Relationships between diabetes-related vascular risk factors and neurodegeneration biomarkers in healthy aging and Alzheimer’s disease.

Vascular risk factors such as hyperglycemia and platelet hyperactivation play a significant role in type 2 diabetes (T2D), a risk factor for AD. We investigated the relationships between glycemia levels, platelet indices (platelet count; mean platelet volume (MPV)) and AD neuroimaging markers in 105 cognitively unimpaired adults, including 21 amyloid-negative older adults (Aβ-neg controls), and 45 amyloid-positive patients with mild cognitive impairment or dementia (Aβ-pos patients). We assessed between-group differences on the two T2D-related vascular risk factors, then the association between blood parameters and multimodal neuroimaging (structural MRI, ¹⁸F-fluorodeoxyglucose, and ¹⁸F-florbetapir-PET) in cognitively unimpaired adults and Aβ-pos patients using multiple regressions. Compared to Aβ-neg controls, Aβ-pos patients showed lower platelet count and higher MPV. In cognitively unimpaired adults, increased glycemia levels were associated with atrophy and hypometabolism in AD-sensitive regions. In Aβ-pos patients, increased MPV was associated with entorhinal and perirhinal cortex atrophy. Subclinical but high glycemia levels in healthy individuals and MPV in AD patients are associated with neurodegeneration in AD-sensitive brain regions but not with amyloid deposition.