Document Detail


Preliminary evidence for brain complications in obese adolescents with type 2 diabetes mellitus.
MedLine Citation:
PMID:  20668831     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
AIMS/HYPOTHESIS: Central nervous system abnormalities, including cognitive and brain impairments, have been documented in adults with type 2 diabetes who also have multiple co-morbid disorders that could contribute to these observations. Assessing adolescents with type 2 diabetes will allow the evaluation of whether diabetes per se may adversely affect brain function and structure years before clinically significant vascular disease develops.
METHODS: Eighteen obese adolescents with type 2 diabetes and 18 obese controls without evidence of marked insulin resistance, matched on age, sex, school grade, ethnicity, socioeconomic status, body mass index and waist circumference, completed MRI and neuropsychological evaluations.
RESULTS: Adolescents with type 2 diabetes performed consistently worse in all cognitive domains assessed, with the difference reaching statistical significance for estimated intellectual functioning, verbal memory and psychomotor efficiency. There were statistical trends for executive function, reading and spelling. MRI-based automated brain structural analyses revealed both reduced white matter volume and enlarged cerebrospinal fluid space in the whole brain and the frontal lobe in particular, but there was no obvious grey matter volume reduction. In addition, assessments using diffusion tensor imaging revealed reduced white and grey matter microstructural integrity.
CONCLUSIONS/INTERPRETATION: This is the first report documenting possible brain abnormalities among obese adolescents with type 2 diabetes relative to obese adolescent controls. These abnormalities are not likely to result from education or socioeconomic bias and may result from a combination of subtle vascular changes, glucose and lipid metabolism abnormalities and subtle differences in adiposity in the absence of clinically significant vascular disease. Future efforts are needed to elucidate the underlying pathophysiological mechanisms.
Authors:
P L Yau; D C Javier; C M Ryan; W H Tsui; B A Ardekani; S Ten; A Convit
Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't     Date:  2010-07-30
Journal Detail:
Title:  Diabetologia     Volume:  53     ISSN:  1432-0428     ISO Abbreviation:  Diabetologia     Publication Date:  2010 Nov 
Date Detail:
Created Date:  2010-09-29     Completed Date:  2011-01-18     Revised Date:  2011-11-01    
Medline Journal Info:
Nlm Unique ID:  0006777     Medline TA:  Diabetologia     Country:  Germany    
Other Details:
Languages:  eng     Pagination:  2298-306     Citation Subset:  IM    
Affiliation:
Department of Psychiatry, New York University School of Medicine, New York, NY, USA.
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Body Mass Index
Brain / pathology*
Diabetes Mellitus, Type 2 / complications*
Female
Humans
Magnetic Resonance Imaging
Male
Neuropsychological Tests
Obesity / complications*
Waist Circumference
Grant Support
ID/Acronym/Agency:
1UL1RR029893/RR/NCRR NIH HHS; DK070985/DK/NIDDK NIH HHS; R01 DK083537-01A1/DK/NIDDK NIH HHS; R21 DK070985-01A1/DK/NIDDK NIH HHS; UL1 RR029893-04/RR/NCRR NIH HHS
Comments/Corrections
Comment In:
Diabetologia. 2010 Nov;53(11):2273-5   [PMID:  20803339 ]

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