TY - JOUR T1 - White matter hyperintensity volume in pre-diabetes, diabetes and normoglycemia JF - BMJ Open Diabetes Research & Care JO - BMJ Open Diab Res Care DO - 10.1136/bmjdrc-2020-002050 VL - 9 IS - 1 SP - e002050 AU - Sergio Grosu AU - Roberto Lorbeer AU - Felix Hartmann AU - Susanne Rospleszcz AU - Fabian Bamberg AU - Christopher L Schlett AU - Franziska Galie AU - Sonja Selder AU - Sigrid Auweter AU - Margit Heier AU - Wolfgang Rathmann AU - Katharina Mueller-Peltzer AU - Karl-Heinz Ladwig AU - Annette Peters AU - Birgit B Ertl-Wagner AU - Sophia Stoecklein Y1 - 2021/06/01 UR - http://drc.bmj.com/content/9/1/e002050.abstract N2 - Introduction As white matter hyperintensities (WMHs) of the brain are associated with an increased risk of stroke, cognitive decline, and depression, elucidating the associated risk factors is important. In addition to age and hypertension, pre-diabetes and diabetes may play important roles in the development of WMHs. Previous studies have, however, shown conflicting results. We aimed to investigate the effect of diabetes status and quantitative markers of glucose metabolism on WMH volume in a population-based cohort without prior cardiovascular disease.Research design and methods 400 participants underwent 3 T MRI. WMHs were manually segmented on 3D fluid-attenuated inversion recovery images. An oral glucose tolerance test (OGTT) was administered to all participants not previously diagnosed with diabetes to assess 2-hour serum glucose concentrations. Fasting glucose concentrations and glycated hemoglobin (HbA1c) levels were measured. Zero-inflated negative binomial regression analyses of WMH volume and measures of glycemic status were performed while controlling for cardiovascular risk factors and multiple testing.Results The final study population comprised 388 participants (57% male; age 56.3±9.2 years; n=98 with pre-diabetes, n=51 with diabetes). Higher WMH volume was associated with pre-diabetes (p=0.001) and diabetes (p=0.026) compared with normoglycemic control participants after adjustment for cardiovascular risk factors. 2-hour serum glucose (p<0.001), but not fasting glucose (p=0.389) or HbA1c (p=0.050), showed a significant positive association with WMH volume after adjustment for cardiovascular risk factors.Conclusion Our results indicate that high 2-hour serum glucose concentration in OGTT, but not fasting glucose levels, may be an independent risk factor for the development of WMHs, with the potential to inform intensified prevention strategies in individuals at risk of WMH-associated morbidity.Data are available upon reasonable request. The informed consent given by KORA study participants does not cover data posting in public databases. However, data are available upon request from KORA/KORA-gen (https://epi.helmholtz-muenchen.de/) by means of a project agreement. Requests should be sent to kora.passt@helmholtz-muenchen.de and are subject to approval by the KORA Board. ER -