Dysglycemia, brain volume and vascular lesions on MRI in a memory clinic population.
OBJECTIVE
It is unclear, if the association between abnormalities in glucose metabolism (dysglycemia) and impaired cognitive functioning is primarily driven by degenerative or vascular brain damage. We therefore examined the relation between dysglycemia and brain volume and vascular lesions on MRI in a memory clinic population.


METHODS
The relations between markers of glycemia (HbA1c and fasting glucose levels) and normalized brain volume, medial temporal lobe atrophy and vascular lesions (white matter hyperintensities, lacunes) were assessed in 274 consecutive patients attending a memory clinic, using linear regression analyses.


RESULTS
Clinical diagnoses were subjective complaints (n=117), mild cognitive impairment (n=62), Alzheimer's disease (n=61) and other type of dementia (n=34). Twenty patients had a history of diabetes. Across the whole study population there was no relation between HbA1c or fasting glucose and the brain MRI measurements, after adjustments for age, sex and diagnostic group. Secondary analyses after stratification by diabetes status, diagnosis and median age (67 years) did not change the results.


CONCLUSIONS
In this memory clinic population, dysglycemia was not associated with either brain volume or vascular lesions. Apparently, dysglycemia is not associated with a specific class of brain pathology in patients with cognitive complaints.
Alzheimer Centre, Department of Neurology, VU University Medical Centre, Amsterdam, the Netherlands; Department of Neurology, University Medical Centre Utrecht, Utrecht, the Netherlands. Electronic address: l.g.exalto-2@umcutrecht.nl.
Lieza G
LG
Exalto
Alzheimer Centre, Department of Neurology, VU University Medical Centre, Amsterdam, the Netherlands; Epidemiology and Biostatistics, VU university, Amsterdam, the Netherlands.
Wiesje M
WM
van der Flier
Alzheimer Centre, Department of Neurology, VU University Medical Centre, Amsterdam, the Netherlands.
Philip
P
Scheltens
Alzheimer Centre, Department of Radiology and Medical Technology, VU University Medical Centre, Amsterdam, the Netherlands; Alzheimer Centre, Department of Physics and Medical Technology, VU University Medical Centre, Amsterdam, the Netherlands.
Hugo
H
Vrenken
Department of Neurology, University Medical Centre Utrecht, Utrecht, the Netherlands.
Geert Jan
GJ
Biessels
D000368:Aged; D000369:Aged, 80 and over; D000544:Alzheimer Disease / Q000150:complications / Q000175:diagnosis* / Q000453:epidemiology; D001284:Atrophy / Q000175:diagnosis; D001786:Blood Glucose / Q000378:metabolism; D001921:Brain / Q000098:blood supply / Q000378:metabolism / Q000473:pathology*; D002561:Cerebrovascular Disorders / Q000150:complications / Q000175:diagnosis* / Q000453:epidemiology; D060825:Cognitive Dysfunction / Q000150:complications / Q000175:diagnosis* / Q000453:epidemiology; D005260:Female; D044882:Glucose Metabolism Disorders / Q000150:complications / Q000175:diagnosis* / Q000453:epidemiology; D006442:Glycated Hemoglobin / Q000378:metabolism; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009929:Organ Size
D001786:Blood Glucose; D006442:Glycated Hemoglobin; C517652:hemoglobin A1c protein, human
Alzheimer's disease; Brain atrophy; Diabetes; Glucose; HbA1c; Hippocampus; Lacunes; Mild cognitive impairment; White matter hyperintensities