@article{d5a5d7b557a54a1a8f9a3f987a57646c,
title = "Sex-related differences in brain volumes and cerebral blood flow among overweight and obese adults with type 2 diabetes: Exploratory analyses from the action for health in diabetes brain magnetic resonance imaging study",
abstract = "Background: Sex may be an important modifier of brain health in response to risk factors. We compared brain structure and function of older overweight and obese women and men with type 2 diabetes mellitus. Methods: Cross-sectional cognitive assessments and magnetic resonance images were obtained in 224 women and 95 men (mean age 69 years) with histories of type 2 diabetes mellitus and overweight or obesity. Prior to magnetic resonance images, participants had completed an average of 10 years of random assignment to either multidomain intervention targeting weight loss or a control condition of diabetes support and education. Total (summed gray and white) matter volumes, white matter hyperintensity volumes, and cerebral blood flow across five brain regions of interest were analyzed using mixed-effects models. Results: After covariate adjustment, women, compared with men, averaged 10.9 [95% confidence interval 3.3, 18.5; ≈1%] cc greater summed region of interest volumes and 1.39 [0.00002, 2.78; ≈54%] cc greater summed white matter hyperintensity volumes. Sex differences could not be attributed to risk factor profiles or intervention response. Their magnitude did not vary significantly with respect to age, body mass index, intervention assignment, or APOE-ϵ4 genotype. Sex differences in brain magnetic resonance images outcomes did not account for the better levels of cognitive functioning in women than men. Conclusions: In a large cohort of older overweight or obese adults with type 2 diabetes mellitus, differences in brain volumes and white matter disease were apparent between women and men, but these did not account for a lower prevalence of cognitive impairment in women compared with men in this cohort. Trial registration: NCT00017953.",
keywords = "Brain imaging, Diabetes, Obesity, Sex",
author = "Espeland, {Mark A.} and Hayden, {Kathleen M.} and Lockhart, {Samuel N.} and Yassine, {Hussein N.} and Siobhan Hoscheidt and Sevil Yasar and Luchsinger, {Jose A.} and Neiberg, {Rebecca H.} and {Diaz Brinton}, Roberta and Owen Carmichael",
note = "Funding Information: The Action for Health in Diabetes is supported through the following cooperative agreements from the National Institutes of Health: DK57136, DK57149, DK56990, DK57177, DK57171, DK57151, DK57182, DK57131, DK57002, DK57078, DK57154, DK57178, DK57219, DK57008, DK57135, and DK56992.The following federal agencies have contributed support: National Institute of Diabetes and Digestive and Kidney Diseases; National Heart, Lung, and Blood Institute; National Institute of Nursing Research; National Center on Minority Health and Health Disparities; Office of Research on Women{\textquoteright}s Health; the Centers for Disease Control and Prevention; and the Department of Veterans Affairs. This research was supported in part by the Intramural Research Program of the National Institute of Diabetes and Digestive and Kidney Diseases. The Indian Health Service (I.H.S.) provided personnel, medical oversight, and use of facilities. The opinions expressed in this paper are those of the authors and do not necessarily reflect the views of the I.H.S. or other funding sources. Funding Information: Additional support was received from the University of Pittsburgh General Clinical Research Center (GCRC) (M01RR000056), the Clinical Translational Research Center (CTRC) funded by the Clinical & Translational Science Award (UL1 RR 024153) and NIH grant (DK 046204); Frederic C. Bartter General Clinical Research Center (M01RR01346); and the Wake Forest Alzheimer{\textquoteright}s Disease Research Center (P30AG049638-01A1). JAL was also additionally supported by K24AG045334. HNY was supported by the NIH grants R21AG056518, R01AG055770 and R01AG054434. Funding Information: The Look AHEAD Brain MRI ancillary study was supported by the National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Department of Health and Human Services: DK092237-01. Additional support was provided bythe Action for Health in Diabetes ADRD Study (Look AHEAD-MIND) R01AG058571. Publisher Copyright: {\textcopyright} 2019 The Author(s) 2019. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.",
year = "2020",
month = mar,
day = "9",
doi = "10.1093/gerona/glz090",
language = "English (US)",
volume = "75",
pages = "771--778",
journal = "Journals of Gerontology - Series A Biological Sciences and Medical Sciences",
issn = "1079-5006",
publisher = "Oxford University Press",
number = "4",
}