Reduced white matter microstructural integrity in prediabetes and diabetes: A population-based study
Jing Jing,
Yijun Zhou,
Yuesong Pan,
Xueli Cai,
Wanlin Zhu,
Zhe Zhang,
Zixiao Li,
Chang Liu,
Xia Meng,
Jian Cheng,
Yilong Wang,
Hao Li,
Zhenzhou Wu,
Suying Wang,
Haijun Niu,
Wei Wen,
Tao Liu,
Tiemin Wei,
Yongjun Wang,
Perminder S. Sachdev
Affiliations
Jing Jing
Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China; China National Clinical Research Center for Neurological Diseases, Beijing, China
Yijun Zhou
Beijing Advanced Innovation Center for Biomedical Engineering, School of Biological Science and Medical Engineering, Beihang University, Beijing, China
Yuesong Pan
Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China; China National Clinical Research Center for Neurological Diseases, Beijing, China
Xueli Cai
Department of Neurology, Lishui Hospital, Zhejiang University School of Medicine, Lishui, Zhejiang, China
Wanlin Zhu
Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China; China National Clinical Research Center for Neurological Diseases, Beijing, China
Zhe Zhang
Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China; China National Clinical Research Center for Neurological Diseases, Beijing, China
Zixiao Li
Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China; China National Clinical Research Center for Neurological Diseases, Beijing, China
Chang Liu
Beijing Advanced Innovation Center for Biomedical Engineering, School of Biological Science and Medical Engineering, Beihang University, Beijing, China
Xia Meng
Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China; China National Clinical Research Center for Neurological Diseases, Beijing, China
Jian Cheng
School of Computer Science and Engineering, Beihang University, Beijing, China
Yilong Wang
Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China; China National Clinical Research Center for Neurological Diseases, Beijing, China
Hao Li
China National Clinical Research Center for Neurological Diseases, Beijing, China
Zhenzhou Wu
BioMind Technology AI Center, China National Clinical Research Center for Neurological Diseases, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
Suying Wang
Cerebrovascular Research Lab, Lishui Hospital, Zhejiang University School of Medicine, Lishui, Zhejiang, China
Haijun Niu
Beijing Advanced Innovation Center for Biomedical Engineering, School of Biological Science and Medical Engineering, Beihang University, Beijing, China
Wei Wen
Centre for Healthy Brain Ageing (CHeBA), School of Psychiatry, UNSW Sydney NSW 2052, Australia; Neuropsychiatric Institute, Prince of Wales Hospital, Sydney, NSW, Australia
Tao Liu
Beijing Advanced Innovation Center for Biomedical Engineering, School of Biological Science and Medical Engineering, Beihang University, Beijing, China; Corresponding authors.
Tiemin Wei
Department of Cardiology, Lishui Hospital, Zhejiang University School of Medicine, Lishui, Zhejiang, China; Corresponding authors.
Yongjun Wang
Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China; China National Clinical Research Center for Neurological Diseases, Beijing, China; Corresponding authors.
Perminder S. Sachdev
Centre for Healthy Brain Ageing (CHeBA), School of Psychiatry, UNSW Sydney NSW 2052, Australia; Neuropsychiatric Institute, Prince of Wales Hospital, Sydney, NSW, Australia
Summary: Background: White matter (WM) microstructural abnormalities have been observed in diabetes. However, evidence of prediabetes is currently lacking. This study aims to investigate the WM integrity in prediabetes and diabetes. We also assess the association of WM abnormalities with glucose metabolism status and continuous glucose measures. Methods: The WM integrity was analyzed using cross-sectional baseline data from a population-based PolyvasculaR Evaluation for Cognitive Impairment and vaScular Events (PRECISE) study. The cohort, including a total of 2218 cases with the mean age of 61.3 ± 6.6 years and 54.1% female, consisted of 1205 prediabetes which are categorized into two subgroups (a group of 254 prediabetes with combined impaired fasting glucose (IFG) and impaired glucose tolerance (IGT) and the other group of 951 prediabetes without combined IFG/IGT), 504 diabetes, and 509 normal control subjects. Alterations of WM integrity were determined by diffusion tensor imaging along with tract-based spatial statistics analysis to compare diffusion metrics on WM skeletons between groups. The mixed-effects multivariate linear regression models were used to assess the association between WM microstructural alterations and glucose status. Findings: Microstructural abnormalities distributed in local WM tracts in prediabetes with combined IFG/IGT and spread widely in diabetes. These WM abnormalities are associated with higher glucose measures. Interpretation: Our findings suggest that WM microstructural abnormalities are already present at the prediabetes with combined IFG/IGT stage. Preventative strategies should begin early to maintain normal glucose metabolism and avert further destruction of WM integrity. Funding: Partially supported by National Key R&D Program of China (2016YFC0901002).
