ORIGINAL RESEARCH article
Front. Endocrinol.
Sec. Clinical Diabetes
The impact of glucose and metabolic disturbances on white matter hyperintensities volume in apparently healthy adults
Aleksandra Szum-Jakubowska 1
Marlena Dubatówka 1
Małgorzata Chlabicz 1
Jacek Jamiołkowski 1
Marcin Hładuński 1
Alexander Teumer 2
Katharina Wittfeld 2
Mikołaj A. Pawlak 3
Irina Kowalska 1
Karol A. Kamiński 1
1. Medical University of Bialystok, Bialystok, Poland
2. Universitatsmedizin Greifswald, Greifswald, Germany
3. Uniwersytet Medyczny im Karola Marcinkowskiego w Poznaniu, Poznań, Poland
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Abstract
Abstract Background: White matter hyperintensities (WMH), commonly seen in brain MRI, are linked to cognitive decline and may be influenced by cardiovascular risk factors. This study explores the relationship between diabetes, prediabetes, metabolic syndrome, and the presence of white matter hyperintensities in apparently healthy population. Methods: The study group includes 735 adult participants without neurological or severe cardiovascular diseases. During the visit, participants took part in detailed clinical examination (medical history, biochemical analysis, carotid arteries ultrasound and brain magnetic resonance imaging). White matter hyperintensities were quantified by SAMSEG tool implemented in Freesurfer software. Results: Participant's median age was 45 (range 36-58) years, 341 (46.39%) were men, 58 (7.9%) had diagnosed diabetes and 345 (46.94%) prediabetes, among 91 (12.38%) individuals fulfilling two definitions of prediabetes – simultaneously impaired glucose tolerance (IGT) and impaired fasting glucose (IFG). Univariate analysis presented positive association between plasma glucose concentrations, glycated hemoglobin, diabetes mellitus, prediabetes, and metabolic syndrome and white matter hyperintensities (P<0.05). Multivariate analysis (R2adj. = 0.33) presented association between glucose metabolism disorders (diabetes mellitus or fulfilling two definitions of prediabetes, β=2.77, P=0.006) and white matter hyperintensities. Conclusion: Patients with glucose metabolism disorders, not only diabetes but also these fulfilling definitions of prediabetes IGT and IFG simultaneously, have significantly larger volumes of white matter hyperintensities. Patients with diabetes or prediabetes may benefit from comprehensive management of cardiovascular risk factors, not only to limit the risk of cardiovascular disease but also potentially to reduce the risk of cognitive impairment.
Summary
Keywords
Brain aging, Diabetes Mellitus, metabolic syndrome, neurodegeneration, prediabetes, white matter hyperintensities
Received
16 January 2026
Accepted
18 February 2026
Copyright
© 2026 Szum-Jakubowska, Dubatówka, Chlabicz, Jamiołkowski, Hładuński, Teumer, Wittfeld, Pawlak, Kowalska and Kamiński. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
*Correspondence: Karol A. Kamiński
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