Sex-Related Differences in Brain Volumes and Cerebral Blood Flow Among Overweight and Obese Adults With Type 2 Diabetes: Exploratory Analyses From the Action for Health in Diabetes Brain Magnetic Resonance Imaging Study
Year: 2019
Type: article
Abstract: BACKGROUND: Sex may be an important modifier of brain health in response to risk factors. We compared brain structure and function of older overweight and obese women and men with type 2 diabetes mellitus. METHODS: Cross-sectional cognitive assessments and magnetic resonance images were obtained in 224 women and 95 men (mean age 69 years) with histories of type 2 diabetes mellitus and overweight or obesity. Prior to magnetic resonance images, participants had completed an average of 10 years of random assignment to either multidomain intervention targeting weight loss or a control condition of diabetes support and education. Total (summed gray and white) matter volumes, white matter hyperintensity volumes, and cerebral blood flow across five brain regions of interest were analyzed using mixed-effects models. RESULTS: After covariate adjustment, women, compared with men, averaged 10.9 [95% confidence interval 3.3, 18.5; ≈1%] cc greater summed region of interest volumes and 1.39 [0.00002, 2.78; ≈54%] cc greater summed white matter hyperintensity volumes. Sex differences could not be attributed to risk factor profiles or intervention response. Their magnitude did not vary significantly with respect to age, body mass index, intervention assignment, or APOE-ε4 genotype. Sex differences in brain magnetic resonance images outcomes did not account for the better levels of cognitive functioning in women than men. CONCLUSIONS: In a large cohort of older overweight or obese adults with type 2 diabetes mellitus, differences in brain volumes and white matter disease were apparent between women and men, but these did not account for a lower prevalence of cognitive impairment in women compared with men in this cohort. TRIAL REGISTRATION: NCT00017953.
Language: English
Subfield: Psychiatry and Mental health
Field: Medicine
Domain: Health Sciences
Open Access status: bronze
Funders: U.S. Department of Health and Human Services, U.S. Department of Veterans Affairs, FedEx Corporation, National Institutes of Health, Centers for Disease Control and Prevention, Indian Health Service, Center for Clinical and Translational Research, Abbott Nutrition, National Institute on Aging, National Heart, Lung, and Blood Institute, National Institute of Nursing Research, National Institute of General Medical Sciences, National Institute of Diabetes and Digestive and Kidney Diseases, National Center on Minority Health and Health Disparities, National Center for Research Resources, Office of Research on Women's Health, Alzheimer's Disease Research Center, Wake Forest School of Medicine
Awards: G1255522451, G1580106113, Wake Forest Alzheimer's Disease Core Center, Action for Health in Diabetes Continuation (Look AHEAD-E), 05/16 Action for Health in Diabetes Extension Study - Research Project, 10/16 Action for Health in Diabetes Extension Study Research Project, G3204466519, General Clinical Research Center, 14/16 Action for Health in Diabetes Extension Study Research Project, 02/16 Action for Health in Diabetes Extension Study Research Study, GENERAL CLINICAL RESEARCH CENTER, University of Pittsburgh Clinical and Translational Science Institute, Biomarkers of ABCA1 mediated functions in Alzheimers disease, 16/16 Action for Health in Diabetes Extension Study Biostatistics Research Center, G5102521317, Action for Health in Diabetes Brain Magnetic Resonance Imaging Ancillary Study, 09/16 Action for Health in Diabetes Extension Study Research Project, DHA brain delivery by APOE genotype, 08/16 Action for Health in Diabetes Extension Study Research Project, 07/16 Action for Health in Diabetes Extension Study Research Project, General Clinical Research Center, Long-term impact of random assignment to intensive lifestyle intervention on Alzheimers disease and related dementias: The Action for Health in Diabetes ADRD Study (Look AHEAD-MIND), 04/16 Action for Health in Diabetes Extension Study Research Project, 03/16 Action for Health in Diabetes Extension Study Research Project, G6695148374, 13/16 Action for Health in Diabetes Extension Study Research Project, 11/16 Action for Health in Diabetes Extension Study Research Project, 15/16 Action for Health in Diabetes Extension Study Research Project, 12/16 Action for Health in Diabetes Extension Study Research Project, 06/16 Action for Health in Diabetes Extension Study Research Project, The delivery of essential fatty acids to the Brain in Alzheimer's disease, G9000285666, Louisiana Clinical and Translational Science Center, Perimenopause in Brain Aging and Alzheimer's Disease, Alzheimer's Disease Research Centers, Midcareer Award for Research in Dementia Risk Factors and Prevention
OpenAlex ID: W2936108813