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

doi:10.1210/jc.2018-02750

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 journal › Article › Academic › peer-review

Abstract

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 language	English
Pages (from-to)	4492-4500
Number of pages	9
Journal	Journal of Clinical Endocrinology and Metabolism
Volume	104
Issue number	10
DOIs	https://doi.org/10.1210/jc.2018-02750
Publication status	Published - 1 Oct 2019

Keywords

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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10.1210/jc.2018-02750

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Carmichael, O., Stuchlik, P., Pillai, S., Biessels, G. J., Dhullipudi, R., Madden-Rusnak, A., Martin, S., Hsia, D. S., Fonseca, V., & Bazzano, L. (2019). High-Normal Adolescent Fasting Plasma Glucose Is Associated with Poorer Midlife Brain Health: Bogalusa Heart Study. Journal of Clinical Endocrinology and Metabolism, 104(10), 4492-4500. https://doi.org/10.1210/jc.2018-02750

@article{33ab816c7e7e4d14953d4bbeda4199d1,

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

abstract = "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.",

keywords = "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",

author = "Owen Carmichael and Patrick Stuchlik and Sreekrishna Pillai and Biessels, {Geert Jan} and Ram Dhullipudi and Anna Madden-Rusnak and Shane Martin and Hsia, {Daniel S.} and Vivian Fonseca and Lydia Bazzano",

note = "Copyright {\textcopyright} 2019 Endocrine Society.",

year = "2019",

month = oct,

day = "1",

doi = "10.1210/jc.2018-02750",

language = "English",

volume = "104",

pages = "4492--4500",

journal = "Journal of Clinical Endocrinology and Metabolism",

issn = "0021-972X",

publisher = "The Endocrine Society",

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Carmichael, O, Stuchlik, P, Pillai, S, Biessels, GJ, Dhullipudi, R, Madden-Rusnak, A, Martin, S, Hsia, DS, Fonseca, V & Bazzano, L 2019, 'High-Normal Adolescent Fasting Plasma Glucose Is Associated with Poorer Midlife Brain Health: Bogalusa Heart Study', Journal of Clinical Endocrinology and Metabolism, vol. 104, no. 10, pp. 4492-4500. https://doi.org/10.1210/jc.2018-02750

TY - JOUR

T1 - High-Normal Adolescent Fasting Plasma Glucose Is Associated with Poorer Midlife Brain Health

T2 - Bogalusa Heart Study

AU - Carmichael, Owen

AU - Stuchlik, Patrick

AU - Pillai, Sreekrishna

AU - Biessels, Geert Jan

AU - Dhullipudi, Ram

AU - Madden-Rusnak, Anna

AU - Martin, Shane

AU - Hsia, Daniel S.

AU - Fonseca, Vivian

AU - Bazzano, Lydia

PY - 2019/10/1

Y1 - 2019/10/1

N2 - 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.

AB - 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.

KW - Adolescent

KW - Adult

KW - Blood Glucose/metabolism

KW - Brain/diagnostic imaging

KW - Child

KW - Cognition/physiology

KW - Cohort Studies

KW - Executive Function/physiology

KW - Fasting/metabolism

KW - Female

KW - Functional Neuroimaging

KW - Gray Matter/diagnostic imaging

KW - Humans

KW - Longitudinal Studies

KW - Magnetic Resonance Imaging

KW - Male

KW - Memory, Short-Term/physiology

KW - Mental Status and Dementia Tests

KW - Middle Aged

KW - Organ Size

KW - Prospective Studies

KW - Stroop Test

KW - White Matter/diagnostic imaging

KW - Young Adult

UR - http://www.scopus.com/inward/record.url?scp=85072057611&partnerID=8YFLogxK

U2 - 10.1210/jc.2018-02750

DO - 10.1210/jc.2018-02750

M3 - Article

C2 - 31058974

AN - SCOPUS:85072057611

SN - 0021-972X

VL - 104

SP - 4492

EP - 4500

JO - Journal of Clinical Endocrinology and Metabolism

JF - Journal of Clinical Endocrinology and Metabolism

IS - 10

ER -

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

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