Long Term Effect of Intensive Lifestyle Intervention on Cerebral Blood Flow |
| |
| Authors: | Mark A Espeland PhD Jose A Luchsinger MD MPH Rebecca H Neiberg MS Owen Carmichael PhD Paul J Laurienti PhD Xavier Pi‐Sunyer MD Rena R Wing PhD Delilah Cook CCRP Edward Horton MD Ramon Casanova PhD Kirk Erickson PhD R Nick Bryan MD the Action for Health in Diabetes Brain Magnetic Resonance Imaging Research Group |
| |
| Institution: | 1. Department of Biostatistical Sciences, School of Medicine, Wake Forest University, Winston‐Salem, North Carolina;2. Department of Medicine, Columbia University Medical Center, New York, New York;3. Brain and Metabolism Imaging in Chronic Disease Laboratory and Institute for Dementia Research and Prevention, Pennington Biomedical Research Center, Baton Rouge, Louisiana;4. Department of Radiology, School of Medicine, Wake Forest University, Winston‐Salem, North Carolina;5. Department of Psychiatry and Human Behavior, The Miriam Hospital and Alpert School of Medicine at Brown University, Providence, Rhode Island;6. Joslin Diabetes Center, Boston, Massachusetts;7. Department of Psychology, University of Pittsburgh, Pittsburgh, Pennsylvania;8. University of Pennsylvania, Philadelphia, Pennsylvania |
| |
| Abstract: | Objectives To determine whether long‐term behavioral intervention targeting weight loss through increased physical activity and reduced caloric intake would alter cerebral blood flow (CBF ) in individuals with type 2 diabetes mellitus. Design Postrandomization assessment of CBF. Setting Action for Health in Diabetes multicenter randomized controlled clinical trial. Participants Individuals with type 2 diabetes mellitus who were overweight or obese and aged 45 to 76 (N = 310). Interventions A multidomain intensive lifestyle intervention (ILI ) to induce weight loss and increase physical activity for 8 to 11 years or diabetes support and education (DSE ), a control condition. Measurements Participants underwent cognitive assessment and standardized brain magnetic resonance imaging (MRI ) (3.0 Tesla) to assess CBF an average of 10.4 years after randomization. Results Weight changes from baseline to time of MRI averaged ?6.2% for ILI and ?2.8% for DSE (P < .001), and increases in self‐reported moderate or intense physical activity averaged 444.3 kcal/wk for ILI and 114.8 kcal/wk for DSE (P = .03). Overall mean CBF was 6% greater for ILI than DSE (P = .04), with the largest mean differences between ILI and DSE in the limbic region (3.39 mL /100 g per minute, 95% confidence interval (CI ) = 0.07–6.70 mL /100 g per minute) and occipital lobes (3.52 mL /100 g per minute, 95% CI = 0.20–6.84 mL /100 g per minute). In ILI , greater CBF was associated with greater decreases in weight and greater increases in physical activity. The relationship between CBF and scores on a composite measure of cognitive function varied between intervention groups (P = .02). Conclusions Long‐term weight loss intervention in overweight and obese adults with type 2 diabetes mellitus is associated with greater CBF . |
| |
| Keywords: | type 2 diabetes mellitus intensive lifestyle intervention obesity cerebral blood flow |
|
|
