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P2‐546: Sex‐related Differences in Brain Volumes and Cerebral Blood Flow Among Overweight and Obese Adults With Type 2 Diabetes

Year: 2019

Type: article

Abstract: Sex may be an important modifier of the effects of cardiometabolic risk factors on brain health. We assessed brain structure and function in older overweight and obese adults with type 2 diabetes mellitus (T2DM), and compared them between men and women. Standardized cognitive tests and magnetic resonance images (MRI) were obtained in 224 women and 95 men (mean age 69 +/- 6.4 years) who were overweight or obese and had a history of T2DM as part of an ancillary study to the Look AHEAD trial. An average of 10 years prior to MRI, participants were randomized to either an intensive lifestyle intervention (ILI) targeting weight loss (decreased energy intake, increased physical activity, and self-monitoring) or a control condition of diabetes support and education (DSE). Sex differences in brain MRI measures including total brain volume (sum of gray and white matter), white matter hyperintensity (WMH) volume, and mean cerebral blood flow (CBF) across five brain regions of interest (ROIs) were analyzed using mixed-effects models with study site, age, and intervention assignment as covariates. Sex differences in cognitive tests were assessed in models that had these same covariates, and did or did not also include brain MRI outcomes as additional covariates. After covariate adjustment, women had an average of 10.9 [95% confidence interval 3.3,18.5] cc greater brain volume and 1.39 [0.00002,2.78] cc greater WMH volume than men. CBF was marginally greater in women than men: 2.44 [−0.64,5.50] ml/100g/min on average. Sex differences in MRI findings could not be attributed to recognized risk factors for brain aging (age, body mass index, APOE-e4 genotype) or to intervention assignment. Women had better cognitive test scores than men on average but brain MRI measures did not explain these sex differences. In a large cohort of older overweight or obese adults with T2DM, women had indicators of better brain health than men, but these sex differences did not account for better cognitive functioning in women compared with men.

Source: Alzheimer s & Dementia

DOI: 10.1016/j.jalz.2019.06.2954