Impact of glycemic control on brain microstructure in type 2 diabetes mellitus: insights from diffusion tensor imaging

Abstract Background Type 2 diabetes mellitus (T2DM) has been associated with brain microstructural alterations, potentially contributing to cognitive decline and neurodegeneration. Diffusion tensor imaging (DTI) provides a non-invasive method to assess these changes. However, the relationship betwee...

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Main Authors: Guanye Zhang, Huanhua Wu, Qian Cao, Jiabin Mo, Xiaozheng Cao, Hong Luo, Xiangyu Tan, Hongru Ou
Format: Article
Language:English
Published: BMC 2025-05-01
Series:BMC Medical Imaging
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Online Access:https://doi.org/10.1186/s12880-025-01696-z
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author Guanye Zhang
Huanhua Wu
Qian Cao
Jiabin Mo
Xiaozheng Cao
Hong Luo
Xiangyu Tan
Hongru Ou
author_facet Guanye Zhang
Huanhua Wu
Qian Cao
Jiabin Mo
Xiaozheng Cao
Hong Luo
Xiangyu Tan
Hongru Ou
author_sort Guanye Zhang
collection DOAJ
description Abstract Background Type 2 diabetes mellitus (T2DM) has been associated with brain microstructural alterations, potentially contributing to cognitive decline and neurodegeneration. Diffusion tensor imaging (DTI) provides a non-invasive method to assess these changes. However, the relationship between glycemic control and brain microstructural integrity remains unclear. This study aims to investigate the association between glycemic control and brain microstructural changes in T2DM using DTI. Methods This retrospective study included 90 participants (30 healthy controls, 60 T2DM patients) who underwent 1.5T MRI DTI at The Affiliated Shunde Hospital of Jinan University between January 2023 and May 2024. T2DM patients were categorized into well-controlled (HbA1c < 7%, n = 30) and poorly controlled (HbA1c ≥ 7%, n = 30) groups. Fractional anisotropy (FA) and apparent diffusion coefficient (ADC) values were analyzed across multiple white matter regions. Pearson’s correlation was used to assess associations between HbA1c and DTI metrics, while group differences were evaluated using Bayesian effect size estimation. Results HbA1c negatively correlated with ADC values in the right hippocampus (r = -0.33, p = 0.0013), suggesting a relationship between poor glycemic control and increased tissue diffusivity. A weak but significant positive correlation between HbA1c and FA in the right hippocampus (r = 0.23, p = 0.03) was observed. ADC values were higher in the poorly controlled T2DM group, indicating potential diabetes-related microstructural changes. No significant FA or ADC differences were found in other brain regions (p > 0.05). Conclusions Poor glycemic control in T2DM is associated with microstructural alterations in the right hippocampus, potentially reflecting early neurodegenerative processes. Longitudinal studies are needed to further investigate these findings.
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spelling doaj-art-018f6030f3d74e7fbbd46f8a57add4642025-08-20T03:08:40ZengBMCBMC Medical Imaging1471-23422025-05-0125111010.1186/s12880-025-01696-zImpact of glycemic control on brain microstructure in type 2 diabetes mellitus: insights from diffusion tensor imagingGuanye Zhang0Huanhua Wu1Qian Cao2Jiabin Mo3Xiaozheng Cao4Hong Luo5Xiangyu Tan6Hongru Ou7Department of Radiology, The Affiliated Shunde Hospital of Jinan UniversityCentral Laboratory, The Affiliated Shunde Hospital of Jinan UniversityDepartment of Radiology, The Affiliated Shunde Hospital of Jinan UniversityDepartment of Radiology, The Affiliated Shunde Hospital of Jinan UniversityCentral Laboratory, The Affiliated Shunde Hospital of Jinan UniversityDepartment of Radiology, The Affiliated Shunde Hospital of Jinan UniversityCenter for Intelligent Medicine Research, Greater Bay Area Institute of Precision Medicine (Guangzhou), Fudan UniversityDepartment of Radiology, The Affiliated Shunde Hospital of Jinan UniversityAbstract Background Type 2 diabetes mellitus (T2DM) has been associated with brain microstructural alterations, potentially contributing to cognitive decline and neurodegeneration. Diffusion tensor imaging (DTI) provides a non-invasive method to assess these changes. However, the relationship between glycemic control and brain microstructural integrity remains unclear. This study aims to investigate the association between glycemic control and brain microstructural changes in T2DM using DTI. Methods This retrospective study included 90 participants (30 healthy controls, 60 T2DM patients) who underwent 1.5T MRI DTI at The Affiliated Shunde Hospital of Jinan University between January 2023 and May 2024. T2DM patients were categorized into well-controlled (HbA1c < 7%, n = 30) and poorly controlled (HbA1c ≥ 7%, n = 30) groups. Fractional anisotropy (FA) and apparent diffusion coefficient (ADC) values were analyzed across multiple white matter regions. Pearson’s correlation was used to assess associations between HbA1c and DTI metrics, while group differences were evaluated using Bayesian effect size estimation. Results HbA1c negatively correlated with ADC values in the right hippocampus (r = -0.33, p = 0.0013), suggesting a relationship between poor glycemic control and increased tissue diffusivity. A weak but significant positive correlation between HbA1c and FA in the right hippocampus (r = 0.23, p = 0.03) was observed. ADC values were higher in the poorly controlled T2DM group, indicating potential diabetes-related microstructural changes. No significant FA or ADC differences were found in other brain regions (p > 0.05). Conclusions Poor glycemic control in T2DM is associated with microstructural alterations in the right hippocampus, potentially reflecting early neurodegenerative processes. Longitudinal studies are needed to further investigate these findings.https://doi.org/10.1186/s12880-025-01696-zType 2 diabetes mellitusDiffusion tensor imagingFractional anisotropyApparent diffusion coefficientGlycemic control
spellingShingle Guanye Zhang
Huanhua Wu
Qian Cao
Jiabin Mo
Xiaozheng Cao
Hong Luo
Xiangyu Tan
Hongru Ou
Impact of glycemic control on brain microstructure in type 2 diabetes mellitus: insights from diffusion tensor imaging
BMC Medical Imaging
Type 2 diabetes mellitus
Diffusion tensor imaging
Fractional anisotropy
Apparent diffusion coefficient
Glycemic control
title Impact of glycemic control on brain microstructure in type 2 diabetes mellitus: insights from diffusion tensor imaging
title_full Impact of glycemic control on brain microstructure in type 2 diabetes mellitus: insights from diffusion tensor imaging
title_fullStr Impact of glycemic control on brain microstructure in type 2 diabetes mellitus: insights from diffusion tensor imaging
title_full_unstemmed Impact of glycemic control on brain microstructure in type 2 diabetes mellitus: insights from diffusion tensor imaging
title_short Impact of glycemic control on brain microstructure in type 2 diabetes mellitus: insights from diffusion tensor imaging
title_sort impact of glycemic control on brain microstructure in type 2 diabetes mellitus insights from diffusion tensor imaging
topic Type 2 diabetes mellitus
Diffusion tensor imaging
Fractional anisotropy
Apparent diffusion coefficient
Glycemic control
url https://doi.org/10.1186/s12880-025-01696-z
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