Cortical and subcortical gray matter structural alterations in normoglycemic obese and type 2 diabetes patients: relationship with adiposity, glucose, and insulin

Abstract

Type 2 diabetes (T2DM) is associated with structural cortical and subcortical alterations, although it is insufficiently clear if these alterations are driven by obesity or by diabetes and its associated complications. We used FreeSurfer5.3 and FSL-FIRST to determine cortical thickness, volume and surface area, and subcortical gray matter volume in a group of 16 normoglycemic obese subjects and 28 obese T2DM patients without clinically manifest micro- and marcoangiopathy, and compared them to 31 lean normoglycemic controls. Forward regression analysis was used to determine demographic and clinical correlates of altered (sub)cortical structure. Exploratively, vertex-wise correlations between cortical structure and fasting glucose and insulin were calculated. Compared with controls, obese T2DM patients showed lower right insula thickness and lower left lateral occipital surface area (PFWE < 0.05). Normoglycemic obese versus controls had lower thickness (PFWE < 0.05) in the right insula and inferior frontal gyrus, and higher amygdala and thalamus volume. Thalamus volume and left paracentral surface area were also higher in this group compared with obese T2DM patients. Age, sex, BMI, fasting glucose, and cholesterol were related to these (sub)cortical alterations in the whole group (all P < 0.05). Insulin were related to temporal and frontal structural deficits (all PFWE < 0.05). Parietal/occipital structural deficits may constitute early T2DM-related cerebral alterations, whereas in normoglycemic obese subjects, regions involved in emotion, appetite, satiety regulation, and inhibition were affected. Central adiposity and elevated fasting glucose may constitute risk factors.

The association between body mass index and brain morphology in children: a population-based study

“…Since controlling for outdoor play time, a measure indicative of physical activity, did not change the results, it is less likely that this finding is due to differences in physical activity between children. A higher left paracentral surface area in patients with normoglymenic obesity has been documented earlier by Bernardes and colleagues (Bernardes et al 2018 ), and thus this brain area may show greater specificity in relation to BMI. Additional studies, preferably longitudinal or interventional studies are needed to confirm the specificity of this finding.…”

Nucleus accumbens volume is related to obesity measures in an age‐dependent fashion

“…We identified 17 samples within 14 studies eligible for the meta‐analysis 8‐10,38‐48. A detailed description of the studies is provided in Table 1.…”

“…We identified 17 samples within 14 studies eligible for the metaanalysis. [8][9][10][38][39][40][41][42][43][44][45][46][47][48] A detailed description of the studies is provided in Table 1. Two studies used samples from the UK Biobank dataset 10,48 ;…”

Cognitive performance in midlife type 2 diabetes: results from the ENBIND study

“…Notably, structural neuroimaging studies in type 2 diabetes have demonstrated a reduced volume in the hippocampus, basal ganglia, and the cortex, including the medial temporal lobe, 26,27 the same areas targeted by the paired associates learning task. The relationship between regional brain volumes in structural neuroimaging studies conducted in those with midlife type 2 diabetes is an important consideration for future research.…”