Resting Amygdalar Activity Independently Predicts Diabetes Risk Across Levels Of Adiposity: A Mechanism Linking Chronic Stress And Metabolic Disease

Introduction: While stress associates with poor glycemic control, its relationship to incident diabetes (DM) risk is unclear. We imaged activity of the amygdala (AA: a validated measure of neural tissue response to stress) to test if it associates with incident DM independently of adiposity. Methods: 293 non-diabetics were studied: 61 in a cross-sectional study (mean age ± SD 63±9 yrs) and 232 (55±10 yrs) in a longitudinal events study. Individuals underwent FDG PET/CT with assessment of AA. In the biomarker study, metabolic markers were measured. In the longitudinal study, visceral adipose tissue (VAT) volumes were assessed (by CT), after which individuals were followed for 2 years for incident DM. Image analyses and DM adjudication were performed by mutually blinded investigators. Cox and log-rank tests were used. Results: Higher AA (upper vs. lower two tertiles) associated with higher HOMA-IR (1.2 vs. 0.7, p=0.045) and lower adiponectin (2.4 vs. 4.6 μg/ml, p=0.025). In the longitudinal study, 21 indivi...