Changes in Brain Volumetric Measures Associated With Type 1 Diabetes Depict an Evolutionary Adaptation Process to Developmental Cognitive Demands

IF 8.3 2区医学 Q1 ENDOCRINOLOGY & METABOLISM

Diabetes/Metabolism Research and Reviews Pub Date : 2026-04-17 DOI:10.1002/dmrr.70169

Andrés Antonio González-Garrido, Geisa Bearitz Gallardo-Moreno, José Manuel Gómez-Barba, Yusniel Santos-Rodríguez, Aurora Espinoza-Valdez, Fabiola Reveca Gómez-Velázquez, Vanessa Doreen Ruiz-Stovel

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引用次数: 0

Abstract

Background

Type 1 diabetes mellitus has been associated with a significant risk of brain volume reduction and cognitive disorders, mainly affecting executive functioning and working memory. Therefore, an early impact of type 1 diabetes can be expected on volumetric measures and anatomic relationships among brain structures underlying these mental processes, as reflecting a process probably driven by developmental cognitive demands. With this aim, we compared volumetric measures and brain anatomical associations in young adults with type 1 diabetes and healthy controls.

Methods

Forty-one clinically well-controlled, right-handed type 1 diabetes patients aged 18–30 and with 10 or more years of disease evolution participated, along with forty-one healthy controls matched by age, sex, IQ, and years of schooling. They were all scanned with a 3-T MRI to obtain brain images with a voxel size of 1 mm³. The images were processed, and cortical gray and white matter were used to compute volumetric measures and cortical thickness, which were analyzed according to the corresponding segmentation map. Graph-theoretical analyses were also performed on adjacency resultant matrices.

Results

Global cortical volumes did not significantly differ between the groups. However, subcortical gray matter volume was significantly lower in the diabetes group (M = 43.4 cm³, SD = 3.3) compared with controls (M = 45 cm³, SD = 3.8; t(80) = −2.04, p = 0.045, d = 0.45). Patients also showed reduced volumes in cerebellar white matter, vermis, and brainstem, as well as decreased volumes in several frontal and subcortical regions, including the putamen and thalamus. These changes were found to correlate meaningfully with longer diabetes duration and age at disease onset. Graph-theoretical analyses further revealed alterations in brain network topology in the diabetes group.

Conclusions

The results suggest that slight brain alterations affecting both brain microstructural integrity and typical organization early occur even in young patients with free-from-diabetes complications and clinically well-controlled type 1 diabetes. Moreover, these brain morphological changes appear to reflect the illness's distinctive impact on the developing brain, likely representing adaptive changes to address increasing cognitive and environmental demands.

Abstract Image

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与1型糖尿病相关的脑容量测量变化描述了对发育认知需求的进化适应过程。

背景：1型糖尿病与脑容量减少和认知障碍的显著风险相关，主要影响执行功能和工作记忆。因此，1型糖尿病的早期影响可以预期在这些心理过程背后的体积测量和大脑结构之间的解剖关系，反映了一个可能由发育认知需求驱动的过程。为此，我们比较了年轻1型糖尿病患者和健康对照者的体积测量和脑解剖学关联。方法：41例临床控制良好的右撇子型1型糖尿病患者，年龄在18-30岁之间，病程≥10年；41例健康对照者，年龄、性别、智商和受教育年限相匹配。他们都接受了3-T核磁共振扫描，获得了体素大小为1mm3的大脑图像。对图像进行处理，利用皮层灰质和白质计算体积测度和皮层厚度，根据相应的分割图进行分析。图理论分析也进行了邻接结果矩阵。结果：两组间皮质整体体积无显著差异。然而，与对照组（M = 45 cm3, SD = 3.8; t(80) = -2.04, p = 0.045, d = 0.45）相比，糖尿病组皮质下灰质体积（M = 43.4 cm3, SD = 3.3）显著降低。患者还表现出小脑白质、蚓部和脑干体积减少，额叶和皮层下几个区域（包括壳核和丘脑）体积减少。这些变化被发现与较长的糖尿病病程和发病年龄有意义相关。图理论分析进一步揭示了糖尿病组大脑网络拓扑结构的改变。结论：结果表明，即使在无糖尿病并发症和临床控制良好的1型糖尿病年轻患者中，早期也会发生轻微的脑改变，影响脑微结构完整性和典型组织。此外，这些脑形态变化似乎反映了疾病对发育中的大脑的独特影响，可能代表了适应变化，以应对日益增长的认知和环境需求。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Diabetes/Metabolism Research and Reviews 医学-内分泌学与代谢

CiteScore

17.20

自引率

2.50%

发文量

审稿时长

4-8 weeks

期刊介绍： Diabetes/Metabolism Research and Reviews is a premier endocrinology and metabolism journal esteemed by clinicians and researchers alike. Encompassing a wide spectrum of topics including diabetes, endocrinology, metabolism, and obesity, the journal eagerly accepts submissions ranging from clinical studies to basic and translational research, as well as reviews exploring historical progress, controversial issues, and prominent opinions in the field. Join us in advancing knowledge and understanding in the realm of diabetes and metabolism.