Adiposity is inversely associated with hippocampal volume in African Americans and European Americans with diabetes.
To assess associations between body mass index (BMI), waist circumference (WC), and computed tomography-determined volumes of pericardial, visceral, and subcutaneous adipose tissue with magnetic resonance imaging-(MRI) based cerebral structure and cognitive performance in individuals with type 2 diabetes (T2D).



This study was performed in 348 African Americans (AAs) and 256 European Americans (EAs) with T2D. Associations between adiposity measures with cerebral volumes of white matter (WMV), gray matter (GMV), white matter lesions, hippocampal GMV, and hippocampal WMV, cognitive performance and depression were examined using marginal models incorporating generalized estimating equations. All models were adjusted for age, sex, education, smoking, HbA1c, hypertension, statins, cardiovascular disease, MRI scanner (MRI outcomes only), and time between scans; some neuroimaging measures were additionally adjusted for intracranial volume.



Participants were 59.9% female with mean (SD) age 57.7(9.3)years, diabetes duration 9.6(6.8)years, and HbA1c 7.8(1.9)%. In AAs, inverse associations were detected between hippocampal GMV and both BMI (β [95% CI]-0.18 [-0.30, -0.07], P=0.0018) and WC (-0.23 [-0.35, -0.12], P=0.0001). In the full bi-ethnic sample, inverse associations were detected between hippocampal WMV and WC (P≤0.0001). Positive relationships were observed between BMI (P=0.0007) and WC (P<0.0001) with depression in EAs.



In patients with T2D, adiposity is inversely associated with hippocampal gray and white matter volumes.
Division of Public Health Sciences, Department of Biostatistical Sciences, Wake Forest School of Medicine, Winston-Salem, NC, USA; Center for Public Health Genomics, Wake Forest School of Medicine, Winston-Salem, NC, USA.
Fang-Chi
FC
Hsu
Department of Internal Medicine, Section on Nephrology, Wake Forest School of Medicine, Winston-Salem, NC, USA; Department of Endocrinology, Beijing Tongren Hospital, Capital Medical University, Beijing, China.
Mingxia
M
Yuan
Centers for Genomics and Personalized Medicine Research & Diabetes Research, Wake Forest School of Medicine, Winston-Salem, NC, USA; Department of Biochemistry, Wake Forest School of Medicine, Winston-Salem, NC, USA.
Donald W
DW
Bowden
Department of Biochemistry, Wake Forest School of Medicine, Winston-Salem, NC, USA.
Jianzhao
J
Xu
Department of Biochemistry, Wake Forest School of Medicine, Winston-Salem, NC, USA.
S Carrie
SC
Smith
Division of Public Health Sciences, Department of Biostatistical Sciences, Wake Forest School of Medicine, Winston-Salem, NC, USA; Center for Public Health Genomics, Wake Forest School of Medicine, Winston-Salem, NC, USA.
Lynne E
LE
Wagenknecht
Division of Public Health Sciences, Department of Biostatistical Sciences, Wake Forest School of Medicine, Winston-Salem, NC, USA; Center for Public Health Genomics, Wake Forest School of Medicine, Winston-Salem, NC, USA.
Carl D
CD
Langefeld
Division of Public Health Sciences, Department of Biostatistical Sciences, Wake Forest School of Medicine, Winston-Salem, NC, USA; Center for Public Health Genomics, Wake Forest School of Medicine, Winston-Salem, NC, USA.
Jasmin
J
Divers
Department of Pathology, Wake Forest School of Medicine, Winston-Salem, NC, USA.
Thomas C
TC
Register
Department of Radiology, Vanderbilt University Medical Center, Nashville, TN, USA.
J Jeffrey
JJ
Carr
Department of Internal Medicine, Section on Gerontology and Geriatric Medicine, Wake Forest School of Medicine, Winston-Salem, NC, USA.
Jeff D
JD
Williamson
Department of Internal Medicine, Section on Gerontology and Geriatric Medicine, Wake Forest School of Medicine, Winston-Salem, NC, USA.
Kaycee M
KM
Sink
Department of Radiology, Advanced Neuroscience Imaging Research (ANSIR) Laboratory, University of Texas Southwestern Medical Center, Dallas, TX, USA.
Joseph A
JA
Maldjian
Center for Public Health Genomics, Wake Forest School of Medicine, Winston-Salem, NC, USA; Department of Internal Medicine, Section on Nephrology, Wake Forest School of Medicine, Winston-Salem, NC, USA. Electronic address: bfreedma@wakehealth.edu.
Barry I
BI
Freedman
D000273:Adipose Tissue / Q000000981:diagnostic imaging; D050154:Adiposity; D001741:Black or African American; D000368:Aged; D015992:Body Mass Index; D003924:Diabetes Mellitus, Type 2 / Q000503:physiopathology*; D005260:Female; D066128:Gray Matter / Q000000981:diagnostic imaging; D006624:Hippocampus / Q000033:anatomy & histology* / Q000000981:diagnostic imaging; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009929:Organ Size; D014057:Tomography, X-Ray Computed; D014481:United States; D055105:Waist Circumference; D066127:White Matter / Q000000981:diagnostic imaging; D044465:White People
Adiposity; African American; Brain; Cognition; Hippocampus; Type 2 diabetes