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Karger AB, Nasrallah IM, Braffett BH, Luchsinger JA, Ryan CM, Bebu I, Arends V, Habes M, Gubitosi-Klug RA, Chaytor N, Biessels GJ, Jacobson AM. Plasma Biomarkers of Brain Injury and Their Association With Brain MRI and Cognition in Type 1 Diabetes. Diabetes Care 2024; 47:1530-1538. [PMID: 38861647 PMCID: PMC11362129 DOI: 10.2337/dc24-0229] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/02/2024] [Accepted: 04/30/2024] [Indexed: 06/13/2024]
Abstract
OBJECTIVE To evaluate associations between plasma biomarkers of brain injury and MRI and cognitive measures in participants with type 1 diabetes (T1D) from the Diabetes Control and Complications Trial/Epidemiology of Diabetes Interventions and Complications (DCCT/EDIC) study. RESEARCH DESIGN AND METHODS Plasma amyloid-β-40, amyloid-β-42, neurofilament light chain (NfL), phosphorylated Tau-181 (pTau-181), and glial fibrillary acidic protein (GFAP) were measured in 373 adults who participated in the DCCT/EDIC study. MRI assessments included total brain and white matter hyperintensity volumes, white matter mean fractional anisotropy, and indices of Alzheimer disease (AD)-like atrophy and predicted brain age. Cognitive measures included memory and psychomotor and mental efficiency tests and assessments of cognitive impairment. RESULTS Participants were 60 (range 44-74) years old with 38 (30-51) years' T1D duration. Higher NfL was associated with an increase in predicted brain age (0.51 years per 20% increase in NfL; P < 0.001) and a 19.5% increase in the odds of impaired cognition (P < 0.01). Higher NfL and pTau-181 were associated with lower psychomotor and mental efficiency (P < 0.001) but not poorer memory. Amyloid-β measures were not associated with study measures. A 1% increase in mean HbA1c was associated with a 14.6% higher NfL and 12.8% higher pTau-181 (P < 0.0001). CONCLUSIONS In this aging T1D cohort, biomarkers of brain injury did not demonstrate an AD-like profile. NfL emerged as a biomarker of interest in T1D because of its association with higher HbA1c, accelerated brain aging on MRI, and cognitive dysfunction. Our study suggests that early neurodegeneration in adults with T1D is likely due to non-AD/nonamyloid mechanisms.
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Affiliation(s)
- Amy B. Karger
- Department of Laboratory Medicine and Pathology, University of Minnesota, Minneapolis, MN
| | - Ilya M. Nasrallah
- Department of Radiology, University of Pennsylvania, Philadelphia, PA
| | | | | | | | - Ionut Bebu
- The Biostatistics Center, George Washington University, Rockville, MD
| | - Valerie Arends
- Department of Laboratory Medicine and Pathology, University of Minnesota, Minneapolis, MN
| | - Mohamad Habes
- Neuroimage Analytics Laboratory and Biggs Institute Neuroimaging Core, Glenn Biggs Institute for Alzheimer's and Neurodegenerative Diseases, University of Texas Health Science Center San Antonio, San Antonino, TX
| | - Rose A. Gubitosi-Klug
- Case Western Reserve University, Rainbow Babies and Children’s Hospital, Cleveland, OH
| | - Naomi Chaytor
- Department of Community and Behavioral Health, Elson S. Floyd College of Medicine, Washington State University, Spokane, WA
| | - Geert J. Biessels
- Department of Neurology, University Medical Center Utrecht Brain Center, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Alan M. Jacobson
- New York University Grossman Long Island School of Medicine, New York University Langone Hospital-Long Island, Mineola, NY
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Adolfsson P, Hanas R, Zaharieva DP, Dovc K, Jendle J. Automated Insulin Delivery Systems in Pediatric Type 1 Diabetes: A Narrative Review. J Diabetes Sci Technol 2024:19322968241248404. [PMID: 38785359 DOI: 10.1177/19322968241248404] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/25/2024]
Abstract
This narrative review assesses the use of automated insulin delivery (AID) systems in managing persons with type 1 diabetes (PWD) in the pediatric population. It outlines current research, the differences between various AID systems currently on the market and the challenges faced, and discusses potential opportunities for further advancements within this field. Furthermore, the narrative review includes various expert opinions on how different AID systems can be used in the event of challenges with rapidly changing insulin requirements. These include examples, such as during illness with increased or decreased insulin requirements and during physical activity of different intensities or durations. Case descriptions give examples of scenarios with added user-initiated actions depending on the type of AID system used. The authors also discuss how another AID system could have been used in these situations.
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Affiliation(s)
- Peter Adolfsson
- Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Department of Pediatrics, The Hospital of Halland Kungsbacka, Kungsbacka, Sweden
| | - Ragnar Hanas
- Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Department of Pediatrics, NU Hospital Group, Uddevalla, Sweden
| | - Dessi P Zaharieva
- Division of Endocrinology, Department of Pediatrics, School of Medicine, Stanford University, Stanford, CA, USA
| | - Klemen Dovc
- Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
- Department of Pediatric Endocrinology, Diabetes and Metabolic Diseases, University Children's Hospital, Ljubljana, Slovenia
| | - Johan Jendle
- School of Medicine, Institute of Medical Sciences, Örebro University, Örebro, Sweden
- Diabetes Endocrinology and Metabolism Research Centre, Örebro University, Örebro, Sweden
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Wu Y, Chen Y, Yang Y, Lin C, Su S, Zhao J, Wu S, Wu G, Liu H, Liu X, Yang Z, Zhang J, Huang B. Predicting brain age using partition modeling strategy and atlas-based attentional enhancement in the Chinese population. Cereb Cortex 2024; 34:bhae030. [PMID: 38342684 DOI: 10.1093/cercor/bhae030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2023] [Revised: 01/13/2024] [Accepted: 01/15/2024] [Indexed: 02/13/2024] Open
Abstract
As a biomarker of human brain health during development, brain age is estimated based on subtle differences in brain structure from those under typical developmental. Magnetic resonance imaging (MRI) is a routine diagnostic method in neuroimaging. Brain age prediction based on MRI has been widely studied. However, few studies based on Chinese population have been reported. This study aimed to construct a brain age predictive model for the Chinese population across its lifespan. We developed a partition prediction method based on transfer learning and atlas attention enhancement. The participants were separated into four age groups, and a deep learning model was trained for each group to identify the brain regions most critical for brain age prediction. The Atlas attention-enhancement method was also used to help the models focus only on critical brain regions. The proposed method was validated using 354 participants from domestic datasets. For prediction performance in the testing sets, the mean absolute error was 2.218 ± 1.801 years, and the Pearson correlation coefficient (r) was 0.969, exceeding previous results for wide-range brain age prediction. In conclusion, the proposed method could provide brain age estimation to assist in assessing the status of brain health.
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Affiliation(s)
- Yingtong Wu
- Medical AI Lab, School of Biomedical Engineering, Medical School, Shenzhen University, 1066 Xueyuan Avenue, Shenzhen 518060, Guangdong Province, China
- Guangdong Key Laboratory of Biomedical Measurements and Ultrasound Imaging, School of Biomedical Engineering, Shenzhen University Medical School, Shenzhen University, 1066 Xueyuan Avenue, Shenzhen 518060, Guangdong Province, China
- Paul C Lauterbur Research Center for Biomedical Imaging, Shenzhen Key Laboratory for MRI, Institute of Biomedical and Health Engineering, Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, 1068 Xueyuan Avenue, Shenzhen 518055, Guangdong Province, China
| | - Yingqian Chen
- Department of Radiology, the First Affiliated Hospital, Sun Yat-sen University, 58 Zhongshan Second Road, Guangzhou 510080, Guangdong Province, China
| | - Yang Yang
- Department of Radiology, Suining Central Hospital, 127 Desheng West Road, Suining 629099, Sichuan Province, China
- Medical Imaging Center of Guizhou Province, Department of Radiology, The Affiliated Hospital of Zunyi Medical University, 149 Dalian Road, Zunyi 563000, Guizhou Province, China
| | - Chuxuan Lin
- Medical AI Lab, School of Biomedical Engineering, Medical School, Shenzhen University, 1066 Xueyuan Avenue, Shenzhen 518060, Guangdong Province, China
- Guangdong Key Laboratory of Biomedical Measurements and Ultrasound Imaging, School of Biomedical Engineering, Shenzhen University Medical School, Shenzhen University, 1066 Xueyuan Avenue, Shenzhen 518060, Guangdong Province, China
| | - Shu Su
- Department of Radiology, the First Affiliated Hospital, Sun Yat-sen University, 58 Zhongshan Second Road, Guangzhou 510080, Guangdong Province, China
| | - Jing Zhao
- Department of Radiology, the First Affiliated Hospital, Sun Yat-sen University, 58 Zhongshan Second Road, Guangzhou 510080, Guangdong Province, China
| | - Songxiong Wu
- Radiology Department, Shenzhen University General Hospital and Shenzhen University Clinical Medical Academy, Shenzhen University, 1066 Xueyuan Avenue, Shenzhen 518060, Guangdong Province, China
| | - Guangyao Wu
- Radiology Department, Shenzhen University General Hospital and Shenzhen University Clinical Medical Academy, Shenzhen University, 1066 Xueyuan Avenue, Shenzhen 518060, Guangdong Province, China
| | - Heng Liu
- Medical Imaging Center of Guizhou Province, Department of Radiology, The Affiliated Hospital of Zunyi Medical University, 149 Dalian Road, Zunyi 563000, Guizhou Province, China
| | - Xia Liu
- Department of Radiology, Shenzhen Mental Health Center, Shenzhen Kangning Hospital, 1080 Cuizhu Road, Shenzhen 518118, Guangdong Province, China
| | - Zhiyun Yang
- Department of Radiology, the First Affiliated Hospital, Sun Yat-sen University, 58 Zhongshan Second Road, Guangzhou 510080, Guangdong Province, China
| | - Jian Zhang
- Shenzhen-Hong Kong Institute of Brain Science-Shenzhen Fundamental Research Institutions, 1068 Xueyuan Avenue, Shenzhen 518055, Guangdong Province, China
- School of Pharmaceutical Sciences, Medical School, Shenzhen University, 1066 Xueyuan Avenue, Shenzhen 518060, Guangdong Province, China
| | - Bingsheng Huang
- Medical AI Lab, School of Biomedical Engineering, Medical School, Shenzhen University, 1066 Xueyuan Avenue, Shenzhen 518060, Guangdong Province, China
- Guangdong Key Laboratory of Biomedical Measurements and Ultrasound Imaging, School of Biomedical Engineering, Shenzhen University Medical School, Shenzhen University, 1066 Xueyuan Avenue, Shenzhen 518060, Guangdong Province, China
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Bousquet A, Sanderson K, O’Shea TM, Fry RC. Accelerated Aging and the Life Course of Individuals Born Preterm. CHILDREN (BASEL, SWITZERLAND) 2023; 10:1683. [PMID: 37892346 PMCID: PMC10605448 DOI: 10.3390/children10101683] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/02/2023] [Revised: 09/29/2023] [Accepted: 10/11/2023] [Indexed: 10/29/2023]
Abstract
Individuals born preterm have shorter lifespans and elevated rates of chronic illness that contribute to mortality risk when compared to individuals born at term. Emerging evidence suggests that individuals born preterm or of low birthweight also exhibit physiologic and cellular biomarkers of accelerated aging. It is unclear whether, and to what extent, accelerated aging contributes to a higher risk of chronic illness and mortality among individuals born preterm. Here, we review accelerated aging phenotypes in adults born preterm and biological pathways that appear to contribute to accelerated aging. We highlight biomarkers of accelerated aging and various resiliency factors, including both pharmacologic and non-pharmacologic factors, that might buffer the propensity for accelerated aging among individuals born preterm.
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Affiliation(s)
- Audrey Bousquet
- Department of Environmental Sciences and Engineering, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC 27599, USA; (A.B.); (R.C.F.)
| | - Keia Sanderson
- Department of Internal Medicine, School of Medicine, University of North Carolina, Chapel Hill, NC 27599, USA;
| | - T. Michael O’Shea
- Department of Pediatrics, School of Medicine, University of North Carolina, Chapel Hill, NC 27599, USA
| | - Rebecca C. Fry
- Department of Environmental Sciences and Engineering, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC 27599, USA; (A.B.); (R.C.F.)
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