title: Influence of type 2 diabetes on brain volumes and changes in brain volumes: results from the Women's Health Initiative Magnetic Resonance Imaging studies.
abstract: OBJECTIVE
  To study how type 2 diabetes adversely affects brain volumes, changes in volume, and cognitive function.
  
  
  METHODS
  Regional brain volumes and ischemic lesion volumes in 1,366 women, aged 72-89 years, were measured with structural brain magnetic resonance imaging (MRI). Repeat scans were collected an average of 4.7 years later in 698 women. Cross-sectional differences and changes with time between women with and without diabetes were compared. Relationships that cognitive function test scores had with these measures and diabetes were examined.
  
  
  RESULTS
  The 145 women with diabetes (10.6%) at the first MRI had smaller total brain volumes (0.6% less; P = 0.05) and smaller gray matter volumes (1.5% less; P = 0.01) but not white matter volumes, both overall and within major lobes. They also had larger ischemic lesion volumes (21.8% greater; P = 0.02), both overall and in gray matter (27.5% greater; P = 0.06), in white matter (18.8% greater; P = 0.02), and across major lobes. Overall, women with diabetes had slightly (nonsignificant) greater loss of total brain volumes (3.02 cc; P = 0.11) and significant increases in total ischemic lesion volumes (9.7% more; P = 0.05) with time relative to those without diabetes. Diabetes was associated with lower scores in global cognitive function and its subdomains. These relative deficits were only partially accounted for by brain volumes and risk factors for cognitive deficits.
  
  
  CONCLUSIONS
  Diabetes is associated with smaller brain volumes in gray but not white matter and increasing ischemic lesion volumes throughout the brain. These markers are associated with but do not fully account for diabetes-related deficits in cognitive function.
authors.affiliation: Department of Biostatistical Sciences, Wake Forest School of Medicine, Winston-Salem, NC, USA. mespelan@wakehealth.edu
authors.forename: Mark A
authors.initials: MA
authors.lastname: Espeland
authors.forename: R Nick
authors.initials: RN
authors.lastname: Bryan
authors.forename: Joseph S
authors.initials: JS
authors.lastname: Goveas
authors.forename: Jennifer G
authors.initials: JG
authors.lastname: Robinson
authors.forename: Mustafa S
authors.initials: MS
authors.lastname: Siddiqui
authors.forename: Simin
authors.initials: S
authors.lastname: Liu
authors.forename: Patricia E
authors.initials: PE
authors.lastname: Hogan
authors.forename: Ramon
authors.initials: R
authors.lastname: Casanova
authors.forename: Laura H
authors.initials: LH
authors.lastname: Coker
authors.forename: Kristine
authors.initials: K
authors.lastname: Yaffe
authors.forename: Kamal
authors.initials: K
authors.lastname: Masaki
authors.forename: Rebecca
authors.initials: R
authors.lastname: Rossom
authors.forename: Susan M
authors.initials: SM
authors.lastname: Resnick
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001921:Brain / Q000033:anatomy & histology* / Q000502:physiology*; D003071:Cognition / Q000502:physiology; D003430:Cross-Sectional Studies; D003924:Diabetes Mellitus, Type 2 / Q000503:physiopathology*; D005260:Female; D006801:Humans; D016387:Women's Health