Neurocognitive decline, dementia and stroke are associated with obesity and type 2 diabetes (T2D) in adults. Volumetric brain changes and cerebral vascular impairment, which may mediate these outcomes, have been demonstrated in youth-onset T2D and obesity. A key to understanding the brain pathophysiology in obesity and T2D in youth requires the integration of brain structure and brain perfusion analysis. In 20 youth with T2D (mean age 16.7 years, BMI 98.5%, 75% female) and 19 obese age, sex, race, and BMI similar controls (mean age 17.4 years, BMI 98.5%, 79% female) we examined the relationship between grey matter volume (GMV) and cerebral blood flow (CBF) by MRI and how this might differ by group (T2D vs. obese controls) . Voxel-wise analysis after adjusting for multiple comparisons demonstrated a statistically significant positive relationship between GMV and CBF in the occipital, fusiform, lingual, and right posterior insula with adjustment for socioeconomic status (p<0.05, see Figure) . No difference in the relationship between GMV and CBF by group was discerned. CBF was positively related to GMV mainly in the posterior regions of the brain in obese youth with and without T2D. Whether vascular impairment due to obesity or T2D leads to structural changes and subsequent impaired cognitive function requires further investigation.
R. Brady: None. A. S. Shah: None. M. W. Difrancesco: None.
Shared Discovery Award CCHMCNational Institutes of Health (R01NS125316)