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

Owen Carmichael*, Patrick Stuchlik, Sreekrishna Pillai, Geert Jan Biessels, Ram Dhullipudi, Anna Madden-Rusnak, Shane Martin, Daniel S. Hsia, Vivian Fonseca, Lydia Bazzano

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review


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. Cognitive scores did not differ by pre-20 mean FPG.

CONCLUSIONS: High-normal adolescent FPG may be associated with preclinical brain changes in midlife.

Original languageEnglish
Pages (from-to)4492-4500
Number of pages9
JournalJournal of Clinical Endocrinology and Metabolism
Issue number10
Publication statusPublished - 1 Oct 2019


  • Adolescent
  • Adult
  • Blood Glucose/metabolism
  • Brain/diagnostic imaging
  • Child
  • Cognition/physiology
  • Cohort Studies
  • Executive Function/physiology
  • Fasting/metabolism
  • Female
  • Functional Neuroimaging
  • Gray Matter/diagnostic imaging
  • Humans
  • Longitudinal Studies
  • Magnetic Resonance Imaging
  • Male
  • Memory, Short-Term/physiology
  • Mental Status and Dementia Tests
  • Middle Aged
  • Organ Size
  • Prospective Studies
  • Stroop Test
  • White Matter/diagnostic imaging
  • Young Adult


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