Brain changes in overweight/obese and normal-weight adults with type 2 diabetes mellitus
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Overweight and obesity may significantly worsen glycaemic and metabolic control in type 2 diabetes. However, little is known about the effects of overweight and obesity on the brains of people with type 2 diabetes. Here, we investigate whether the presence of overweight or obesity influences the brain and cognitive functions during early stage type 2 diabetes.
This study attempted to uncouple the effects of overweight/obesity from those of type 2 diabetes on brain structures and cognition. Overweight/obese participants with type 2 diabetes had more severe and progressive abnormalities in their brain structures and cognition during early stage type 2 diabetes compared with participants with normal weight. Relationships between each of these measures and disease duration were also examined.
Global mean cortical thickness was lower in the overweight/obese type 2 diabetes group than in the normal-weight type 2 diabetes group (z = −2.96, p for group effect = 0.003). A negative correlation was observed between disease duration and global mean white matter integrity (z = 2.42, p for interaction = 0.02) in the overweight/obese type 2 diabetes group, but not in the normal-weight type 2 diabetes group. Overweight/obese individuals with type 2 diabetes showed a decrease in psychomotor speed performance related to disease duration (z = −2.12, p for interaction = 0.03), while normal-weight participants did not.
The current study attempted to uncouple the effects of overweight/obesity from those of type 2 diabetes on brain structures and cognition. Overweight/obese participants with type 2 diabetes had more severe and progressive abnormalities in brain structures and cognition during early stage type 2 diabetes compared with normal-weight participants.
KeywordsCognitive function Grey matter Obesity Overweight Type 2 diabetes mellitus White matter
High-sensitivity C-reactive protein
Region of interest
The authors thank all volunteers for their participation in this study and thank S A. Chang, J. Kim, D.-J. Lim and J. M. Lee, Department of Internal Medicine, College of Medicine, The Catholic University of Korea, for their valuable comments and assistance.
The datasets generated during and/or analysed during the current study are available from the corresponding author on reasonable request.
This study was supported by grants from the Korean Health Technology R&D Project, Ministry of Health & Welfare, Republic of Korea (no. A121080), the National Research Foundation of Korea (no. 2015M3C7A1028373) and the ICT R&D programme of the Institute for Information & Communications Technology Promotion (no. B0132-17-1001).
Duality of interest statement
The authors declare that there is no duality of interest associated with this manuscript.
SY, JK and IKL designed the study; and SY, HC and IKL collected and analysed/interpreted the data, wrote and reviewed the manuscript, and approved the final draft of the manuscript. JK, D-WL, GHK, YSH, SM, SP, SunL, SujL, SB and DCS substantially contributed to the conception and design, analysis and interpretation of data, and reviewed and approved the final draft of the manuscript. SY and IKL are the guarantors of this study.
- 20.Expert Panel on the Identification, Evaluation, and Treatment of Overweight and Obesity in Adults (US), National Heart, Lung, and Blood Institute, National Institute of Diabetes and Digestive Kidney Diseases (US) (1998) Clinical guidelines on the identification, evaluation, and treatment of overweight and obesity in adults: the evidence report. National Institutes of Health, National Heart, Lung, and Blood Institute. Available from: https://www.ncbi.nlm.nih.gov/books/NBK2003/. Accessed 8 Oct 2016