title: Global brain atrophy but not hippocampal atrophy is related to type 2 diabetes.
abstract: OBJECTIVE
  It has been suggested that in patients with type 2 diabetes mellitus (T2DM), brain atrophy is most pronounced in the hippocampus, but this has not been investigated systematically. The present pooled analysis of three studies examined if hippocampal atrophy is more prominent than global brain atrophy in patients with T2DM relative to controls.
  
  
  METHODS
  Data were derived from a cohort study of patients with vascular disease (SMART-Medea (T2DM=120; no T2DM=502)), and from two case-control studies (UDES1 (T2DM=61; controls=30) and UDES2 (T2DM=54; controls=53)). In SMART-Medea and UDES1, hippocampal volume was obtained by manual tracing on 1.5 Tesla (T) MRI scans. Total brain and intracranial volume (ICV) were determined by an automated segmentation method. In UDES2, hippocampal and total brain volume were determined by FreeSurfer and ICV by manual segmentation on 3 T MRI scans.
  
  
  RESULTS
  The pooled analyses, adjusted for age and sex, showed a significant negative relation between T2DM and total brain-to-ICV ratio (standardized mean difference=-1.24%, 95% CI: -1.63; -0.86), but not between T2DM and hippocampal-to-ICV ratio (0.00%, 95% CI: -0.01; 0.00) or between T2DM and hippocampal-to-total brain volume ratio (0.01%, 95% CI: -0.01; 0.02). In patients with T2DM no associations were found between brain volume measures and HbA1c or memory.
  
  
  CONCLUSIONS
  Patients with T2DM had greater brain atrophy but not hippocampal atrophy, compared to controls. These findings do not support specific vulnerability of the hippocampus in patients with T2DM.
authors: UMC Utrecht, Julius Center for Health Sciences and Primary Care, Utrecht, The Netherlands; UMC Utrecht, Department of Neurology, Brain Center Rudolf Magnus, Utrecht, The Netherlands.
authors: Laura E M
authors: LE
authors: Wisse
authors: UMC Utrecht, Department of Radiology, Utrecht, The Netherlands.
authors: Jeroen
authors: J
authors: de Bresser
authors: UMC Utrecht, Julius Center for Health Sciences and Primary Care, Utrecht, The Netherlands. Electronic address: m.geerlings@umcutrecht.nl.
authors: Mirjam I
authors: MI
authors: Geerlings
authors: UMC Utrecht, Department of Neurology, Brain Center Rudolf Magnus, Utrecht, The Netherlands; J. Philip Kistler Stroke Center, MA General Hospital, Harvard Medical School, Boston, USA.
authors: Yael D
authors: YD
authors: Reijmer
authors: Erasmus MC, Department of Epidemiology and Neurology, Rotterdam, The Netherlands.
authors: Marileen L P
authors: ML
authors: Portegies
authors: UMC Utrecht, Department of Neurology, Brain Center Rudolf Magnus, Utrecht, The Netherlands.
authors: Manon
authors: M
authors: Brundel
authors: UMC Utrecht, Department of Neurology, Brain Center Rudolf Magnus, Utrecht, The Netherlands.
authors: L Jaap
authors: LJ
authors: Kappelle
authors: UMC Utrecht, Julius Center for Health Sciences and Primary Care, Utrecht, The Netherlands.
authors: Yolanda
authors: Y
authors: van der Graaf
authors: UMC Utrecht, Department of Neurology, Brain Center Rudolf Magnus, Utrecht, The Netherlands.
authors: Geert Jan
authors: GJ
authors: Biessels
mesh_terms: D000368:Aged; D001284:Atrophy / Q000209:etiology; D001921:Brain / Q000473:pathology*; D016022:Case-Control Studies; D003072:Cognition Disorders / Q000209:etiology; D003924:Diabetes Mellitus, Type 2 / Q000150:complications / Q000473:pathology*; D005260:Female; D006624:Hippocampus / Q000473:pathology*; D006801:Humans; D016014:Linear Models; D008279:Magnetic Resonance Imaging; D008297:Male; D008569:Memory Disorders / Q000209:etiology / Q000473:pathology; D008875:Middle Aged; D009483:Neuropsychological Tests
keywords: Atrophy; Brain; Hippocampus; MRI; Type 2 diabetes