Impaired glymphatic function in relation to cumulative blood glucose exposure: A population-based cohort study

Objective: The relationship between prolonged blood glucose exposure and glymphatic system function of the brain remains unknown. This study aimed to investigate the association between cumulative blood glucose levels and neuroimaging metrics associated with glymphatic function. Methods: This study...

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Main Authors: Yufan Zhang, Jing Sun, Sihui Guo, Ying Hui, Xiaoshuai Li, Jing Li, Xinyu Zhao, Pengfei Zhao, Shuohua Chen, Shouling Wu, Zhenchang Wang, Han Lv
Format: Article
Language:English
Published: Elsevier 2025-12-01
Series:IBRO Neuroscience Reports
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Online Access:http://www.sciencedirect.com/science/article/pii/S2667242125001253
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author Yufan Zhang
Jing Sun
Sihui Guo
Ying Hui
Xiaoshuai Li
Jing Li
Xinyu Zhao
Pengfei Zhao
Shuohua Chen
Shouling Wu
Zhenchang Wang
Han Lv
author_facet Yufan Zhang
Jing Sun
Sihui Guo
Ying Hui
Xiaoshuai Li
Jing Li
Xinyu Zhao
Pengfei Zhao
Shuohua Chen
Shouling Wu
Zhenchang Wang
Han Lv
author_sort Yufan Zhang
collection DOAJ
description Objective: The relationship between prolonged blood glucose exposure and glymphatic system function of the brain remains unknown. This study aimed to investigate the association between cumulative blood glucose levels and neuroimaging metrics associated with glymphatic function. Methods: This study was conducted in a multicenter, community-based cohort study. Magnetic resonance imaging (MRI) data were collected once between 2020 and 2022. The assessment of brain glymphatic function can be conducted using the diffusion tensor imaging analysis along the perivascular space (DTI-ALPS) index. Cumulative fasting blood glucose (FBG) values from 2014 to 2018 were calculated for each participant as a prolonged exposure, while a single measurement of FBG at the same time of MRI acquisition represented a short-term exposure. A generalized linear model was used to evaluate the association of blood glucose exposure and DTI-ALPS index. Results: A total of 251 subjects were included. Prolonged hyperglycemic exposure with FBG ≥ 7.0 mmol/L was significantly associated with lower average DTI-ALPS index (β = -0.058, 95 % confidence interval, -0.096 to -0.019). These findings remained significant among participants over 60 years old and those not taking hypoglycemic medication. No significant associations were observed in single measurement. Conclusion: Prolonged exposure to hyperglycemia is significantly associated with a lower average DTI-ALPS index, potentially playing a crucial role in the impairment of glymphatic function, especially among older adults. A well controlled blood glucose level may demonstrate a protective effect on glymphatic function, indicating better brain health.
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spelling doaj-art-0a3bf04c1938465f97fdec04e09010952025-08-20T05:08:06ZengElsevierIBRO Neuroscience Reports2667-24212025-12-011943744410.1016/j.ibneur.2025.08.009Impaired glymphatic function in relation to cumulative blood glucose exposure: A population-based cohort studyYufan Zhang0Jing Sun1Sihui Guo2Ying Hui3Xiaoshuai Li4Jing Li5Xinyu Zhao6Pengfei Zhao7Shuohua Chen8Shouling Wu9Zhenchang Wang10Han Lv11Department of Radiology, Beijing Friendship Hospital, Capital Medical University, No. 95 Yongan Road, Xicheng District, Beijing 100050, ChinaDepartment of Radiology, Beijing Friendship Hospital, Capital Medical University, No. 95 Yongan Road, Xicheng District, Beijing 100050, ChinaDepartment of Radiology, Beijing Friendship Hospital, Capital Medical University, No. 95 Yongan Road, Xicheng District, Beijing 100050, ChinaDepartment of Radiology, Kailuan General Hospital, Tangshan, Hebei 063000, China; Corresponding authors.Department of Radiology, Beijing Friendship Hospital, Capital Medical University, No. 95 Yongan Road, Xicheng District, Beijing 100050, ChinaDepartment of Radiology, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, ChinaClinical Epidemiology and Evidence-based Medicine Unit, Capital Medical University, No. 95 Yongan Road, Xicheng District, Beijing 100050, ChinaDepartment of Radiology, Beijing Friendship Hospital, Capital Medical University, No. 95 Yongan Road, Xicheng District, Beijing 100050, ChinaDepartment of Cardiology, Kailuan General Hospital, Tangshan, Hebei 063000, ChinaDepartment of Cardiology, Kailuan General Hospital, Tangshan, Hebei 063000, ChinaDepartment of Radiology, Beijing Friendship Hospital, Capital Medical University, No. 95 Yongan Road, Xicheng District, Beijing 100050, China; Corresponding authors.Department of Radiology, Beijing Friendship Hospital, Capital Medical University, No. 95 Yongan Road, Xicheng District, Beijing 100050, China; Corresponding authors.Objective: The relationship between prolonged blood glucose exposure and glymphatic system function of the brain remains unknown. This study aimed to investigate the association between cumulative blood glucose levels and neuroimaging metrics associated with glymphatic function. Methods: This study was conducted in a multicenter, community-based cohort study. Magnetic resonance imaging (MRI) data were collected once between 2020 and 2022. The assessment of brain glymphatic function can be conducted using the diffusion tensor imaging analysis along the perivascular space (DTI-ALPS) index. Cumulative fasting blood glucose (FBG) values from 2014 to 2018 were calculated for each participant as a prolonged exposure, while a single measurement of FBG at the same time of MRI acquisition represented a short-term exposure. A generalized linear model was used to evaluate the association of blood glucose exposure and DTI-ALPS index. Results: A total of 251 subjects were included. Prolonged hyperglycemic exposure with FBG ≥ 7.0 mmol/L was significantly associated with lower average DTI-ALPS index (β = -0.058, 95 % confidence interval, -0.096 to -0.019). These findings remained significant among participants over 60 years old and those not taking hypoglycemic medication. No significant associations were observed in single measurement. Conclusion: Prolonged exposure to hyperglycemia is significantly associated with a lower average DTI-ALPS index, potentially playing a crucial role in the impairment of glymphatic function, especially among older adults. A well controlled blood glucose level may demonstrate a protective effect on glymphatic function, indicating better brain health.http://www.sciencedirect.com/science/article/pii/S2667242125001253Cohort studyBlood glucoseHyperglycemiaGlymphatic functionNeuroimagingDTI-ALPS
spellingShingle Yufan Zhang
Jing Sun
Sihui Guo
Ying Hui
Xiaoshuai Li
Jing Li
Xinyu Zhao
Pengfei Zhao
Shuohua Chen
Shouling Wu
Zhenchang Wang
Han Lv
Impaired glymphatic function in relation to cumulative blood glucose exposure: A population-based cohort study
IBRO Neuroscience Reports
Cohort study
Blood glucose
Hyperglycemia
Glymphatic function
Neuroimaging
DTI-ALPS
title Impaired glymphatic function in relation to cumulative blood glucose exposure: A population-based cohort study
title_full Impaired glymphatic function in relation to cumulative blood glucose exposure: A population-based cohort study
title_fullStr Impaired glymphatic function in relation to cumulative blood glucose exposure: A population-based cohort study
title_full_unstemmed Impaired glymphatic function in relation to cumulative blood glucose exposure: A population-based cohort study
title_short Impaired glymphatic function in relation to cumulative blood glucose exposure: A population-based cohort study
title_sort impaired glymphatic function in relation to cumulative blood glucose exposure a population based cohort study
topic Cohort study
Blood glucose
Hyperglycemia
Glymphatic function
Neuroimaging
DTI-ALPS
url http://www.sciencedirect.com/science/article/pii/S2667242125001253
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