Association of carotid atherosclerosis with brain tissue integrity and metabolic parameters in type 2 diabetes patients

Abstract

Background: Type 2 diabetes mellitus (T2DM) is known to adversely impact brain health, leading to cognitive decline and brain tissue volume reduction. This study aimed to assess the damage to gray-white matter junction tissue volume (gwJTV) in T2DM patients with and without carotid artery plaques, and its association with various metabolic parameters.

Methods: We conducted a cross-sectional study involving 69 T2DM patients, employing three-dimensional T1-weighted MRI scans to measure brain tissue volumes, particularly gwJTV, and analyzing blood samples for metabolic parameters. Voxel-based (VBA) and region-of-interest (ROI) analyses of gwJTV were performed to evaluate the group difference with and without carotid artery plaques and to determine correlations to metabolic biomarkers.

Results: Voxel-based and region-of-interest analyses revealed that participants with carotid plaques had lower gwJTV than those without at the specific brain area. ROI results study further demonstrated positive associations between gwJTV and metabolic parameters such as AST, ApoB, and LDL, and negative associations with C-peptide, creatinine, and hsCRP.

Conclusion: Our findings suggest that gwJTV could be a valuable imaging biomarker for monitoring brain and vascular health in T2DM patients, particularly those affected by carotid atherosclerosis.

Keywords: brain; carotid artery plaque; gray-white matter junction volume; metabolic parameters; type 2 diabetes.

Figure 1

Results of the voxel-based group comparison of GMV (a), WMV (b), and gwJTV (c) between participants without and with carotid plaques adjusted for the participant’s age. A significance level of α = 0.0005 was applied without correction for multiple comparisons and a minimum cluster size of at least 100 contiguous voxels. The red indicates a significant group difference between participants without plaque and those with plaque. The detailed association brain areas are listed in Supplementary Table S2 . GMV, gray matter volume; WMV, white matter volume; gwJTV, gray-white matter junction tissue volume.

Figure 2

Summary of the voxel-based multiple regression analysis result between brain tissue volumes of GMV (a), WMV (b), and gwJTV (c) and metabolic biomarkers adjusted for the participant’s age. A significance level of α = 0.0005 was applied without correction for multiple comparisons and a minimum cluster size of at least 100 contiguous voxels. The colors indicate a positive association with red with the (+) sign and a negative association with blue with the (-) sign. The detailed association brain areas are listed in Supplementary Table S3 for gwJTV, Supplementary Table S4 for GMV, and Supplementary Table S5 for WMV. GMV, gray matter volume; WMV, white matter volume; gwJTV, gray-white matter junction tissue volume; ALT, Alanine aminotransferase; ApoA1, apolipoprotein A1; ApoB, apolipoprotein B; AST, aspartate aminotransferase; BA1ratio, apolipoprotein A1/B ratio; BMI, body mass index; Cr, creatinine; HbA1c, Glycated hemoglobin; HDL, high-density lipoprotein; HOMAIR, Homeostasis model assessment of insulin resistance; HScrp, high-sensitivity C-reactive protein; LDL, low-density lipoprotein; SBP, systolic blood pressure; TC, total cholesterol; TG, triglyceride.