Abdominal Obesity and Brain Atrophy in Type 2 Diabetes Mellitus

• Published in: PloS one Vol. 10; no. 11; p. e0142589
• Main Authors: Climie, Rachel E D, Moran, Chris, Callisaya, Michele, Blizzard, Leigh, Sharman, James E, Venn, Alison, Phan, Thanh G, Beare, Richard, Forbes, Josephine, Blackburn, Nicholas B, Srikanth, Velandai
• Format: Journal Article
• Language: English
• Published: United States Public Library of Science 11.11.2015; Public Library of Science (PLoS)
• Subjects: Abdomen; Adipose tissue; Adiposity; Age; Aged; Aging; Atrophy; Atrophy - complications; Body mass; Body Mass Index; Body size; Brain; Brain - physiopathology; Brain diseases; Brain Diseases - complications; Brain Diseases - physiopathology; Brain research; Cognition & reasoning; Cognitive ability; Cohort Studies; Complications and side effects; Correlation analysis; Cross-Sectional Studies; Dementia; Diabetes; Diabetes Complications - physiopathology; Diabetes mellitus; Diabetes mellitus (non-insulin dependent); Diabetes Mellitus, Type 2 - complications; Diabetes Mellitus, Type 2 - physiopathology; Endocrinology; Exercise; Family medical history; Female; Gastrointestinal surgery; Genotype; Gray Matter - pathology; Hip; Hippocampus; Hippocampus - pathology; Humans; Insulin resistance; Longitudinal studies; Magnetic Resonance Imaging; Male; Mathematical models; Medical research; Middle Aged; Motor Activity; Multivariate Analysis; NMR; Nuclear magnetic resonance; Obesity; Obesity, Abdominal - complications; Physical activity; Physiological aspects; Proteins; Regression Analysis; Risk analysis; Risk Factors; Statistical analysis; Stroke; Substantia grisea; Surveys and Questionnaires; Tasmania; Type 2 diabetes; Waist-Hip Ratio; Weight control; Tasmania; Australia; Victoria Australia; Tasmania Australia
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0142589

Type 2 diabetes mellitus (T2D) is associated with gray matter atrophy. Adiposity and physical inactivity are risk factors for T2D and brain atrophy. We studied whether the associations of T2D with total gray matter volume (GMV) and hippocampal volume (HV) are dependent on obesity and physical activity. In this cross-sectional study, we measured waist-hip ratio (WHR), body mass index (BMI), mean steps/day and brain volumes in a community dwelling cohort of people with and without T2D. Using multivariable linear regression, we examined whether WHR, BMI and physical activity mediated or modified the association between T2D, GMV and HV. There were 258 participants with (mean age 67 ± 7 years) and 302 without (mean age 72 ± 7 years) T2D. Adjusting for age, sex and intracranial volume, T2D was independently associated with lower total GMV (p = 0.001) and HV (p<0.001), greater WHR (p<0.001) and BMI (p<0.001), and lower mean steps/day (p = 0.002). After adjusting for covariates, the inclusion of BMI and mean steps/day did not significantly affect the T2D-GMV association, but WHR attenuated it by 32% while remaining independently associated with lower GMV (p<0.01). The T2D-HV association was minimally changed by the addition of BMI, steps/day or WHR in the model. No statistical interactions were observed between T2D and measures of obesity and physical activity in explaining brain volumes. Abdominal obesity or its downstream effects may partially mediate the adverse effect of T2D on brain atrophy. This requires confirmation in longitudinal studies.