Impact of Type 1 Diabetes in the Developing Brain in Children: A Longitudinal Study

作者：Nelly Mauras, Bruce A. Buckingham, Neil H. White, Eva Tsalikian, Stuart A. Weinzimer, Booil Jo, Allison Cato, Larry A. Fox, Tandy Aye, Ana María Arbeláez, Tamara Hershey, Michael Tansey, William V. Tamborlane, Lara C. Foland‐Ross, Hanyang Shen, Kimberly Englert, Paul K. Mazaika, Matthew Marzelli, Allan L. Reiss · 发表于：Diabetes Care · 年份：2021 · DOI：10.2337/dc20-2125 · 被引用次数：100 · 研究领域：Diabetes Management and Research、Pancreatic function and diabetes、Diabetes and associated disorders

OBJECTIVE To assess whether previously observed brain and cognitive differences between children with type 1 diabetes and control subjects without diabetes persist, worsen, or improve as children grow into puberty and whether differences are associated with hyperglycemia. RESEARCH DESIGN AND METHODS One hundred forty-four children with type 1 diabetes and 72 age-matched control subjects without diabetes (mean ± SD age at baseline 7.0 ± 1.7 years, 46% female) had unsedated MRI and cognitive testing up to four times over 6.4 ± 0.4 (range 5.3–7.8) years; HbA1c and continuous glucose monitoring were done quarterly. FreeSurfer-derived brain volumes and cognitive metrics assessed longitudinally were compared between groups using mixed-effects models at 6, 8, 10, and 12 years. Correlations with glycemia were performed. RESULTS Total brain, gray, and white matter volumes and full-scale and verbal intelligence quotients (IQs) were lower in the diabetes group at 6, 8, 10, and 12 years, with estimated group differences in full-scale IQ of −4.15, −3.81, −3.46, and −3.11, respectively (P < 0.05), and total brain volume differences of −15,410, −21,159, −25,548, and −28,577 mm3 at 6, 8, 10, and 12 years, respectively (P < 0.05). Differences at baseline persisted or increased over time, and brain volumes and cognitive scores negatively correlated with a life-long HbA1c index and higher sensor glucose in diabetes. CONCLUSIONS Detectable changes in brain volumes and cognitive sco...