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Grosu, S.* ; Lorbeer, R.* ; Hartmann, F.* ; Rospleszcz, S. ; Bamberg, F.* ; Schlett, C.L.* ; Galiè, F.* ; Selder, S.* ; Auweter, S.* ; Heier, M. ; Rathmann, W.* ; Mueller-Peltzer, K.* ; Ladwig, K.-H. ; Peters, A. ; Ertl-Wagner, B.B.* ; Stoecklein, S.*

White matter hyperintensity volume in pre-diabetes, diabetes and normoglycemia.

BMJ Open Diab. Res. Care 9:e002050 (2021)
Publ. Version/Full Text DOI PMC
Open Access Gold
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INTRODUCTION: As white matter hyperintensities (WMHs) of the brain are associated with an increased risk of stroke, cognitive decline, and depression, elucidating the associated risk factors is important. In addition to age and hypertension, pre-diabetes and diabetes may play important roles in the development of WMHs. Previous studies have, however, shown conflicting results. We aimed to investigate the effect of diabetes status and quantitative markers of glucose metabolism on WMH volume in a population-based cohort without prior cardiovascular disease. RESEARCH DESIGN AND METHODS: 400 participants underwent 3 T MRI. WMHs were manually segmented on 3D fluid-attenuated inversion recovery images. An oral glucose tolerance test (OGTT) was administered to all participants not previously diagnosed with diabetes to assess 2-hour serum glucose concentrations. Fasting glucose concentrations and glycated hemoglobin (HbA1c) levels were measured. Zero-inflated negative binomial regression analyses of WMH volume and measures of glycemic status were performed while controlling for cardiovascular risk factors and multiple testing. RESULTS: The final study population comprised 388 participants (57% male; age 56.3±9.2 years; n=98 with pre-diabetes, n=51 with diabetes). Higher WMH volume was associated with pre-diabetes (p=0.001) and diabetes (p=0.026) compared with normoglycemic control participants after adjustment for cardiovascular risk factors. 2-hour serum glucose (p<0.001), but not fasting glucose (p=0.389) or HbA1c (p=0.050), showed a significant positive association with WMH volume after adjustment for cardiovascular risk factors. CONCLUSION: Our results indicate that high 2-hour serum glucose concentration in OGTT, but not fasting glucose levels, may be an independent risk factor for the development of WMHs, with the potential to inform intensified prevention strategies in individuals at risk of WMH-associated morbidity.
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Publication type Article: Journal article
Document type Scientific Article
Keywords Mri ; Brain Diseases ; Diabetes Complications ; Metabolic ; Pre-diabetic State; Impaired Glucose-tolerance; Risk-factors; Cerebrovascular-disease; General-population; Unselected Cohort; Blood-pressure; Lesions; Leukoaraiosis; Association; Mri
Language english
Publication Year 2021
HGF-reported in Year 2021
ISSN (print) / ISBN 2052-4897
e-ISSN 2052-4897
Journal BMJ Open Diabetes Research & Care
Quellenangaben Volume: 9, Issue: 1, Pages: , Article Number: e002050 Supplement: ,
Publisher BMJ Publishing Group
Publishing Place London
Reviewing status Peer reviewed
Institute(s) Institute of Epidemiology (EPI)
POF-Topic(s) 30202 - Environmental Health
Research field(s) Genetics and Epidemiology
PSP Element(s) G-504000-010
G-504000-006
G-504000-003
G-504090-001
Grants Siemens Healthcare
German Research Foundation (Deutsche Forschungsgemeinschaft)
Munich Center of Health Sciences, Ludwig-Maximilians-Universitat as part of LMUinnovativ
State of Bavaria
Helmholtz Zentrum Munchen -German Research Center for Environmental Health - German Federal Ministry of Education and Research (BMBF)
DOI 10.1136/bmjdrc-2020-002050
WOS ID WOS:000688258300001
Scopus ID 85108959653
PubMed ID 34183320
Erfassungsdatum 2021-07-07
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