Glucose indices are associated with cognitive and structural brain measures in young adults

Galit Weinstein, Pauline Maillard, Jayandra J. Himali, Alexa S. Beiser, Rhoda Au, Philip A. Wolf, Sudha Seshadri, Charles DeCarli

Research output: Contribution to journalArticle

49 Citations (Scopus)

Abstract

Objective: To evaluate the possible early consequences of impaired glucose metabolism on the brain by assessing the relationship of diabetes, fasting blood glucose (FBG) levels, and insulin resistance with cognitive performance and brain integrity in healthy young and middle-aged adults. Methods: The sample included dementia-free participants (mean age 40 ± 9 years; 53% women) of the Framingham Heart Study third-generation cohort with cognitive testing of memory, abstract reasoning, visual perception, attention, and executive function (n 2,126). In addition, brain MRI examination (n 1,597) was used to determine white matter, gray matter, and white matter hyperintensity (WMH) volumes and fractional anisotropy measures. We used linear regression models to assess relationships between diabetes, FBG, and insulin resistance with cognition, lobar gray matter, and WMH volumes as well as voxel-based microstructural white matter integrity and gray matter density, adjusting for potential confounders. Mediating effect of brain lesions on the association of diabetes with cognitive performance was also tested. Results: Diabetes was associated with worse memory, visual perception, and attention performance; increased WMH; and decreased total cerebral brain and occipital lobar gray matter volumes. The link of diabetes with attention and memory was mediated through occipital and frontal atrophy, and the latter also through hippocampal atrophy. Both diabetes and increased FBG were associated with large areas of reductions in gray matter density and fractional anisotropy on voxel-based analyses. Conclusions: We found that hyperglycemia is associated with subtle brain injury and impaired attention and memory even in young adults, indicating that brain injury is an early manifestation of impaired glucose metabolism.

Original languageEnglish (US)
Pages (from-to)2329-2337
Number of pages9
JournalNeurology
Volume84
Issue number23
DOIs
StatePublished - Jun 9 2015

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Young Adult
Glucose
Brain
Blood Glucose
Fasting
Visual Perception
Anisotropy
Brain Injuries
Atrophy
Insulin Resistance
Linear Models
Executive Function
Hyperglycemia
Cognition
Dementia
Gray Matter
White Matter

ASJC Scopus subject areas

  • Clinical Neurology

Cite this

Weinstein, G., Maillard, P., Himali, J. J., Beiser, A. S., Au, R., Wolf, P. A., ... DeCarli, C. (2015). Glucose indices are associated with cognitive and structural brain measures in young adults. Neurology, 84(23), 2329-2337. https://doi.org/10.1212/WNL.0000000000001655

Glucose indices are associated with cognitive and structural brain measures in young adults. / Weinstein, Galit; Maillard, Pauline; Himali, Jayandra J.; Beiser, Alexa S.; Au, Rhoda; Wolf, Philip A.; Seshadri, Sudha; DeCarli, Charles.

In: Neurology, Vol. 84, No. 23, 09.06.2015, p. 2329-2337.

Research output: Contribution to journalArticle

Weinstein, G, Maillard, P, Himali, JJ, Beiser, AS, Au, R, Wolf, PA, Seshadri, S & DeCarli, C 2015, 'Glucose indices are associated with cognitive and structural brain measures in young adults', Neurology, vol. 84, no. 23, pp. 2329-2337. https://doi.org/10.1212/WNL.0000000000001655
Weinstein G, Maillard P, Himali JJ, Beiser AS, Au R, Wolf PA et al. Glucose indices are associated with cognitive and structural brain measures in young adults. Neurology. 2015 Jun 9;84(23):2329-2337. https://doi.org/10.1212/WNL.0000000000001655
Weinstein, Galit ; Maillard, Pauline ; Himali, Jayandra J. ; Beiser, Alexa S. ; Au, Rhoda ; Wolf, Philip A. ; Seshadri, Sudha ; DeCarli, Charles. / Glucose indices are associated with cognitive and structural brain measures in young adults. In: Neurology. 2015 ; Vol. 84, No. 23. pp. 2329-2337.
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