabe
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  3. Satoru Ide
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  4. Fumiyasu Tsushima
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  5. Sayuri Tatsuo
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  9. Takuro Iwane
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  10. Makoto Daimon
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  12. Shigeyuki Nakaji
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  13. Shingo Kakeda
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Corresponding author

Correspondence to Satoru Ide.

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Guarantor

The scientific guarantor of this publication is Shingo Kakeda.

Conflict of interest

The authors of this manuscript declare no relationships with any companies, whose products or services may be related to the subject matter of the article.

Statistics and biometry

No complex statistical methods were necessary for this paper.

Informed consent

Written informed consent was obtained from all subjects (patients) in this study.

Ethical approval

Institutional Review Board approval was obtained.

Methodology

• prospective

• cross-sectional study/observational

• performed at one institution

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Tatsuo, S., Watanabe, K., Ide, S. et al. Association of prediabetes with reduced brain volume in a general elderly Japanese population. Eur Radiol 33, 5378–5384 (2023). https://doi.org/10.1007/s00330-023-09509-z

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  • DOI: https://doi.org/10.1007/s00330-023-09509-z

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