A15943 Cerebral atrophy in patients with type 2 diabetes and left ventricular hypertrophy

Abstract

Objectives: Type 2 diabetes mellitus (T2DM) is associated with an increased risk of dementia. Left ventricular hypertrophy (LVH) is prevalent in T2DM and an independent predictor of cognitive impairment. In this preliminary analysis, we compared brain atrophy between healthy participants and T2DM, and those with T2DM according to the presence or not of LVH. Methods: Non-demented healthy participants without diabetes (n = 37, controls) participating in the Cognition And Neocortical Volume After Stroke study were compared to 39 patients with T2DM. A 3T MRI was undertaken and FreeSurfer v6.0 was used to perform volumetric segmentation of the MR images. Differences in total brain volume (TBV), mean cortical thickness and subcortical volumes were compared. T2DM patients also had an echocardiographic assessment of LVH and 24-hour blood pressure monitoring. Results: Compared to controls, T2DM patients were younger (mean ± SD) 63 ± 7 vs. 68 ± 6 years (p = 0.003), with more obesity (BMI 31 ± 6 vs. 26 ± 4, p < 0.0001) and hypertension (73 vs. 43%, p = 0.013). T2DM patients had significantly more atrophy of the amygdala (p = 0.016), nucleus accumbens (p = 0.001) and brainstem (p = 0.010). Differences remained significant after adjustment for age, education level, total intracranial volume (TIV), BMI and hypertension. T2DM patients with LVH (36%) had more atrophy in the amygdala (p = 0.020) and reduced TBV (p = 0.006) compared to T2DM patients without LVH. Differences in TBV were independent of sex, TIV and education level (p = 0.005). Conclusion: T2DM contributes to accelerated structural brain aging, manifesting as cerebral atrophy. The co-presence of LVH in T2DM may represent a risk factor for subsequent cognitive impairment and dementia.