Gray matter alterations and correlation of nutritional intake with the gray matter volume in prediabetes

Abstract

The neurophysiology of prediabetes plays an important role in preventive medicine. The dysregulation of glucose metabolism is likely linked to changes in neuron-related gray matter. Therefore, we designed this study to investigate gray matter alterations in medication-naive prediabetic patients. We expected to find alterations in the gray matter of prediabetic patients.A total of 64 prediabetic patients and 54 controls were enrolled. All subjects received T1 scans using a 3-T magnetic resonance imaging machine. Subjects also completed nutritional intake records at the 24-hour and 3-day time points to determine their carbohydrate, protein, fat, and total calorie intake. We utilized optimized voxel-based morphometry to estimate the gray matter differences between the patients and controls. In addition, the preprandial serum glucose level and the carbohydrate, protein, fat, and total calorie intake levels were tested to determine whether these parameters were correlated with the gray matter volume.Prediabetic patients had lower gray matter volumes than controls in the right anterior cingulate gyrus, right posterior cingulate gyrus, left insula, left super temporal gyrus, and left middle temporal gyrus (corrected P < 0.05; voxel threshold: 33). Gray matter volume in the right anterior cingulate was also negatively correlated with the preprandial serum glucose level gyrus in a voxel-dependent manner (r = –0.501; 2-tailed P = 0.001).The cingulo-temporal and insula gray matter alterations may be associated with the glucose dysregulation in prediabetic patients.

Association of impaired fasting glucose and Type 2 Diabetes Mellitus with brain volume changes in Alzheimer’s Disease patients analyzed by MRI: a retrospective study

“…However, the regions involved in different studies seem to be inconsistent and different from the typical AD biomarker-medial temporal atrophy (Bernard et al, 2014;Gili et al, 2011;Guo et al, 2014). In patients with T2DM or impaired fasting glucose (IFG), the volume of the brain was observed to be smaller, including the whole brain, cingulated cortex and temporal gyrus (Hou et al, 2016;Li et al, 2016). McIntyre et al (2010) observed that individuals with T2DM exhibit volumetric abnormalities in both cortical and subcortical structures.…”

Brain deficits in prediabetic adults: A systematic review

“…In a cross‐sectional study measuring GM alterations in adults with IFG and those with normoglycemia, those with IFG were found to have lower GMVs than those with normoglycemia in the right ACC, right posterior cingulate cortex, left insula, left superior temporal gyrus, and left MTG (Hou, Lai, et al., 2016). In addition, serum glucose levels were negatively correlated with total GMV and right ACC GMV (Hou, Lai, et al., 2016).…”

“…In a cross‐sectional study measuring GM alterations in adults with IFG and those with normoglycemia, those with IFG were found to have lower GMVs than those with normoglycemia in the right ACC, right posterior cingulate cortex, left insula, left superior temporal gyrus, and left MTG (Hou, Lai, et al., 2016). In addition, serum glucose levels were negatively correlated with total GMV and right ACC GMV (Hou, Lai, et al., 2016). Similarly, a study assessing reductions in subcortical GM structures (thalamus, caudate, putamen, pallidum, hippocampus, amygdala, nucleus accumbens) showed significantly lower volumes for the left hippocampus, left amygdala, and right putamen in prediabetics when compared to those with normoglycemia (Cui et al., 2019).…”

“…In summary, of the 13 studies assessing volumetric measures, seven (Cui et al., 2019; Dong et al., 2019; Hou, Lai, et al., 2016; Markus et al., 2017; Marseglia et al., 2019; Samaras et al., 2014; van Agtmaal et al., 2018) provide evidence that prediabetics experience some brain volumetric decline compared to those with normoglycemia. One study argued that brain deficits seen in prediabetes occur in a progressive declining manner (van Agtmaal et al., 2018), such that prediabetics experience decline greater than those with normal glucose levels but less than diabetics.…”

“…While some studies have found no differences in brain volume or cerebrovascular function between adults with normal blood glucose levels (normoglycemia) and those with prediabetes, other studies have found significant differences suggesting that prediabetics experience some neural decline. For example, Schneider and colleagues (2017) found no differences in total brain volume (TBV) and hippocampal volume (HV) between these two populations, while Hou and colleagues (2016) found lower gray matter volume (GMV) for prediabetics in areas such as the right anterior cingulate cortex (ACC) and left middle temporal gyrus (MTG). Evidently, the relationship between prediabetes and brain health is unclear, and conducting a systematic review of the literature will help summarize what is known thus far and identify what future research may be needed.…”