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BMI influences cognitive dysfunction in early type 2 diabetes
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Alterations in cortical thinning, white matter integrity and psychomotor speed performance are more pronounced in adults with early-stage type 2 diabetes and overweight or obesity compared with normal-weight adults with diabetes and healthy controls, according to findings published in Diabetologia.
“Obesity has been linked to metabolic dysfunction and may further exacerbate type 2 diabetes-related metabolic abnormalities,” In Kyoon Lyoo, MD, of the Ewha Brain Institute at Ewha Woman’s University in Seoul, South Korea, and colleagues wrote. “Obesity-related metabolic
dysfunction is also independently associated with brain alterations and may impair cognitive function, which further increases the risk of dementia. However, little is known about how the concurrent presence of overweight/obesity and type 2 diabetes may affect the brain.”
Lyoo and colleagues analyzed data from 50 adults with overweight or obesity and type 2 diabetes aged 30 to 60 years, with a mean disease duration of 5 years, as well as 50 normal-weight adults with type 2 diabetes matched for age, sex and disease duration, and 50 normal-weight adults without diabetes matched for age and sex (controls). All participants with type 2 diabetes were undergoing lifestyle modification therapy and/or taking glucose-lowering agents; none had progressed to insulin therapy or experienced severe hypoglycemia.
All participants completed cognition assessments and underwent MRI; medical history and medication status was assessed at baseline and follow-up at 1 year, along with blood pressure, blood glucose, renal function and lipid profile. Researchers used linear mixed-effects models to assess group differences in brain and cognitive measures between the total type 2 diabetes group and the normal-weight control group, using “group” as a fixed-effect term and within-individual dependence as a random-effect term, and adjusting for age and sex.
Researchers found that global mean cortical thickness was lower in adults with overweight or obesity and type 2 diabetes vs. normal-weight adults with type 2 diabetes (P for group effect = .003). There was an interaction between disease duration and weight status on global mean fractional anisotropy (P for group effect = .02); a gradual decrease in global mean fractional anisotropy was observed in adults with overweight/obesity and type 2 diabetes, but not in normal-weight adults with type 2 diabetes, according to researchers.
The total type 2 diabetes group also exhibited a reduction in memory compared with controls (P for group effect = .002), as well as a reduction in psychomotor speed vs. controls (P for group effect = .001); there was an interaction effect of disease duration and weight status on psychomotor speed performance (P for interaction = .03). Researchers observed a progressive decline in psychomotor speed performance in the group with overweight/obesity and type 2 diabetes.
“These findings suggest that weight status may play additive roles in type 2 diabetes-related brain and cognitive alterations,” the researchers wrote. – by Regina Schaffer
Disclosure: The researchers report no relevant financial disclosures.
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