High-Normal Adolescent Fasting Plasma Glucose Is Associated With Poorer Midlife Brain Health: Bogalusa Heart Study

作者：Owen Carmichael, Patrick Stuchlik, Sreekrishna R. Pillai, Geert Jan Biessels, Ram Dhullipudi, Anna Madden-Rusnak, Shane Martin, Daniel S. Hsia, Vivian Fonseca, Lydia Bazzano · 发表于：The Journal of Clinical Endocrinology & Metabolism · 年份：2019 · DOI：10.1210/jc.2018-02750 · 被引用次数：22 · 研究领域：Diabetes Management and Research、Hyperglycemia and glycemic control in critically ill and hospitalized patients、Dementia and Cognitive Impairment Research

CONTEXT: It is unclear how adolescent glycemic status relates to brain health in adulthood. OBJECTIVE: To assess the association between adolescent fasting plasma glucose (FPG) and MRI-based brain measures in midlife. DESIGN: Between 1973 and 1992, the Bogalusa Heart Study (BHS) collected FPG from children, 3 to 18 years old, and followed up between 1992 and 2018. Cognitive tests and brain MRI were collected in 2013 to 2016 and 2018. SETTING: Observational longitudinal cohort study. PARTICIPANTS: Of 1298 contacted BHS participants, 74 completed screening, and 50 completed MRI. MAIN OUTCOME MEASURES: Mean FPG per participant at ages <20, 20 to 40, and over 40 years old; brain white matter hyperintensity (WMH) volume, gray matter volume, and functional MRI (fMRI) activation to a Stroop task; tests of logical and working memory, executive function, and semantic fluency. RESULTS: At MRI, participants were middle aged (51.3 ± 4.4 years) and predominantly female (74%) and white (74%). Mean FPG was impaired for zero, two, and nine participants in pre-20, 20 to 40, and over-40 periods. The pre-20 mean FPG above the pre-20 median value (i.e., above 83.5 mg/dL) was associated with greater WMH volume [mean difference: 0.029% of total cranial volume, CI: (0.0059, 0.052), P = 0.015] and less fMRI activation [-1.41 units (-2.78, -0.05), P = 0.043] on midlife MRI compared with below-median mean FPG. In controlling for over-40 mean FPG status did not substantially modify the associations. Co...